Pharmacotherapy for Altitude-Related Illness

Abstract

Altitude-related illness is a frequent cause of morbidity and occasional mortality among recreational sports travelers in the United States and throughout the world. High-altitude illness describes the cerebral and pulmonary syndromes (acute mountain sickness, high-altitude cerebral edema, and high-altitude pulmonary edema) that can occur in unacclimatized persons ascending too rapidly to high altitude. The pathogenesis of these syndromes is primarily hypobaric hypoxia that causes compensatory changes in the brain and lungs, resulting in hyperperfusion of microvascular beds, increased capillary pressure, and a microvascular leak with resulting edema and a characteristic constellation of symptoms. Prevention and treatment involve education about rate of ascent; diet; alcohol intake; physical activity; oxygen; hyperbaric chambers; and pharmacotherapy, including acetazolamide, dexamethasone, nifedipine, and salmeterol in selected circumstances.