Prophylactic Acetaminophen or Ibuprofen Result in Equivalent Acute Mountain Sickness Incidence at High Altitude: A Prospective Randomized Trial

Kanaan, Nicholas C.; Peterson, Alicia L.; Pun, Matiram; Holck, Peter; Starling, Jennifer; Basyal, Bikash; Freeman, Thomas F.; Gehner, Jessica R.; Keyes, Linda E.; Levin, Dana R.; O’Leary, Catherine J.; Stuart, Katherine E.; Thapa, Ghan Bahadur; Tiwari, Aditya; Velgersdyk, Jared; Zafren, Ken; Basnyat, Buddha

doi:10.1016/j.wem.2016.12.011

Cited by 19 publications

(16 citation statements)

References 17 publications

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“…44 Another study claimed to show benefit, but the trial did not include a placebo arm and instead compared the incidence of AMS with ibuprofen with historically reported rates from the region in which the study was conducted. 45 Although no studies have compared ibuprofen with dexamethasone, 2 studies have compared ibuprofen with acetazolamide. The first found an equal incidence of high altitude headache and AMS in the acetazolamide and ibuprofen groups, with both showing significant protection compared to placebo.…”

Section: Ibuprofenmentioning

confidence: 99%

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update

Luks

Auerbach

Freer

et al. 2019

Wilderness & Environmental Medicine

Self Cite

168

181

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To provide guidance to clinicians about best preventive and therapeutic practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for prevention and treatment of acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. Recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks/burdens according to criteria put forth by the American College of Chest Physicians. The guidelines also provide suggested approaches to prevention and management of each form of acute altitude illness that incorporate these recommendations. This is an updated version of the original WMS Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness published in 2010 and subsequently updated as the WMS Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness in 2014.

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Section: Ibuprofenmentioning

confidence: 99%

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update

Luks

Auerbach

Freer

et al. 2019

Wilderness & Environmental Medicine

Self Cite

168

181

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“…Finally, both steroids and nonsteroidal anti-inflammatory drugs (NSAIDS) equally reduce AMS incidence despite their different modes of action ( Dumont et al, 2000 ; Gertsch et al, 2012 ; Zheng et al, 2014 ). This suggests that both COX-2 mediated inflammation as well as analgesic mechanisms that mediate nociception contribute to AMS symptomology ( Hartmann et al, 2000 ; Song et al, 2016 ; Kanaan et al, 2017 ). Indeed, inflammatory mediators released during tissue injury can activate nociceptors and can contribute to pain hypersensitivity ( Kidd and Urban, 2001 ).…”

Section: Pathophysiological Consequencesmentioning

confidence: 99%

Hypoxia and Inflammation: Insights From High-Altitude Physiology

2021

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The key regulators of the transcriptional response to hypoxia and inflammation (hypoxia inducible factor, HIF, and nuclear factor-kappa B, NF-κB, respectively) are evolutionarily conserved and share significant crosstalk. Tissues often experience hypoxia and inflammation concurrently at the site of infection or injury due to fluid retention and immune cell recruitment that ultimately reduces the rate of oxygen delivery to tissues. Inflammation can induce activity of HIF-pathway genes, and hypoxia may modulate inflammatory signaling. While it is clear that these molecular pathways function in concert, the physiological consequences of hypoxia-induced inflammation and how hypoxia modulates inflammatory signaling and immune function are not well established. In this review, we summarize known mechanisms of HIF and NF-κB crosstalk and highlight the physiological consequences that can arise from maladaptive hypoxia-induced inflammation. Finally, we discuss what can be learned about adaptive regulation of inflammation under chronic hypoxia by examining adaptive and maladaptive inflammatory phenotypes observed in human populations at high altitude. We aim to provide insight into the time domains of hypoxia-induced inflammation and highlight the importance of hypoxia-induced inflammatory sensitization in immune function, pathologies, and environmental adaptation.

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“…Accordingly, Dumont et al (2000) showed a reduction in AMS incidence and severity with anti-inflammatory drug treatment. Both steroids and non-steroidal anti-inflammatory drugs reduced the incidence of AMS, despite their different mechanisms of action (Gertsch et al, 2010(Gertsch et al, , 2012Kanaan et al, 2017;Lipman et al, 2012;Nepal et al, 2020;Rock et al, 1989;Tang et al, 2014;Zheng et al, 2014). However, other studies demonstrated no significant association between pro-inflammatory cytokine concentration and AMS incidence (Lundeberg et al, 2018;Swenson et al, 1997).…”

Section: Acute Mountain Sickness and Inflammatory Marker Expressionmentioning

confidence: 99%

Inflammatory gene expression during acute high‐altitude exposure

Pham

Frost

Parikh

et al. 2022

The Journal of Physiology

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Prophylactic Acetaminophen or Ibuprofen Result in Equivalent Acute Mountain Sickness Incidence at High Altitude: A Prospective Randomized Trial

Cited by 19 publications

References 17 publications

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update

Hypoxia and Inflammation: Insights From High-Altitude Physiology

Inflammatory gene expression during acute high‐altitude exposure

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