Low-dose theophylline reduces symptoms of acute mountain sickness

Journal of Travel Medicine

Volumn 15, Issue 5, 2008, Pages 307-314

  Küpper, Thomas E A H ^a,b,c   Strohl, Kingman P ^d   Hoefer, Markus ^e   Gieseler, Ulf ^f   Netzer, Cordula M ^d   Netzer, Nikolaus C ^a,d  

^a PARACELSUS MEDICAL UNIVERSITY   (Austria)

^b RWTH AACHEN UNIVERSITY   (Germany)

^c Medical Commission of the Union Internationale des Associations   (Switzerland)

^d CASE WESTERN RESERVE UNIVERSITY   (United States)

^e SAARLAND UNIVERSITY   (Germany)

^f Diakonissenkrankenhaus ^*  (Germany)

Author keywords

[No Author keywords available]

Indexed keywords

OXYGEN; PLACEBO; THEOPHYLLINE;

ABSENCE OF SIDE EFFECTS; ACUTE DISEASE; ADULT; ALTITUDE; ALTITUDE DISEASE; ARTICLE; BREATHING; CLINICAL ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DIZZINESS; DOUBLE BLIND PROCEDURE; DRUG BLOOD LEVEL; DRUG EFFECT; FLUORESCENCE POLARIZATION IMMUNOASSAY; GASTROINTESTINAL SYMPTOM; HEADACHE; HEART PALPITATION; HUMAN; HYPERTENSION; LOW DRUG DOSE; MALE; MOUNTAINEERING; NAUSEA; POLYSOMNOGRAPHY; RANDOMIZED CONTROLLED TRIAL; RECORDING; SCORING SYSTEM; SLEEP; SLEEP APNEA SYNDROME; SLOW RELEASE FORMULATION; SYMPTOM;

ACCLIMATIZATION; ACUTE DISEASE; ADULT; ALTITUDE SICKNESS; BRONCHODILATOR AGENTS; DELAYED-ACTION PREPARATIONS; DOSE-RESPONSE RELATIONSHIP, DRUG; DOUBLE-BLIND METHOD; GERMANY; HUMANS; MALE; MOUNTAINEERING; THEOPHYLLINE; TREATMENT OUTCOME;

EID: 53749086841     PISSN: 11951982     EISSN: 17088305     Source Type: Journal    
DOI: 10.1111/j.1708-8305.2008.00228.x     Document Type: Article

References (49)

