Clinical Case: The Overheated Marathon Runner

About Course

This case features JS, a 45-year-old recreational marathon runner who presents to his community pharmacist with new-onset excessive sweating that began after starting atomoxetine for adult ADHD. His history of depression, hypertension, and use of multiple psychotropic medications (citalopram, bupropion, atomoxetine) introduces overlapping mechanisms affecting thermoregulation. Through a patient-centered consultation, this case examines how polypharmacy, neurotransmitter effects on the hypothalamus, and environmental factors contribute to medication-induced hyperhidrosis and dehydration risk in endurance athletes. Students will apply critical thinking to differential diagnosis, hydration management, and non-pharmacologic versus pharmacologic treatment options.

How to identify and evaluate medication-induced hyperhidrosis in athletes
The role of neurotransmitters (serotonin, norepinephrine, dopamine) in thermoregulation and sweating
How polypharmacy and overlapping mechanisms increase risk for excessive sweating and dehydration
Strategies for distinguishing medication side effects from environmental or endocrine causes
Evidence-based recommendations for managing excessive sweating, including OTC and prescription options
Hydration assessment and prevention of dehydration in endurance athletes
How to tailor lifestyle and medication counseling to optimize performance and safety in hot environments

Course Content

NSAID Selection

Patient Case
Knowledge Check
The Wrap Up

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Clinical Case: The Overheated Marathon Runner

About Course

What Will You Learn?

Course Content

NSAID Selection

Patient Case

Knowledge Check

The Wrap Up

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