Medication
25 rows · Drugs used to treat Mountain Sickness / Altitude Sickness The following list of medications are in some way related to or used in the treatment of this condition. Select drug class All drug classes carbonic anhydrase inhibitors (3) glucocorticoids (5) carbonic anhydrase inhibitor anticonvulsants (3)
Therapy
Abbreviations: AMS, acute mountain sickness; HACE, high-altitude cerebral edema; HAPE, high-altitude pulmonary edema; IM, intramuscular; IV, intravenous; SR, sustained release. 1 Acetazolamide can also be used at this dose as an adjunct to dexamethasone in HACE treatment, but dexamethasone remains the primary treatment for that disorder.
Self-care
Jun 27, 2017 · Our assessment of the most commonly-used pharmacological interventions suggests that acetazolamide is an effective pharmacological agent to prevent acute HAI in dosages of 250 to 750 mg/day. This information is based on evidence of moderate quality.
Nutrition
Apr 15, 1998 · In addition, therapy should be started with oral acetazolamide (Diamox), a carbonic anhydrase inhibitor with weak diuretic properties; the dosage is 125 to 250 mg twice daily ( …
What medications are used to treat high altitude sickness?
The physician should educate patients about the signs and symptoms of high-altitude illnesses and inform them of the risks assumed by the high-altitude traveler. Acetazolamide prophylaxis Acetazolamide is the drug of choice for prophylaxis against AMS.
How does acetazolamide treat altitude sickness?
Jul 21, 2011 · Various drugs have been tried for high altitude illnesses with variable effect (Table 2). A small, placebo-controlled study showed that the administration of acetazolamide reduced the severity of symptoms . Dexamethasone is as effective as acetazolamide and starts acting within 12 hours while acetazolamide takes around 24 hours . Other drugs which have been …
What is the treatment for high altitude pulmonary edema?
Apr 07, 2020 · The CDC recommends the following pharmacologic agents and regimens for HAPE prophylaxis [ 4] : Oral nifedipine (generally reserved for HAPE-susceptible individuals) - 30 mg sustained-release...
What are the 3 types of altitude sickness?
Apr 07, 2020 · The treatment of high-altitude pulmonary edema (HAPE) includes rest, administration of oxygen (first line), and descent to a lower altitude (first line if oxygen is unavailable). [ 2 , 3 , 4 , 7 , 18 ] If diagnosed early, recovery is rapid with a …
Which medicine is used for high altitude?
Acetazolamide, or Diamox, is the standard medical prophylaxis agent for high altitude illness. The medication is effective in preventing acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE).
What is the most effective treatment for altitude sickness?
Treating altitude sickness stop and rest where you are. do not go any higher for at least 24 to 48 hours. if you have a headache, take ibuprofen or paracetamol. if you feel sick, take an anti-sickness medicine, such as promethazine.
Which of the following drugs is recommended for the treatment of patients with high altitude cerebral Oedema?
Generally, the use of acetazolamide is preferred, but dexamethasone can be used for prevention if there are side effects or contraindications. Some individuals are more susceptible to HACE than others, and physical fitness is not preventive.
What is the best medication to treat high altitude pulmonary edema?
Acetazolamide, which appears to hasten acclimatization, is considered the drug of choice because of a low incidence of significant adverse effects. Because acetazolamide hastens acclimatization, it should be effective at preventing all forms of acute altitude illness.Apr 7, 2020
Why is Diamox used?
Acetazolamide is used to prevent and reduce the symptoms of altitude sickness. This medication can decrease headache, tiredness, nausea, dizziness, and shortness of breath that can occur when you climb quickly to high altitudes (generally above 10,000 feet/3,048 meters).
How Diamox works for altitude sickness?
Acetazolamide prevents AMS when taken before ascent; it can also help speed recovery if taken after symptoms have developed. The drug works by acidifying the blood and reducing the respiratory alkalosis associated with high elevations, thus increasing respiration and arterial oxygenation and speeding acclimatization.
What medication is used to treat HAPE?
The CDC recommends the following pharmacologic agents and regimens for HAPE prophylaxis : Oral nifedipine (generally reserved for HAPE-susceptible individuals) - 30 mg sustained-release formulation every 12 hours (same regimen for HAPE treatment) Oral tadalafil - 10 mg twice daily. Oral sildenafil - 50 mg every 8 hours.Apr 7, 2020
What is the initial treatment for HACE?
Dexamethasone swiftly reverses symptoms (2-4 h) but does not improve acclimatization. It is the drug of choice for treating HACE and should be given early. Both agents may be used to treat AMS if the victim does not descend.Feb 22, 2019
What is the best and only treatment for HACE or HAPE?
