This is a guest post by Dr. Jeremy Windsor.
Steroids and Acute Mountain Sickness
In recent years, many attempts have been made to identify safe and effective medications to prevent acute mountain sickness (AMS). Acetazolamide (Diamox), currently the “drug of choice” for this purpose, is not perfect and occasionally causes objectionable side effects. Dexamethasone (Decadron), a powerful steroid medication, has become increasingly popular for prevention and treatment in certain circles. While there is ample evidence to suggest that dexamethasone is effective, a recent case report highlights that this drug is not without risk.
In the latest issue of the journal Wilderness & Environmental Medicine [WEM 21(4):345-348, 2010] in an article entitled “Complications of steroid use on Mt. Everest,” Bishnu Subedi and colleagues working for the Himalayan Rescue Association (HRA) described the case of a 27 year-old man who was prescribed a course of three drugs, including dexamethasone, intended to support him during his attempt to climb Mt. Everest. After more than three weeks of taking the medications, the mountaineer noticed the appearance of a rash and decided to stop taking them. Rather than wait for the rash to subside, he chose to continue his acclimatization program and ascend to Camp 3 at 7010m altitude. The patient arrived exhausted and confused; onlookers quickly recognized that something was seriously wrong and so a rescue party was organized to help him back to safety. Read more »