Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.See all posts »
Acetylsalicylic Acid (Aspirin) Analog versus Acetazolamide for Acute Mountain Sickness
The results showed that calcium carbasalate did not prevent acute mountain sickness (AMS) or headache. A very interesting finding was that more than half the individuals taking acetazolamide developed AMS. This may indicate that the dose taken is not sufficient in general, or perhaps only that the ascent rate was too fast for this (or any) dose of acetazolamide to be effective in prevention of AMS. This is even more intriguing, and deserves further investigation, because the trend in recent clinical recommendations has been to use lower doses (e.g., 250 mg per day) of acetazolamide for the purpose of high altitude acclimatization, in order to achieve a beneficial effect while minimizing the side effects. So, it is very important to understand which circumstances of ascent call for a higher dosing regimen.
AMS is a very debilitating disorder, and is likely the harbinger of high altitude cerebral edema (brain swelling). At the very least, it causes headache, poor appetite, fatigue, nausea, and soft tissue swelling, and is markedly disruptive for adventures and recreation at high altitude. This particular study supports our current understanding that non-steroidal antiinflammatory drugs and common analgesics, such as aspirin, ibuprofen, and acetaminophen, are not useful to prevent AMS, and may only serve to mask an important symptom (headache) that indicates when a person is entering a dangerous physiological situation. Of course, if the patient and observers are confident that the headache is mild and that AMS is not progressing, it is reasonable to treat the headache with an analgesic.
photo courtesy of www.7summits.com
Tags: acetazolamide, acute mountain sickness, AMS, wilderness medicine, outdoor medicine, healthline
Recent Blog Posts
Jul 01, 2013
In Advance of a Wildfire
Feb 11, 2013
Topical Ivermectin Lotion for Treating Head Lice
Feb 04, 2013
Public Health Interventions and Snowmobile Fatality Rates