main principles of treating acute mountain sickness are to stop further ascent, to descend if symptoms do not improve over 24 hours or deteriorate, and to descend urgently if signs of high altitude pulmonary oedema or high altitude cerebral oedema occur
rest
resting at the same altitude often relieves the symptoms of acute mountain sickness, and most patients will improve without treatment at the same altitude in 24-48 hours
simple analgesics and antiemetics
may reduce headache and nausea in mild acute mountain sickness
carbonic anhydrase inhibitor, acetazolamide
effective in reducing the symptoms of acute mountain sickness, although the optimum dosage is unknown: 250 mg every eight hours is widely used and has been shown to be effective
dexamethasone
dexamethasone (8 mg initially, then 4 mg every 6 hours) may also be used to relieve symptoms
high altitude cerebral oedema
person with symptoms of high altitude cerebral oedema should descend immediately. Delay may be fatal
steroids
dexamethasone (8 mg initially, then 4 mg every 6 hours orally or parenterally) will usually relieve some symptoms, making evacuation easier
oxygen
if available, should be used as an aid to evacuation
hyperbaric chambers improve oxygenation and relieve symptoms, making unaided descent easier
high altitude pulmonary oedema
descent is the mainstay of treatment
even a few hundred metres may be beneficial
oxygen
supplemental oxygen should be given if available
a portable hyperbaric chamber has been developed that simulates descent
nifedipine
effective in preventing and treating high altitude pulmonary oedema in susceptible individuals (10 mg orally initially, then 20 mg slow release preparation every 12 hours
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