Prophylaxis and Treatment of Acute Mountain Sickness


Acute mountain sickness (AMS) can be avoided in most circumstances by “slow ascent”, which includes not increasing the sleeping altitude above 2500 m by more than 300 m per 24 h. Care should also be taken to ensure an adequate fluid intake. Warning signs of AMS, such as headache, lassitude, insomnia, nausea, cough, peripheral and periorbital edemas and dyspnea on exertion should be respected and lead to rest days. Travelers who tend to become sick in spite of these prophylactic measures can take acetazolamide as prophylaxis, usually in a dose of 500 mg once a day. The efficacy of dexamethasone in the prophylaxis of AMS has also been demonstrated. Inefficient or dangerous medications include antacids, iron and vitamin preparations, phenytoin, potassium supplements, furosemide and medroxyprogesterone.

Mild cases of AMS can be treated with rest days and symptomatic medications. Severely affected patients should descend, be evacuated to a lower altitude or , if this is impossible, be treated with oxygen. If this is not available, dexamethasone 8 mg initially followed by 4 mg every 6 h alleviates the severity of AMS. This treatment should be reserved for emergencies to facilitate safe descent and is generally more effective for cerebral symptoms than for the pulmonary manifestations of AMS.


Acute Mountain Sickness Periodic Breathing Hypoxic Ventilatory Response Expiratory Positive Airway Pressure Aviat Space Environ 
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© Springer-Verlag Berlin Heidelberg 1989

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  • O. Oelz

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