Low-dose acetylsalicylic acid analog and acetazolamide for prevention of acute mountain sickness.

Détails

ID Serval
serval:BIB_3D2937E920C0
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Low-dose acetylsalicylic acid analog and acetazolamide for prevention of acute mountain sickness.
Périodique
High Altitude Medicine and Biology
Auteur(s)
Kayser B., Hulsebosch R., Bosch F.
ISSN
1527-0297 (Print)
ISSN-L
1527-0297
Statut éditorial
Publié
Date de publication
2008
Volume
9
Numéro
1
Pages
15-23
Langue
anglais
Résumé
Analgesic drugs like acetylsalicylic acid, paracetamol, and ibuprofen are frequently used by subjects suffering from headache of acute mountain sickness (AMS). It is not clear if the effect is due to analgesia or prevention of AMS. We performed a randomized controlled clinical trial comparing a low dose of an acetylsalicylic acid analog, calcium carbasalate (380 mg /day), to placebo in a cohort of altitude-naïve subjects attempting a fast climb of Mt. Kilimanjaro (5896 m). A third noncontrolled open arm was proposed-the usual recommended preventive treatment of acetazolamide 500 mg/day. Of 93 potential participants, 44 chose prevention with acetazolamide, 18 refused participation, 15 received calcium carbasalate, and 16 received placebo. Mean age was 39 +/- 9 (SD) yr and 15% were female. AMS was quantified by the Lake Louise Symptom Score and physician assessment. Calcium carbasalate at 380 mg/day did not have any preventive effect on AMS and did not have any effect on the prevalence and intensity of headache. Event rate of AMS in the pooled carbasalate-placebo group was 84% and 55% in the acetazolamide group. The number needed to treat (NNT) at 500 mg/day of acetazolamide was 3. One subject on acetazolamide developed high altitude cerebral edema and was treated with dexamethasone, oxygen, and descent by evacuation. In conclusion, low-dose calcium carbasalate is not effective for prevention of AMS. In addition, these results corroborate the contention that in typical steep climbing profile settings, such as used by commercial enterprise on Mt. Kilimanjaro, acetazolamide 500 mg/day may not be sufficient to prevent AMS or to sufficiently reduce symptom intensity in almost half of subjects.
Mots-clé
Acetazolamide/administration & dosage, Acute Disease, Adult, Altitude Sickness/drug therapy, Altitude Sickness/prevention & control, Aspirin/administration & dosage, Aspirin/analogs & derivatives, Carbonic Anhydrase Inhibitors/administration & dosage, Cohort Studies, Dose-Response Relationship, Drug, Female, Headache/drug therapy, Headache/prevention & control, Humans, Male, Middle Aged, Mountaineering, Nepal, Pulmonary Edema/prevention & control, Questionnaires, Severity of Illness Index, Treatment Outcome, Urea/administration & dosage, Urea/analogs & derivatives
Pubmed
Web of science
Création de la notice
19/09/2013 10:22
Dernière modification de la notice
20/08/2019 14:33
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