Treatment for Chronic Mountain Sickness

1
Treatment for Chronic Mountain Sickness

2
Tx

• Until recently there has been no pharmacologic
  treatment utilized to stop the progressive loss
  of adaptation to chronic hypoxia as seen in CMS
  patients. A few pharmacologic agents, such as
• medroxyprogesterone,
• enalapril,
• almitrine
• They have undergone clinical trials, but none are
  currently used in therapy.

3
Tx

• Current treatment of CMS includes removing the
  patients from the high altitude and blood
  letting. If all the patients with CMS were
  removed from these high altitudes the region
  would suffer socially and economically. Beside
  that the families of these patients would
  experience severe consequences.

4
Tx

• One of the first treatments discovered for CMS
  that does not have negative side effects is
  Acetazolamide. It is effective and yet is a low
  cost medication making it feasible for many
  living in high altitudes to have the benefit of
  reduced hypoventilation, and blunted
  erythropoiesis.

5
Tx

• Acetazolamide (ACZ) an inhibitor of carbonic
  anhydrase,
• Decreases the reabsorption of bicarbonates in the
  proximal tubule of the kidney
• Promotes diuresis,
• Increases cerebral blood flow
• Stimulates ventilation via metabolic acidosis.

6
Tx

• ACZ has been shown helpful in reducing central
  apneas in high altitude mountaineers or in
  patients with sleep-related breathing disorders
  at sea level but has never been evaluated.