Altitude sickness medical therapy: Difference between revisions

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{{Altitude sickness}}
{{Altitude sickness}}
{{CMG}}
{{CMG}} {{AE}} {{F.K}}


==Overview==
==Overview==
[[Pharmacologic]] medical therapies for altitude sickness include [[acetazolamide]], [[dexamethasone]]. Pharmacologic therapy for [[nausea]] and [[vomiting]] of altitude sickness include [[promethazine]], [[ondansetron]].


==Medical Therapy==
==Medical Therapy==
The classification of patients with acute mountain sickness as mild or moderate is based on the [[headache]]'s severity and the presence of other manifestations such as [[nausea]], [[dizziness]], [[fatigue]] or [[insomnia]].
*[[Pharmacologic]] medical therapies for altitude sickness include [[acetazolamide]], [[dexamethasone]]. [[Pharmacologic]] therapy for headache of altitude sickness is [[NSAIDS]] and [[nausea]] and [[vomiting]] of altitude sickness are treated by [[promethazine]], [[ondansetron]].


The management of mild acute mountain sickness includes:
===Disease Name===
# Discontinuation of ascent.
*[[Pharmacologic]] therapy of high altitude sickness include:<ref name="pmid19099331">{{cite journal |vauthors=Stream JO, Grissom CK |title=Update on high-altitude pulmonary edema: pathogenesis, prevention, and treatment |journal=Wilderness Environ Med |volume=19 |issue=4 |pages=293–303 |date=2008 |pmid=19099331 |doi=10.1580/07-WEME-REV-173.1 |url=}}</ref>
# Treatment with [[acetazolamide]] (250 mg q12h).
**Preferred regimen (1): [[Acetazolamide]] 250 mg PO q12h  
# Descent: The patient should descend below the point at which the symptoms occurred.
**Preferred regimen (2): [[Dexamethasone]]  4 mg PO q6h


Similarly, the following steps are recommended for the management of moderate acute mountain sickness:
*[[Pharmacologic]] therapy for [[headache]] of altitude sickness include:<ref name="pmid9552906">{{cite journal |vauthors=Burtscher M, Likar R, Nachbauer W, Philadelphy M |title=Aspirin for prophylaxis against headache at high altitudes: randomised, double blind, placebo controlled trial |journal=BMJ |volume=316 |issue=7137 |pages=1057–8 |date=April 1998 |pmid=9552906 |pmc=28508 |doi= |url=}}</ref><ref name="pmid8117220">{{cite journal |vauthors=Broome JR, Stoneham MD, Beeley JM, Milledge JS, Hughes AS |title=High altitude headache: treatment with ibuprofen |journal=Aviat Space Environ Med |volume=65 |issue=1 |pages=19–20 |date=January 1994 |pmid=8117220 |doi= |url=}}</ref>
# Immediate descent.
** Preferred regimen (1): [[Acetaminophen]] 325-650 mg PO q4h PRN
# Administration of [[oxygen]] (2-4 L/min).
** Alternative regimen (2): [[Ibuprofen]] 200-400 mg q4-6h
# Treatment with [[dexamethasone]] (8 mg PO/IM/IV, then, 4 mg q6h).
** Alternative regimen (3): [[Aspirin]] 325-650 mg PO q4-6h PRN
# Hyperbaric therapy: The patient is placed in a portable altitude chamber or bag.


Treatment of chronic mountain sickness involves descent from altitude, where the symptoms will diminish and the [[hematocrit]] will slowly return to normal. Acute treatment at altitude involves bleeding, or removing some circulating blood, to reduce the hematocrit; however this is not ideal for extended periods of time.
*[[Pharmacologic]] therapy for [[nausea]] and [[vomiting]] of altitude sickness include:<ref name="pmid19099324">{{cite journal |vauthors=Shapiro R |title=Ondansetron for the treatment of nausea associated with altitude sickness |journal=Wilderness Environ Med |volume=19 |issue=4 |pages=317–8 |date=2008 |pmid=19099324 |doi=10.1580/07-WEME-LE-176.1 |url=}}</ref>
 
** Preferred regimen (1): [[Promethazine]] 12.5-25 mg PO q4-6h PRN
Treatment of high altitude cerebral edema (HACE) involves immediate descent as a necessary life-saving measure (2,000 - 4,000 feet). There are some medications (e.g. [[dexamethasone]]) that may be prescribed for treatment in the field, but these require proper medical training in their use. Anyone suffering from HACE must be evacuated to a medical facility for proper follow-up treatment. A [[Gamow bag]] can sometimes be used to stabilize the sufferer before transport or descending.
** Aletrantive regimen (2): [[Ondansetron]] 4mg PO q8h


==References==
==References==

Latest revision as of 13:30, 21 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]

Overview

Pharmacologic medical therapies for altitude sickness include acetazolamide, dexamethasone. Pharmacologic therapy for nausea and vomiting of altitude sickness include promethazine, ondansetron.

Medical Therapy

Disease Name

References

  1. Stream JO, Grissom CK (2008). "Update on high-altitude pulmonary edema: pathogenesis, prevention, and treatment". Wilderness Environ Med. 19 (4): 293–303. doi:10.1580/07-WEME-REV-173.1. PMID 19099331.
  2. Burtscher M, Likar R, Nachbauer W, Philadelphy M (April 1998). "Aspirin for prophylaxis against headache at high altitudes: randomised, double blind, placebo controlled trial". BMJ. 316 (7137): 1057–8. PMC 28508. PMID 9552906.
  3. Broome JR, Stoneham MD, Beeley JM, Milledge JS, Hughes AS (January 1994). "High altitude headache: treatment with ibuprofen". Aviat Space Environ Med. 65 (1): 19–20. PMID 8117220.
  4. Shapiro R (2008). "Ondansetron for the treatment of nausea associated with altitude sickness". Wilderness Environ Med. 19 (4): 317–8. doi:10.1580/07-WEME-LE-176.1. PMID 19099324.

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