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There are several connections between drugs and cold. Drugs can lower body temperature; ambient temperature together with the adaptive capacity of the organism can influence various physiological and also pharmacological processes; furthermore, hypothermia can have an effect on drug pharmacokinetics and pharmacodynamics which is of considerable clinical importance, since the application of hypothermia as a therapeutic adjuvant is on the rise. The present paper discusses different aspects of these problems, concluding with a proposal that it may now be time to ask for the results of a "cold effect test" before a new drug is accepted for common use, especially in hypothermic patients.

General anesthesia induces hypothermia due to decreased metabolic rate and impaired thermoregulation. Adverse effects of hypothermia are common. Many warming devices are in use to prevent heat loss, but little attention has been paid to stimulating the body's own heat generation. NIT, nutrient-induced thermogenesis, signifies the concept that all nutrients raise energy expenditure. The greatest thermic effect is ascribed to amino acids and proteins, 30-40%. During anesthesia the thermogenic effect of i.v. amino acids was increased. The results support the existence of an inhibitory action normally exerted by central thermosensors in order to prevent hyperthermia. During anesthesia, central thermosensors are impaired, and hence amino acid thermogenesis is exaggerated, which may prevent hypothermia.