Spironolactone in Acute Mountain Sickness

Brown, Grace; Liston, W.A.; Brookfield, D. S. K.; Sutton, J. R.

doi:10.1016/s0140-6736(77)92802-1

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…This may not simulate outdoor trekking conditions as in our study. As AMS is altitude-dependent, another study 7 was different from ours because it was carried out at 3500 m, unlike ours whose starting point was 4300 m. Two other studies 8,10 originated at around 3000 m. In all the previous studies, spironolactone was administered 48 hours before participants ascended altitudes higher than 3000 m. In the previous studies all the participants took spironolactone for at least 48 hours at high altitude (both these points are again addressed under limitations of the study). In all the studies, the spironolactone dosage used was 100 mg, as in our study, except in 1 study 8 where they used 75 mg per day.…”

Section: Discussionmentioning

confidence: 75%

“…4 While ours was a large double-blind, randomized study, 2 of the other studies 7,9 were blinded and randomized and 2 were not. 8,10 Most importantly, unlike our study, which recruited 311 people, the largest previous study 7 had a sample size of 29 people, and other studies noted 8,9 enrolled just 9 and 13 subjects.…”

Section: Discussionmentioning

confidence: 79%

“…Spironolactone, an aldosterone antagonist and a mild diuretic, is an inexpensive drug that has shown promise in the prevention of AMS in a number of very small trials. [7][8][9][10] The efficacy of spironolactone is plausible since those persons developing AMS while trekking may have a higher aldosterone level, 11,12 mediated through the activation of the renin angiotensin mechanism triggered by the stress of exercise. This may help retain more water and sodium, leading to over-perfusion of capillary beds and capillary leakage in the setting of a hypoxic environment.…”

Section: Introductionmentioning

confidence: 99%

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Spironolactone Does Not Prevent Acute Mountain Sickness: A Prospective, Double-Blind, Randomized, Placebo-Controlled Trial by SPACE Trial Group (Spironolactone and Acetazolamide Trial in the Prevention of Acute Mountain Sickness Group)

Basnyat¹,

Holck

Pun

et al. 2011

Wilderness & Environmental Medicine

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Spironolactone Does Not Prevent Acute Mountain Sickness: A Prospective, Double-Blind, Randomized, Placebo-Controlled Trial by SPACE Trial Group (Spironolactone and Acetazolamide Trial in the Prevention of Acute Mountain Sickness Group)

Basnyat¹,

Holck

Pun

et al. 2011

Wilderness & Environmental Medicine

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“…All members started taking spironolactone 25 mg or placebo tablets three times daily from 48 hours before reaching 3000 m. Three climbers dropped out before 3700 m without evidence of AMS. Of the six on spironolactone, two suffered from AMS compared with five of the six on placebo 19 …”

Section: Prophylaxis In Amsmentioning

confidence: 99%

Cases of Acute Mountain Sickness on Mount Agri

Ergün

1994

Int J Clinical Practice

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SUMMARY Between 1983 and 1990 a total of 74 freestyle mountaineers and 88 mountaineers with skis attempted to climb Mount Agri (Ararat). From the freestyle group two mountaineers were affected by acclimatisation disorder at 3200 m and seven at 4200 m above sea level. Acute mountain sickness (AMS) affected four mountaineers at 4200 m, eight at 4700 m, two at 5000 m and two at 5165 m, while 49 reached the summit. Only one of the mountaineers with skis was affected by AMS (at 4200 m), while all the others reached the summit. The symptoms of acclimatisation disorder and AMS, according to their degree of frequency, were headache, weakness, dyspnoea and palpitation, anorexia, nausea, vomiting, giddiness, ataxia and insomnia. Pulse rates varied between 115 and 124/min, and breathing between 30 and 38/min.

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Interventions for treating acute high altitude illness

Simancas‐Racines

Arévalo-Rodríguez

Osorio

et al. 2018

Cochrane Database of Systematic Reviews

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Background Acute high altitude illness is defined as a group of cerebral and pulmonary syndromes that can occur during travel to high altitudes. It is more common above 2500 metres, but can be seen at lower elevations, especially in susceptible people. Acute high altitude illness includes a wide spectrum of syndromes defined under the terms 'acute mountain sickness' (AMS), 'high altitude cerebral oedema' and 'high altitude pulmonary oedema'. There are several interventions available to treat this condition, both pharmacological and nonpharmacological; however, there is a great uncertainty regarding their benefits and harms. Objectives To assess the clinical effectiveness, and safety of interventions (non-pharmacological and pharmacological), as monotherapy or in any combination, for treating acute high altitude illness. Search methods We searched CENTRAL, MEDLINE, Embase, LILACS, ISI Web of Science, CINAHL, Wanfang database and the World Health Organization International Clinical Trials Registry Platform for ongoing studies on 10 August 2017. We did not apply any language restriction. Selection criteria We included randomized controlled trials evaluating the effects of pharmacological and non-pharmacological interventions for individuals suffering from acute high altitude illness: acute mountain sickness, high altitude pulmonary oedema or high altitude cerebral oedema. Data collection and analysis Two review authors independently assessed the eligibility of study reports, the risk of bias for each and performed the data extraction. We resolved disagreements through discussion with a third author. We assessed the quality of evidence with GRADE.

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Spironolactone in Acute Mountain Sickness

Cited by 6 publications

References 10 publications

Spironolactone Does Not Prevent Acute Mountain Sickness: A Prospective, Double-Blind, Randomized, Placebo-Controlled Trial by SPACE Trial Group (Spironolactone and Acetazolamide Trial in the Prevention of Acute Mountain Sickness Group)

Spironolactone Does Not Prevent Acute Mountain Sickness: A Prospective, Double-Blind, Randomized, Placebo-Controlled Trial by SPACE Trial Group (Spironolactone and Acetazolamide Trial in the Prevention of Acute Mountain Sickness Group)

Cases of Acute Mountain Sickness on Mount Agri

Interventions for treating acute high altitude illness

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