Mountain Sickness Drugs

[BarePaw]

I am a pharmacy student working on a project regarding mountain sickness. These are the drugs I have found so far that have been used for altitude sickness (not all have good evidence for this use). Have any of you heard of others?

 

Acetazolamide (Diamox)

Methazolamide (Neptazane)

Nitric Oxide (INOmax)

Sildenafil (Viagra) (weak evidence)

Ginkgo Biloba (conflicting evidence)

Dexamethasone

 

Thanks.

[David Trippett]

THC

[G-spotter]

psilocybin

[cj001f]

Coca - 100 million andinistas can't be wrong.

[dinomyte]

LOL....no chance of getting a serious answer with this group!

 

Let's see....I've take n Ginkgo and serious amounts of alcohol....no prob to this point!!!

[Farrgo]

I second coca. Works like a charm.

[cj001f]

I second coca. Works like a charm.

 

Or at least as well as Diamox at 1/100th the price.

[iluka]

Acetazolamide (Diamox): Good evidence for its usefulness preventing and treating AMS

 

Methazolamide (Neptazane): Not used as much in practice but works the same as acetazolamide so it should be effective.

 

Nitric Oxide (INOmax): Never studied for the prevention or treatment of AMS. It is used for research purposes and, given the way it works, it would be useful for HAPE prevention and treatment but there is no way to administer it easily in the field. When used in the hospital, it is fantastically expensive.

 

Sildenafil (Viagra) (weak evidence): actually the evidence of its usefulness is improving. It is not useful to prevent or treat AMS or HACE but does interfere with the mechanisms that cause HAPE. Some limited data shows it can improve exercise tolerance at altitude (see a previous thread from two weeks ago on High Altitude Performance)

 

Ginkgo Biloba (conflicting evidence): I would not waste my time with this. The studies that showed it "worked" had small numbers of patients. Some more recent larger studies have shown no benefit. Stick with Diamox for which there is good data.

 

Dexamethasone: Good evidence to support its use to prevent or treat AMS and HACE. A paper is going to be published soon (I think it will be in the Annals of Internal Medicine) that shows that it may also be useful for prevention of HAPE.

 

Others to add to the list:

Tadalafil (Cialis): the same study that looked at Dexamethasone and HAPE showed that this medicine can block the development of HAPE in people known to be prone to the disease. It has no role in AMS or HACE.

 

Nifedipine: the current standard for prevention and management of HAPE

 

Salmeterol: an inhaled medication (long acting version albuterol): a study within the past 5 years in the New England Journal of Medicine showed it can be used to prevent HAPE in people known to be susceptible to the disease.

 

Some useful review articles on altitude illness:

http://www.ncbi.nlm.nih.gov/entrez/query...l=pubmed_docsum

 

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed

 

 

 

[catbirdseat]

Both acetazolamide and methazolamide are carbonic anhydrase inhibitors used to treat glaucoma. They differ only by a single methyl group.

[ScaredSilly]

My favorite drug for preventing AMS is large quanties of dihydogen-monoxide.

[Stonehead]

Both acetazolamide and methazolamide are carbonic anhydrase inhibitors used to treat glaucoma. They differ only by a single methyl group.

 

As I understand, Diamox acts also as a diuretic. That's the problem with performance enhancers, you tweak one part of the system, then the whole system is affected. So, the problem is finding the right dosage to benefit enough without feeling the detrimental effects of dehydration.

[ivan]

THC

this shouldn't be dismissed as a mere joke - my denali trip entirely hinged upon it, especially above 14k - my partner abstained and lost all motivation for life and became a little puss

[archenemy]

I second coca. Works like a charm.

 

Or at least as well as Diamox at 1/100th the price.

Not true. I bought a huge bag of dried coca leaves in Peru. It covered our group for a week (chewing and making Mate de Coca) and I had to throw the half bag away when it was time to leave. Total cost = $2

 

My deductible is considerably higher than that.

[iluka]

I second coca. Works like a charm.

 

Or at least as well as Diamox at 1/100th the price.

 

Diamox is generic and pretty cheap as a result