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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Pharmacologic prophylaxis for acute mountain sickness: a systematic shortcut review
Rawle A Seupaul1, Julie L Welch, Sarah T Malka
1Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. rseupaul@iupui.edu
Annals of Emergency Medicine
|December 14, 2011
Summary
Acetazolamide effectively prevents acute mountain sickness, though paresthesias are a potential side effect. Sumatriptan and gabapentin also show promise for preventing altitude sickness, warranting further investigation.
Area of Science:
- Emergency Medicine
- Pharmacology
- Altitude Medicine
Background:
- Acute mountain sickness (AMS) is a common condition affecting individuals at high altitudes.
- Pharmacologic interventions are frequently used to prevent AMS.
- Previous reviews identified acetazolamide and dexamethasone as effective, but newer agents require evaluation.
Purpose of the Study:
- To evaluate the most current evidence on pharmacologic interventions for preventing acute mountain sickness.
- To assess the efficacy and safety of agents studied since 2000.
Main Methods:
- Systematic review of randomized placebo-controlled trials (N≥50) and systematic reviews published from 2000 to July 2011.
- Searched multiple databases including MEDLINE, EMBASE, and Cochrane.
- Assessed trial quality using standard criteria.
Main Results:
- Acetazolamide demonstrated efficacy in reducing AMS symptoms (NNT 3-8).
- Sumatriptan (NNT=4) and gabapentin (NNT=6) also showed benefits in single trials.
- Antioxidants, magnesium, and Ginkgo biloba were not effective. Dexamethasone trials did not meet criteria.
Conclusions:
- Acetazolamide remains an effective option for AMS prevention, with paresthesias as a noted side effect.
- Sumatriptan and gabapentin show potential for AMS prevention but require additional research.
- Evidence for other agents like antioxidants, magnesium, and Ginkgo biloba is lacking.
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