Altitude illness is a spectrum of conditions that are common in travelers at high altitude (above 2,500 meters/8,000 feet). Altitude illnesses include acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Altitude illness can range from mild to life-threatening.
Symptoms of AMS include: mild to moderate headache, nausea, poor appetite, fatigue, sleep disturbances, and mild dizziness. HAPE causes a productive cough and shortness of breath. HACE causes severe headache, severe dizziness, an unsteady gait, nausea and vomiting, confusion, and changes in mental status.
While mild AMS can be managed with medications and slowing your ascent, severe AMS, HAPE, and HACE are medical emergencies. If you notice any shortness of breath, confusion, severe headache, severe nausea and vomiting, or an unsteady gait, you should descend to a lower elevation and seek medical attention immediately.
For prevention of AMS and treatment of mild to moderate AMS, consider acetaZOLAMIDE (generic for Diamox). For severe AMS, consider adding dexamethasone and immediately descend to a lower altitude and seek medical care.
For prevention of
Acute Mountain Sickness (AMS)
If you have
You may have
Acute Mountain Sickness (AMS)
If you have
You may have
High Altitude Pulmonary Edema (HAPE)
If you have
You may have
High Altitude Cerebral Edema (HACE)
dexamethasone 4 mg every 8 hours
acetaZOLAMIDE 250 mg twice a day
descend to a lower altitude and seek emergency medical care
For children age 17 and under
dexamethasone should not be used in children for altitude illness unless recommended by a treating physician
See also: Pediatrics
Dexamethasone (generic for Decadron) is a steroid used to treat a wide variety of inflammatory conditions including croup, asthma and allergy. It is also used to prevent and treat acute mountain sickness. In the context of acute mountain sickness, recommendations are to carry dexamethasone for extended excursions above 3k-4k meters (10,000-12,000 feet). This medication is taken at the first sign of high altitude cerebral edema (HACE), a life-threatening form of altitude sickness, as an adjunct to the definitive treatment: immediate descent. HACE is characterized by unsteady gait (ataxia), confusion, stupor, and other severe neurologic signs.
Acetazolamide is a diuretic is used to prevent and treat acute mountain sickness. Altitude illness is a spectrum of conditions that are common in travelers at high altitude (above 2,500 meters/8,000 feet). Altitude illnesses include acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Altitude illness can range from mild to life-threatening. Acetazolamide can be used for prevention of AMS and treatment of mild to moderate AMS.
Nifedipine is a blood pressure medication that can be used in emergency circumstances to treat high altitude pulmonary edema (HAPE). Oxygen and descent are the most important treatments for HAPE. However, if oxygen and descent are difficult or impossible, nifedpine may be a useful adjunct treatment.
Sildenafil may be used in emergency circumstances to treat high altitude pulmonary edema (HAPE). It works by opening up the blood vessels in the lungs (pulmonary vasodilation). While this medication is included here because of its emergency use in altitude illness, it is best known for its use as a treatment for erectile dysfunction, under the brand name Viagra.
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