Kent R. Olson, MD
Abnormalities of temperature regulation are common with drug overdose and poisoning, and can have catastrophic consequences.
Causes include excessive muscle hyperactivity, metabolic overdrive, inhibition of sweating, and exposure to high ambient temperatures. Drugs and poisons may have combined effects involving more than one of these mechanisms:
Consequences include death and severe brain and other organ system damage. In one retrospective study, one third of patients with severe hyperthermia died and one third suffered neurological injury.
Causes include exposure to cold environment, metabolic hypoactivity, and drugs that reduce metabolic demand or impair thermoregulatory mechanisms.
Hypothermia is not as immediately life-threatening as hyperthermia. Patients in a hypothermic state usually recover fully after rewarming, as long as they do not have a cardiac arrest or prolonged period of hypoxia.
Rewarming should be carried out slowly unless the patient is in cardiac arrest, in which case aggressive rewarming is necessary.