Besides descent, other HAPE treatments include: Supplemental oxygen – This is the most effective treatment and should be started as soon as possible. It should be continued until symptoms resolve.Oct 16, 2019
How do Emts treat pulmonary edema?
Nitroglycerin remains the universal therapy and, in some cases, Lasix is appropriate, but consider modifying routine practice. As a prehospital care provider, you must ensure the pulmonary edema patient has adequate oxygenation and can be effectively treated before it is too late.
How does furosemide relieve pulmonary edema?
Furosemide was the most commonly used diuretic. Loop diuretics inhibit reabsorption of NaCl and produce natriuresis and diuresis. The diuretic effect occurs 35–45 minutes after IV administration.Feb 13, 2015
How is high altitude cerebral edema treated?
Brain edema can be treated with the use of Acetazolamide, it provokes metabolic acidosis, thus increasing respiratory minute volume; Dexamethasone, and/or portable hyperbaric chamber, depending on intensity and severity of symptoms.Jan 17, 2019
How does acclimatization help with altitude?
Acclimatization prevents altitude illness, improves sleep and cognition, and increases comfort and well-being, although exercise performance will always be reduced compared to what it would be at lower elevations.
What is the most common form of altitude sickness?
AMS is the most common form of altitude illness, affecting, for example, 25% of all visitors sleeping above 8,000 ft (2,500 m) in Colorado. Symptoms are similar to those of an alcohol hangover: headache is the cardinal symptom, sometimes accompanied by fatigue, loss of appetite, nausea, and occasionally vomiting.
What is the differential diagnosis of AMS?
The differential diagnosis of AMS/HACE is broad and includes dehydration, exhaustion, hypoglycemia, hypothermia, hyponatremia, carbon monoxide poisoning, infections, drug effects, and neurologic problems including migraine. Focal neurologic symptoms and seizures are rare in HACE and should lead to suspicion of an intracranial lesion or seizure disorder. Descending ≥300 m in elevation relieves HACE symptoms rapidly. Alternatively, supplemental oxygen at 2 L per minute relieves headache quickly and helps resolve AMS over hours, but it is rarely available. People with AMS can also safely remain at their current elevation and treat symptoms with nonopiate analgesics and antiemetics, such as ondansetron. They may also take acetazolamide, which speeds acclimatization and effectively treats AMS but is better for prophylaxis than treatment. Dexamethasone is more effective than acetazolamide at rapidly relieving the symptoms of moderate to severe AMS. If symptoms are getting worse while the traveler is resting at the same elevation, or in spite of medication, he or she must descend.
What is a HAPE diagnosis?
Although the progression of decreased exercise tolerance, increased breathlessness, and breathlessness at rest is almost always recognizable as HAPE, the differential diagnosis includes pneumonia, bronchospasm, myocardial infarction, or pulmonary embolism. Descent in this situation is urgent and mandatory, accomplished with as little exertion as is feasible for the patient. If descent is not immediately possible, supplemental oxygen or a portable hyperbaric chamber is critical. Patients with HAPE who have access to oxygen (at a hospital or high-altitude medical clinic, for example) may not need to descend to lower elevation and can be treated with oxygen at the current elevation. In the field setting, where resources are limited and there is a lower margin for error, nifedipine can be used as an adjunct to descent, oxygen, or portable hyperbaric therapy. A phosphodiesterase inhibitor may be used if nifedipine is not available, but concurrent use of multiple pulmonary vasodilators is not recommended.
How has a traveler responded to high elevations previously?
How a traveler has responded to high elevations previously is the most reliable guide for future trips if the elevation and rate of ascent are similar, although this is not an infallible predictor. Given a baseline susceptibility, 3 factors largely influence the risk of a traveler developing altitude illness: elevation at destination, ...
Why do people travel to high elevations during pregnancy?
Travel to high elevations during pregnancy warrants confirmation of good maternal health and verification of a low-risk gestation. A discussion with the traveler of the dangers of having a pregnancy complication in remote, mountainous terrain is also appropriate.
How long does it take to acclimate to high elevation?
The process of acute acclimatization to high elevation takes 3–5 days; therefore, acclimatizing for a few days at 8,000–9,000 ft (2,500–2,750 m) before proceeding to a higher elevation is ideal. Acclimatization prevents altitude illness, improves sleep and cognition, and increases comfort and well-being, although exercise performance will always be ...
What is high altitude sickness?
High altitude illness (HAI) is a term used to describe a group of brain and breathing conditions that can occur while travelling to altitudes above 2500 metres ( ~ 8200 feet ). HAI is generally characterized by headache, nausea, vomiting and tiredness (often called acute mountain sickness), but may affect the brain or the lungs in different ...
