Acclimatizing with Acetazolamide

Abstract

Although it is best to prevent acute mountain sickness (AMS) 1 by gradual ascent without using any drugs, this may not always be an option in many settings. Rescuers may need to go up rapidly to high altitudes; or logistically, owing to a lack of camp site, it may not be possible for trekkers and climbers to spend the night at an optimal altitude. Furthermore, airports in places like Lhasa, Tibet (3,490 m) and La Paz, Bolivia (4,058 m) may cause travelers to arrive at high altitude without the ability to acclimatize en route. Some people who are predisposed to AMS may be protected by taking a prophylactic drug while ascending high altitudes. Many, such as pilgrims, often disregard strongly delivered advice about gradual ascent in their single‐minded determination to ascend the sacred site. 2 In addition, there is a fast‐growing population of climbers in pursuit of a summit who are being advised by physicians to use prophylactic medicine to both improve performance and achieve summit success. Poor knowledge and lack of awareness of side effects may lead to widespread misuse of drugs. Finally, sudden military deployment to high altitude regions of the world, such as the Hindu Kush mountains in Afghanistan, may necessitate drug prophylaxis for the prevention of AMS. Two articles 3,4in the present issue deal with the use of acetazolamide at high altitude in the … Corresponding Author: Buddha Basnyat, MD, MSc, FACP, FRCP (E), Nepal International Clinic, Lal Durbar Marg, GPO Box 3596, Kathmandu, Nepal. E‐mail: rishibas{at}wlink.com.np