Prophylaxis of acute mountain sickness

Graded ascent is essential for the prophylaxis of acute mountain sickness. The current recommendations for graded high-altitude acclimatization are to spend 2 to 3

nights below 3000 m before going higher and thereafter not to increase sleeping altitude by more than 600 m/day ( Hackett and R,o..a..c,h..,.199.5). If a climber is still susceptible to acute mountain sickness, drug prophylaxis is recommended. The drug of choice is indisputably acetazolamide. Many studies have shown that acetazolamide 250 mg twice daily started 24 h before ascent is effective in preventing the symptoms of acute mountain sickness ( Ward et.3L 1995). A 500-mg capsule of the slow-release preparation may be as effective as a 250-mg dose twice daily. It is recommended that the prophylactic treatment is continued for the first day or two at high altitude. Although dexamethasone has been proved to be as effective as acetazolamide in the prophylaxis of acute mountain sickness, it cannot be recommended because of its well-known side-effects (Hackettand Roach 1995).

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