How many studies have been done on HAI?
Eleven studies included people at a high risk of this condition due to their history of HAI or other illnesses such as asthma. Twenty-four trials provided the intervention between three and five days prior to the ascent, and 23 trials, between one and two days beforehand.
Does acetazolamide cause paraesthesia?
Acetazolamide is associated with an increased risk of paraesthesia , although there are few reports about other adverse events from the available evidence. The clinical benefits and harms of other pharmacological interventions such as ibuprofen, budenoside and dexamethasone are unclear.
Is acetazolamide a placebo?
Our findings suggest that acetazolamide is an effective treatment for the prevention of acute HAI in dosages of 250 to 750 mg/day, when this drug is compared to a placebo (i.e. a pill with no active agent). Most of the available information relates to the prevention of uncomplicated HAI (headache, nausea, vomiting and tiredness) rather than to more serious brain or lung problems. We also found that acetazolamide is associated with an increased risk of paraesthesia in the fingers (i.e. a sensation of tingling, tickling, pricking, or burning of the skin), although this outcome is not well reported in the available evidence. The benefits and harms of other drugs such as ibuprofen, budenoside and dexamethasone are unclear, due to the small number of studies.
What is high altitude illness?
High-altitude illness is a spectrum of disease related to hypobaric hypoxia and its consequences. It includes AMS, high-altitude cerebral edema (HACE) and high-altitude pulmonary edema (HAPE). The diagnosis is based primarily on the history and physical examination.
What are the symptoms of high altitude sickness?
Cardinal symptoms include dyspnea on exertion and at rest, cough, nausea, difficulty sleeping, headache and mental status changes. Treatment requires descent, and gradual acclimatization provides the most effective prevention.
Why is PaO2 low?
Since the PaO 2 is low because of atmospheric hypoxia and the blood volume is low because of dehydration, circulating levels of catecholamines increase , causing increased heart rate, blood pressure and venous tone. Clinicians can use this tachycardic response to roughly estimate how well a person is acclimatizing.
How high does high altitude retinopathy occur?
It commonly occurs at altitudes over 5,000 m (16,000 ft), is usually asymptomatic and usually resolves after one to two weeks, even if the patient remains at altitude. 1.
How high can you descend to get pulmonary edema?
Or descend 460 m (1,500 ft) or more until symptoms have resolved. High-altitude pulmonary edema (HAPE) Descend at least 610 m (2,000 ft) and keep descending until the symptoms have resolved.
What is the role of chemoreceptors in the carotid body?
During ascent to altitude, chemoreceptors in the carotid body detect the decreasing partial pressure of arterial oxygen (PaO 2) and stimulate the hypoxic ventilatory response.6 This causes hyperventilation, which results in water loss, increased PaO 2 and decreased partial pressure of arterial carbon dioxide (PaCO 2 ).
What is the atmospheric pressure of Mount Everest?
The barometric pressure of Mount Everest (8,850 m [29,028 ft]) is 253 mm Hg at latitude 27 degrees north.
What is the drug used to treat HAPE?
These agents are helpful in the prevention of HAPE. Acetazolamide (Diamox) View full drug information. Acetazolamide is used in the prevention of HAPE. It is not used in the treatment of this condition. Acetazolamide promotes renal excretion of bicarbonate, which stimulates respiration.
How long does acetazolamide take to work?
For the prophylaxis of altitude illness, start 24-48 hours before ascent and continue for 48 hours after arrival at high altitude. These agents have profound and varied metabolic effects.
How high can you climb in a day?
All people ascending to more than 3,500 m in 1 day. All people ascending more than 500 m per day (increase in sleeping elevation) above 3,000 m, without extra days for acclimatization. Very rapid ascents. The CDC recommends the following pharmacologic agents and regimens for HAPE prophylaxis [ 4] :
Is nifedipine effective for pulmonary edema?
Drugs are not as effective as descent from altitude and oxygen in the treatment of high-altitude pulmonary edema (HAPE). Nifedipine, by reducing pulmonary arterial pressure, may be effective in treating HAPE. [ 29] However, in two separate studies, nifedipine did not outperform placebo or oxygen alone. [ 33, 34]
What is a HAPE?
Prophylaxis for high-altitude pulmonary edema (HAPE) is indicated for persons who have been identified (from past experience) as being susceptible to developing high-altitude illness or who must ascend rapidly to a high altitude.
Why is acetazolamide considered the drug of choice?
