You’re all set to relish a long-cherished trip to the mountains. But once your flight lands and you arrive at your mile-high vacation spot keen for some hiking or sightseeing, you all of a sudden feel overcome by fatigue and dizziness. Thinking this would be due to the stress of traveling, you decide to have a quick cat nap before adventuring. But you are unable to sleep due to massive headache that’s arrived ostensibly out of nowhere. What’s going on?The answer might be altitude sickness, opines pulmonologist Humberto Choi, MD.
Now you are reminded of the advice of your friend that you had not given ear to. He had advised to visit a travel clinic and take guidance and prophylaxis (medication to prevent altitude sickness). From now on never forget that anybody can get altitude sickness. Altitude sickness, also known as acute mountain sickness (AMS), occurs when your body is unable to acclimatize to a low-pressure, low-oxygen environment — usually at about 8,000 feet above the sea level. This can lead to breathing issues and a host of other symptoms which can range from extremelytrivial to even life-threatening.
Prophylaxis (preventive medication)for altitude sickness (AMS)
Acetazolamide (Diamox)is most commonly used prophylaxis for AMS. When taken for prevention, acetazolamide accelerates acclimatization to high-elevation hypoxia, thereby reducing incidence and severity of AMS. If taken after symptoms have already shown up then it enhances recovery. The drug induces bicarbonate diuresis and metabolic acidosis, which rouses ventilation and increases arterial and alveolar oxygenation. High-elevation ventilatory acclimatization that typically takes 3–5 days takes only 1 day if acetazolamide is used. Acetazolamide also eradicates central sleep apnea, or periodic breathing, which is very common at high altitudes, even in those who lack any history of sleep disorder breathing.Allergic reactions to Diamox (Acetazolamide) are very uncommon. As acetazolamide is a sulfonamide derivative, there is possibility of cross-sensitivity between acetazolamide, sulfonamides, and other sulfonamide derivatives.
Dexamethasone may be used as a preventive agent by those unable to take acetazolamide. Dexamethasone is quite effective for preventing and treating AMS (acute mountain sickness) and HACE (High-Altitude Cerebral Edema) and might prevent HAPE (High-Altitude Pulmonary Edema)too. Unlike acetazolamide, if this drug is discontinued at elevation before getting acclimatized, mild rebound is possible. Acetazolamide is better to prevent AMS while climbing, and dexamethasone should be reserved for treatment, usually as an aide to descent. Ibuprofen 600 mg taken every 8 hours can prevent AMS. Nifedipineis capable of preventing and ameliorating HAPE.Tadalafil (phosphodiesterase 5 (PDE5) inhibitors), 10 mg taken two times a day during ascent, can avert HAPE. It is also being studied as a likely treatment.