Acetazolamide in High Altitude

       Hypoxia is the cause of the hyperventilation in high altitude. This is followed by hypocapnia and respiratory alkalosis. As a consequence respiration rhythm related alkalosis and hypocapnia causing cerebral vasospasm, respiratory center failure, that is manifested by headaches, sleep disturbances and periodical breathing (hyperpnoea - apnoea).
    Acetazolamide (Diamoxe) as a carbonic anhydrase inhibitor contributes excretion of bicarbonates (NAHCO3), increases diuresis and decreases alkalosis. These features are widely used for acclimatization in high altitude to compensate alkalosis and stimulate a respiratory center when periodic breathing is presented.
    We observed 12 alpinists at 4200-6600 meters in mountains of Pamir (Kyrgyzstan) in June of 2004.
During first days five alpinists had developed headaches and insomnia. In addition, three of them were suffering due to periodic breathing at night. All of them had acidic diuresis (Ph 3.0 – 4.3).
    Acetazolamide 125mg daily dose was given to all alpinists, one hour before the bedtime during three days.
    After receiving this drug urine ph was elevating (7.5 – 8.0) and the patients had fewer complaints.
    Their acclimatization process became smoother, and they reached the pick of communism successfully.
    One alpinist returned from the altitude of 6800m due to non medication related gastrointestinal problems.
    Because of the low dose were used, no one had side effects as numbness of the leaps and extremities, change of the test or allergic reactions.
    Our observation of the features of the Acetazolamide confirmed the given literature data according to which acetazolamide suggested as the effective remedy to prevent, reduce and treat negative presentations of acclimatization and acute mountain sickness.

Dr. Zurab Astakhishvili