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Glucocorticoids as prophylaxis against acute mountain sickness
M Basu1, R C Sawhney, Surender Kumar
1Defence Institute of Physiology & Allied Sciences, Lucknow Road, Timarpur, Delhi-110054, India. em_dipas@yahoo.com
Clinical Endocrinology
|December 4, 2002
Summary
Low-dose glucocorticoids effectively prevent acute mountain sickness (AMS) in healthy men ascending to high altitude. Prednisolone 20 mg offered the optimal reduction in AMS symptoms without altering physiological responses to hypoxia.
Area of Science:
- Altitude Medicine
- Pharmacology
- Human Physiology
Background:
- Acute mountain sickness (AMS) impairs performance at high altitude.
- Rapid ascent to high altitude triggers AMS symptoms like headache and nausea.
- Prophylactic treatment is crucial for individuals working at high altitudes.
Purpose of the Study:
- To evaluate the efficacy of low-dose glucocorticoids in preventing AMS.
- To determine the optimal glucocorticoid dosage for AMS prevention.
- To assess the impact of glucocorticoids on physiological responses to hypoxia.
Main Methods:
- Fifty healthy men were randomized into five groups (placebo, prednisolone 10, 20, 40 mg, dexamethasone 0.5 mg).
- Medication was administered for 2 days at sea level and 3 days at 3450 m.
- AMS severity was scored using the Lake Louise system; physiological parameters and hormone levels were measured.
Main Results:
- Glucocorticoid treatment significantly reduced AMS scores compared to placebo.
- Prednisolone 20 mg demonstrated the most effective reduction in AMS symptoms.
- Oxygen saturation, heart rate, and blood pressure responses were similar across groups.
- Hormonal responses (cortisol, ACTH) to hypoxia were not significantly altered by low-dose glucocorticoids.
Conclusions:
- Low-dose glucocorticoids are effective in curtailing acute mountain sickness.
- Prednisolone 20 mg is an optimal prophylactic dose for AMS prevention.
- Glucocorticoid administration does not interfere with the natural adrenal response to high altitude.