1. Maggiorini M, Buhler B, Walter M, Oelz O. Prevalence of acute mountain sickness in the Swiss Alps. BMJ 1990 301 : 853 855.
2. Montgomery AB, Mills J, Luce JM. Incidence of acute mountain sickness at intermediate altitude. JAMA 1989 261 : 732 734.
3. Honigman B, Theis MK, Koziol-McLain J, et al. Acute mountain sickness in a general tourist population at moderate altitudes [see comments]. Ann Intern Med 1993 118 : 587 592. Erratum in : Ann Intern Med 1994 120 : 698.
4. Hackett PH, Rennie D. The incidence, importance, and prophylaxis of acute mountain sickness. Lancet 1976 2 : 1149 1155.
5. Gallagher SA, Hackett PH. High-altitude illness. Emerg Med Clin North Am 2004 22 : 329 355, viii.
6. Hackett P. The Lake Louise Consensus on the definition and quantification of altitude illness. In : Sutton J, Coates G, Houston C, eds. Advances in the biosciences vol. 84. Hypoxia and mountain medicine: proceedings of the 7th International Hypoxia Symposium Feb 26-Mar 2, 1991; Lake Louise, Canada. Oxford : Pergamon Press, 1992 : 327 330.
7. Dumont L, Mardirosoff C, Tramer MR. Efficacy and harm of pharmacological prevention of acute mountain sickness: quantitative systematic review. BMJ 2000 321 : 107 114.
8. Hackett PH, Roach HC. High-altitude illness. N Engl J Med 2001 345 : 1279.
9. Milledge J. The ventilatory response to hypoxia: how much is good for a mountaineer? Postgrad Med J 1986 63 : 169 172.
10. Hackett PH. High altitude cerebral edema and acute mountain sickness. A pathophysiology update. Adv Exp Med Biol 1999 474 : 23 45.
11. Gibbs JS. Pulmonary hemodynamics: implications for high altitude pulmonary edema (HAPE). A review. Adv Exp Med Biol 1999 474 : 81 91.
12. Bartsch P, Swenson ER, Maggiorini M. Update: high altitude pulmonary edema. Adv Exp Med Biol 2001 502 : 89 106.
13. McQaid KE, Keenan AK. Endothelial barrier dysfunction and oxidative stress: roles for nitric oxide? Exp Physiol 1997 82 : 369 376.
14. Plateel M, Dehouck MP, Torpier G, et al. Hypoxia increases the susceptibility to oxidant stress and the permeability of the blood-brain barrier endothelial cell monolayer. J Neurochem 1995 65 : 2138 2145.
15. Magalhaes J, Ascensao A, Viscor G, et al. Oxidative stress in humans during and after 4 hours of hypoxia at a simulated altitude of 5500 m. Aviat Space Environ Med 2004 75 : 16 22.
16. Jefferson JA, Simoni J, Escudero E, et al. Increased oxidative stress following acute and chronic high altitude exposure. High Alt Med Biol 2004 5 : 61 69.
17. Eichenberger U, Weiss E, Riemann D, et al. Nocturnal periodic breathing and the development of acute high altitude illness. Am J Respir Crit Care Med 1996 154 (6 Pt 1 1748 1754.
18. Burgess KR, Johnson P, Edwards N, Cooper J. Acute mountain sickness is associated with sleep desaturation at high altitude. Respirology 2004 9 : 485 492.
19. Erba P, Anastasi S, Senn O, et al. Acute mountain sickness is related to nocturnal hypoxemia but not to hypoventilation. Eur Respir J 2004 24 : 303 308.
20. Sugie T. [Periodic breathing at high altitude relation to acclimatization and acute mountain sickness]. Nippon Kyobu Shikkan Gakkai Zasshi 1995 33 : 1355 1360.
21. Barash IA, Beatty C, Powell FL, et al. Nocturnal oxygen enrichment of room air at 3800 meter altitude improves sleep architecture. High Alt Med Biol 2001 2 : 525 533.
22. Larson EB, Roach RC, Schoene RB, Hornbein TF. Acute mountain sickness and acetazolamide. Clinical efficacy and effect on ventilation. JAMA 1982 248 : 328 332.
23. Swenson ER, Leatham KL, Roach RC, et al. Renal carbonic anhydrase inhibition reduces high altitude sleep periodic breathing. Respir Physiol 1991 86 : 333 343.
24. Grissom CK, Roach RC, Sarnquist FH, Hackett PH. Acetazolamide in the treatment of acute mountain sickness: clinical efficacy and effect on gas exchange. Ann Intern Med 1992 116 : 461 465.
25. Ellsworth AJ, Meyer EF, Larson EB. Acetazolamide or dexamethasone use versus placebo to prevent acute mountain sickness on Mount Rainier. West J Med 1991 154 : 289 293.
26. Montgomery AB, Luce JM, Michael P, Mills J. Effects of dexamethasone on the incidence of acute mountain sickness at two intermediate altitudes. JAMA 1989 261 : 734 736.
