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General Climbing Discussion

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steriods!! 10-Jun-2004 At 1:34:50 PM vwills

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There is a good review on Altitude illness in the British Medical Journal, April 2003.
Drugs can be taken in 2 settings: as prophylaxis or treatment so its important to differentiate.

Regarding Acetazolamide (Diamox): prophylaxis may be a good idea in people who have experienced AMS previously as this group is at high risk of recurrent symptoms.However the effective dose is unknown. The metaanalysis they included as a reference suggests 750mg as a once daily dose is effective whereas its more commonly suggested 125mg twice daily is the appropriate dose for prevention with few sideeffects such as tingling or excessive diuresis(pissing).
It is a sulphur derivative so beware of allergies.

Dexamethasone works as a preventative over 4000m but it has potentially dangerous side effects including psychosis or extreme euphoria, not good in a small tent a long way up a mountain.

Prophylactic aspirin does help and might have the added advantage of reducing deep vein thrombosis or stroke at the risk of an upset stomach or peptic ulcers.

One small trial I've read also suggests a high carbohydrate diet can help prevent symptoms as you produce more carbon dioxide which increases your respiratory rate ahead of other adaptive processes.

Like everyone else has said the most important thing is to ascend slowly and descend or rest if symptoms start.

Medical treatment of severe AMS/ cerebral oedema/ pulmonary oedema is not "cheating"! Its an attempt to save someones life. Over 7000metres about 1/5 deaths are related to altitude illness.