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Advances in the available non-biological pharmacotherapy prevention and treatment of acute mountain sickness and high altitude cerebral and pulmonary oedema.
Expert Opin Pharmacother. 2018 12; 19(17):1891-1902.EO

Abstract

INTRODUCTION

The physiological responses on exposure to high altitude are relatively well known, but new discoveries are still being made, and novel prevention and treatment strategies may arise. Basic information has changed little since our previous review in this journal 10 years ago, but considerable more detail on standard therapies, and promising new approaches are now available.

AREAS COVERED

Herein, the authors review the role of pharmacological agents in preventing and treating high-altitude illnesses. The authors have drawn on their own experience and that of international experts in this field. The literature search was concluded in March 2018.

EXPERT OPINION

Slow ascent remains the primary prevention strategy, with rapid descent for the management of serious altitude illnesses. Pharmacological agents are particularly helpful when rapid ascent cannot be avoided or when rapid descent is not possible. Acetazolamide remains the drug of choice for prophylaxis of acute mountain sickness. However, evidence indicates that reduced dosage schemes compared to the current recommendations are warranted. Calcium channel blockers and phosphodiesterase inhibitors remain the drugs of choice for the management of high-altitude pulmonary edema. Dexamethasone should be reserved for the treatment of more severe cases of altitude illnesses such as cerebral edema.

Authors+Show Affiliations

a School of Sport, Exercise, & Rehabilitation Sciences , University of Birmingham , Birmingham , UK.a School of Sport, Exercise, & Rehabilitation Sciences , University of Birmingham , Birmingham , UK.b Department of Vascular Surgery , University Hospitals of Coventry and Warwickshire; Warwick Medical School , Coventry , UK.a School of Sport, Exercise, & Rehabilitation Sciences , University of Birmingham , Birmingham , UK.c Department of Medicine , University of Birmingham , Edgbaston , UK.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

30307756

Citation

Joyce, K E., et al. "Advances in the Available Non-biological Pharmacotherapy Prevention and Treatment of Acute Mountain Sickness and High Altitude Cerebral and Pulmonary Oedema." Expert Opinion On Pharmacotherapy, vol. 19, no. 17, 2018, pp. 1891-1902.
Joyce KE, Lucas SJE, Imray CHE, et al. Advances in the available non-biological pharmacotherapy prevention and treatment of acute mountain sickness and high altitude cerebral and pulmonary oedema. Expert Opin Pharmacother. 2018;19(17):1891-1902.
Joyce, K. E., Lucas, S. J. E., Imray, C. H. E., Balanos, G. M., & Wright, A. D. (2018). Advances in the available non-biological pharmacotherapy prevention and treatment of acute mountain sickness and high altitude cerebral and pulmonary oedema. Expert Opinion On Pharmacotherapy, 19(17), 1891-1902. https://doi.org/10.1080/14656566.2018.1528228
Joyce KE, et al. Advances in the Available Non-biological Pharmacotherapy Prevention and Treatment of Acute Mountain Sickness and High Altitude Cerebral and Pulmonary Oedema. Expert Opin Pharmacother. 2018;19(17):1891-1902. PubMed PMID: 30307756.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Advances in the available non-biological pharmacotherapy prevention and treatment of acute mountain sickness and high altitude cerebral and pulmonary oedema. AU - Joyce,K E, AU - Lucas,S J E, AU - Imray,C H E, AU - Balanos,G M, AU - Wright,A D, Y1 - 2018/10/11/ PY - 2018/10/12/pubmed PY - 2019/1/29/medline PY - 2018/10/12/entrez KW - Acetazolamide KW - acute mountain sickness KW - dexamethasone KW - high altitude KW - high-altitude cerebral edema KW - high-altitude pulmonary edema KW - nifedipine SP - 1891 EP - 1902 JF - Expert opinion on pharmacotherapy JO - Expert Opin Pharmacother VL - 19 IS - 17 N2 - INTRODUCTION: The physiological responses on exposure to high altitude are relatively well known, but new discoveries are still being made, and novel prevention and treatment strategies may arise. Basic information has changed little since our previous review in this journal 10 years ago, but considerable more detail on standard therapies, and promising new approaches are now available. AREAS COVERED: Herein, the authors review the role of pharmacological agents in preventing and treating high-altitude illnesses. The authors have drawn on their own experience and that of international experts in this field. The literature search was concluded in March 2018. EXPERT OPINION: Slow ascent remains the primary prevention strategy, with rapid descent for the management of serious altitude illnesses. Pharmacological agents are particularly helpful when rapid ascent cannot be avoided or when rapid descent is not possible. Acetazolamide remains the drug of choice for prophylaxis of acute mountain sickness. However, evidence indicates that reduced dosage schemes compared to the current recommendations are warranted. Calcium channel blockers and phosphodiesterase inhibitors remain the drugs of choice for the management of high-altitude pulmonary edema. Dexamethasone should be reserved for the treatment of more severe cases of altitude illnesses such as cerebral edema. SN - 1744-7666 UR - https://www.unboundmedicine.com/medline/citation/30307756/Advances_in_the_available_non_biological_pharmacotherapy_prevention_and_treatment_of_acute_mountain_sickness_and_high_altitude_cerebral_and_pulmonary_oedema_ L2 - http://www.tandfonline.com/doi/full/10.1080/14656566.2018.1528228 DB - PRIME DP - Unbound Medicine ER -