27. Hackett PH, Roach RC, Wood RA, et al. Dexamethasone for prevention and treatment of acute mountain sickness. Aviat Space Environ Med 1988 59 : 950 954.
28. Levine B, Yoshimura K, Kobayashi T, et al. Dexamethasone in the treatment of acute mountain sickness. N Engl J Med 1989 321 : 1707 1713.
29. Greene MK, Kerr AM, McIntosh IB, Prescott RJ. Acetazolamide in prevention of acute mountain sickness: a double blind cross over study. BMJ 1981 283 : 811 823.
30. Gertsch JH, Basnyat B, Johnson EW, et al. Randomised, double blind, placebo controlled comparison of ginkgo biloba and acetazolamide for prevention of acute mountain sickness among Himalayan trekkers: the prevention of high altitude illness trial (PHAIT). BMJ 2004 328 : 797.
31. Basnyat B, Gertsch JH, Johnson EW, et al. Efficacy of low-dose acetazolamide (125 mg BID) for the prophylaxis of acute mountain sickness: a prospective, double-blind, randomized, placebo-controlled trial. High Alt Med Biol 2003 4 : 45 52.
32. Basnyat B, Gertsch JH, Holck PS, et al. Acetazolamide 125 mg BD is not significantly different from 375 mg BD in the prevention of acute mountain sickness: the prophylactic acetazolamide dosage comparison for efficacy (PACE) trial. High Alt Med Biol 2006 7 : 17 27.
33. Carlsten C, Swenson ER, Ruoss S. A dose-response study of acetazolamide for acute mountain sickness prophylaxis in vacationing tourists at 12,000 feet (3630 m). High Alt Med Biol 2004 5 : 33 39.
34. Murciano D, Aubier M, Lecocguic Y, Pariente R. Effects of theophylline on diaphragmatic strength and fatigue in patients with chronic obstructive pulmonary disease. N Engl J Med 1984 311 : 349 353.
35. Lakshiminaryan S, Sahn S, Weil J. Effect of aminophylline on ventilatory responses in normal man. Am Rev Respir Dis 1978 117 : 33 38.
36. Hudgel D, Thanakitcharu S. Pharmacologic treatment of sleep-disordered breathing. Am J Respir Crit Care Med 1998 158 : 691 699.
37. Morii S, Ngai AC, Ko KR, Winn HR. Role of adenosine in regulation of cerebral blood flow: effects of theophylline during normoxia and hypoxia. Am J Physiol Heart Circ Physiol 1987 253 : H165 H175.
38. Rabe K, Magnussen H, Dent G. Theophylline and selective PDE inhibitors as bronchodilators and smooth muscle relaxants. Eur Respir J 1995 8 : 637 642.
39. Fischer R, Lang SM, Steiner U, et al. Theophylline improves acute mountain sickness. Eur Respir J 2000 15 : 123 127.
40. Roach R, Bärtsch P, Hackett PH, Oelz O. The Lake Louise acute mountain sickness scoring system. In : 8th International Hypoxia Symposium, Hypoxia and Molecular Medicine Feb 9-13, 1993; Lake Louise, Canada. Burlington : Queen City Printers.
41. Angelini C, Cogo A, Madrigale G, et al. Increased aldosterone levels in acute mountain sickness at Capanna Regina Margherita. Wilderness Environ Med 1997 8 : 247 249.
42. Keller HR, Maggiorini M, Bärtsch P, Oelz O. Simulated descent versus dexamethasone in the treatment of acute mountain sickness: a randomised trial. BMJ 1995 310 : 1232 1235.
43. Kupper T Workload and professional requirements for alpine rescue Professoral Thesis. Aachen : Department of Aerospace Medicine, Aachen Technical University, 2006.
44. Wickramasinghe H, Anholm JD. Sleep and breathing at high altitude. Sleep Breath 1999 3 : 89 102.
45. Lahiri S, Data PG. Chemosensitivity and regulation of ventilation during sleep at high altitudes. Int J Sports Med 1992 13 (Suppl 1 S31 S33.
46. Anholm JD, Powles AC, Downey RD, et al. Operation Everest II: arterial oxygen saturation and sleep at extreme simulated altitude. Am Rev Respir Dis 1992 145 (4 Pt 1 817 826.
47. Mahomed AG, Theron AJ, Anderson R, Feldman C. Anti-oxidative effects of theophylline on human neutrophils involve cyclic nucleotides and protein kinase A. Inflammation 1998 22 : 545 557.
48. Committee to Advise on Tropical Medicine and Travel (CATMAT). Statement on high-altitude illnesses. An Advisory Committee Statement (ACS). Can Commun Dis Rep 2007 33 : 1 20.
49. Fischer R, Lang SM, Leitl M, et al. Theophylline and acetazolamide reduce sleep-disordered breathing at high altitude. Eur Respir J 2004 23 : 47 52.