General Generalities
Prevention of high altitude illness is best accomplished by?
Gradual acclimatization
What does AMS stand for and what is the time frame for its development?
Acute Mountain Sickness
Between 2 and 48 hours
Name one targeted therapy for AMS and its MOA
Acetazolamide (Diamox) which facilitates kidneys' dumping bicarb
What does HAPE stand for and what is the timeframe?
High altitude pulmonary edema, 1-3 days
Name a long term physiologic change that occurs due to high altitude over time
Red blood cell production increases
Most common first symptom of AMS?
Headache
When to begin administering this medication when using it as prevention?
Day before planned ascent
What does HACE stand for and what is the timeframe?
High altitude cerebral edema, >2 days
True or False: There is a change in the percentage of oxygen in the air at altitude?
False
The percentage of oxygen in the air is relatively constant at about 20% but the absolute amount of oxygen decreases with declining barometric pressure
List two general principles in prevention of altitude related disorders
-Climb high, sleep low
-Ascend less than 1000ft in 24 hour period when above 8000ft
Common second medication that can also reduce the incidence of AMS?
Ibuprofen 600mg TID 6 hours before ascent
True or False: Prior physical conditioning is protective against HAPE/HACE?
False
Only acclimatization is protective
Most common range for severe high altitude illness?
12-18k ft (3500-5500m)
Name the acid-base disorder of high altitude illness
Respiratory alkalosis
Common dosing of this medication for adults? Children?
125mg-250mg BID PO
2.5mg/kg BID PO
List at least one medical AND non-medical treatment for HAPE
Descend at least 3000ft, oxygen, keep patient upright, Gamow bag
Nifedipine, sildenafil, tadalafil
List 3 common co-occurring environmental related hazards at altitude
-Cold temperatures
-Increased UV percentage leading to sunburn, etc.
-Dehydration
Descent (if severe), rest, fluid intake, tylenol/NSAIDs, acetazolamide, supplemental O2
List the two most common side effects of this medication
Diuresis, paresthesias
BONUS: Acetazolamide should be avoided in people with what two medication allergies?
List one medical treatment for HACE other than acetazolamide
Dexamethasone