Acetazolamide, which appears to hasten acclimatization, is considered the drug of choice because of a low incidence of significant adverse effects. [ 28] Because acetazolamide hastens acclimatization, it should be effective at preventing all forms of acute altitude illness.
Does dexamethasone reduce pulmonary artery pressure?
The conclusion was that both dexa methasone and tadalafil decrease systolic pulmonary artery pressure and may reduce the incidence of HAPE in adults with a history of HAPE. [ 27] . Dexamethasone prophylaxis may also reduce the incidence of acute mountain sickness in these adults.
Does acetazolamide prevent reentry?
Clinical observations suggest acetazolamide may prevent reentry HAPE, a disorder seen in individuals who reside at high altitude, travel to lower elevation, and then develop HAPE upon rapid return to their homes.
What is the most common form of altitude sickness?
There are three kinds of altitude sickness: Acute Mountain Sickness (AMS) is the mildest form and it’s very common. The symptoms can feel like a hangover – dizziness, headache, muscle aches, nausea. High Altitude Pulmonary Edema (HAPE) is a buildup of fluid in the lungs that can be very dangerous and even life threatening.
How long does it take for a person to feel better at higher altitudes?
Dizziness. Nausea. Vomiting. Fatigue and loss of energy. Shortness of breath. Problems with sleep. Loss of appetite. Symptoms usually come on within 12 to 24 hours of reaching a higher elevation and then get better within a day or two as your body adjusts to the change in altitude.
What is it called when you walk too fast?
Sometimes called “mountain sickness,” altitude sickness is a group of symptoms that can strike if you walk or climb to a higher elevation, or altitude, too quickly.
What does it mean when you have a headache that doesn't get better?
A severe headache that doesn’t get better with medication. A tightening in your chest. If you develop a severe form of altitude sickness like HAPE or HACE, you might have: Confusion. Shortness of breath even at rest. Inability to walk. A cough that produces a white or pink frothy substance. Coma.
How many feet do you climb in a day?
If you walk, hike, or climb over 10,000 feet, only go up an additional 1,000 feet per day. For every 3,000 feet you climb, rest at least a day at that height. “Climb high and sleep low”: If you have to climb over 1,000 feet in a day, make sure you come back down to a lower altitude to sleep.
How high can you go to get altitude sickness?
But if you travel to a place at a higher altitude than you’re used to, your body will need time to adjust to the change in pressure. Any time you go above 8,000 feet, you can be at risk for altitude sickness.
What is the best medicine for a hace?
You’ll have to see a doctor as soon as possible and you may need to go to the hospital. If you have HACE, you might need a steroid called dexamethasone. If you have HAPE, you will need supplemental oxygen and may need medications, as well as moving to a lower altitude.
How to avoid altitude sickness?
The best way to prevent altitude sickness is to go slow — called acclimatization. This process allows your body time to adjust to the change in oxygen levels. Take your time when traveling up. For instance, spend a day at a point midway up before continuing to ascend.
What are the symptoms of altitude sickness?
Symptoms of moderate altitude sickness are more intense and worsen instead of improve over time: Worsening fatigue, weakness and shortness of breath. Coordination problems and difficulty walking. Severe headache, nausea and vomiting. Chest tightness or congestion.
What is it called when you get nauseous when you hike up a mountain?
What is altitude sickness ? If you’ve ever hiked up a mountain and felt yourself getting nauseous or lightheaded, you may have experienced altitude sickness, also called mountain sickness. This condition happens when you travel to a high altitude (elevation) too quickly. It doesn’t happen only to hikers.
How long does it take for a headache to go away when you move up?
If you get a headache and at least one other symptom with 24 to 48 hours of moving to a higher elevation, it’s most likely altitude sickness. If you’re climbing, a more experienced climber may recognize symptoms of altitude sickness and guide you to get help.
How long does it take to feel better after altitude sickness?
Within three days, you should feel completely better. Severe altitude sickness, HACE and HAPE: If you have severe symptoms, you must be taken immediately to an elevation that’s no higher than 4,000 feet. Get to a healthcare provider as soon as possible. You may need hospitalization.
How high is the altitude in New York?
Climbing to these elevations can bring on symptoms of altitude sickness: High altitude: 8,000 to 12,000 feet above sea level. Very high altitude: 12,000 to 18,000 feet. Extremely high altitude: 18,000+ feet. For context, New York City is at an elevation of 33 feet above sea level.
How high can you climb in a day?
Go slow: Once above 10,000 feet, don’t increase your altitude more than 1,000 feet a day. Rest: Build a rest day into your schedule for every 3,000 feet you climb. “Climb high and sleep low”: If you climb more than 1,000 feet in a day, come down to sleep at a lower altitude.
