Dexamethasone in the treatment of acute mountain sickness

Article Abstract:

Acute mountain sickness occurs when individuals rapidly ascend to heights above 2,500 meters. The illness is characterized by headache, tiredness, nausea, loss of appetite, and vomiting. It can progress to become a severe life threatening illness, high-altitude edema. Mountain sickness may result from different degrees of swelling of the brain. The efficiency of the anti-inflammatory drug dexamethasone in treating mountain sickness was investigated with six men who were exposed to low air pressure in a hypobaric chamber to simulate altitudes of 3,700 meters for 48 hours on two separate occasions. Dexamethasone reduced the symptoms of acute mountain sickness by 63 percent. Slightly elevated blood sugar levels were seen as a complication of the treatment. However, dexamethasone did not improve any of the physiological effects of high altitude, such as periods during sleep when breathing stops, decreased oxygen in blood, fluid imbalance, hormonal changes or psychological disturbances that are associated with exposure to high altitudes. Dexamethasone is thought to reduce the symptoms of mountain sickness by relieving the nausea and by elevating mood rather than by affecting any of the physiological mechanisms. Therefore, it is recommended that dexamethasone be used to treat acute mountain sickness only if descent is not possible.

Drug therapy, Cerebral edema, Mountain sickness, Altitude sickness

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The cost to the central nervous system of climbing to extremely high altitude

Article Abstract:

Exposures to high altitudes can lead to both short- and long-lasting neurobehavioral impairments, due to low levels of oxygen in the brain. Thirty-five mountaineers were subject to neuropsychological and physiological testing both before and one to 30 days after climbs to altitudes between 5,500 and 8,800 meters, as were six subjects that were in an altitude chamber which simulated an altitude of 8,800 meters. A decline in visual long-term memory was observed in both the mountaineers and the subjects in the simulated climb. Verbal long-term memory was affected only in the simulated-ascent group, while the mountaineers made twice as many errors on a verbal expression test after the climb. Individuals who breathed more often in response to the decreased oxygen in the high altitudes showed reduced verbal learning and poor long-term verbal memory. This may have been due to a decreased blood flow in the brain caused by hypocapnia, inadequate carbon dioxide in the blood. Thus, although individuals with a greater ventilatory response to the lack of oxygen function better physically at high altitudes, they develop long-lasting neurobehavioral impairment.

Research, Diagnosis, Hypoxia, Anoxia, Psychophysiology, Neuropsychology, Aphasia

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Dexamethasone, granisetron, or both for the prevention of nausea and vomiting during chemotherapy for cancer

Article Abstract:

Vomiting caused by chemotherapy may be prevented by giving patients a combination of granisetron and dexamethasone. A study of 408 first-time chemotherapy patients found that giving them the combination of drugs in the first 24 hours of chemotherapy was more effective than giving either drug alone. The combination therapy had a 20% higher rate of protection from vomiting, nausea, or both, and was associated with a lower rate of treatment failure. Granisetron, a serotonin-receptor antagonist, was associated with less protection from nausea occurring shortly after chemotherapy. All three treatments, dexamethasone plus granisetron, dexamethasone alone, and granisetron alone, were equally well tolerated by patients. The combination treatment provided protection against delayed vomiting (vomiting 24 hours or more after chemotherapy). Dexamethasone by itself may be sufficiently able to prevent chemotherapy-induced vomiting, but future studies will need to prove this.

Chemotherapy, Antiemetics

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