• Alexander M Posch, Stewart Dandorf, and David C Hile.
• Nova Southeastern University College of Osteopathic Medicine, Davie, FL (Mr Posch) and the Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD (Drs Dandorf and Hile). Electronic address: ap2305@mynsu.nova.edu.
• Wilderness Environ Med. 2018 Dec 1; 29 (4): 541-545.

AbstractLowlanders rapidly ascending to high altitude (>2500 m) often develop acute mountain sickness (AMS). While acclimatization is the most effective method of reducing symptoms of AMS (ie, headache, fatigue, nausea, gastrointestinal distress, etc.), it may take several days to become fully acclimated. Prophylactic use of acetazolamide (AZ), a carbonic anhydrase inhibitor, has become a popular alternative to staged acclimatization because it can be a less time-consuming method of reducing symptoms of AMS. While numerous studies have shown the effectiveness of AZ in mitigating the symptoms of AMS, a review of the existing literature regarding the effects of AZ on submaximal and maximal exercise performance at sea level and at altitude has not been performed. Literature search identified 17 peer reviewed articles examining the effects of AZ on exercise performance both at sea level and at altitude, as well as the associated side effects of prophylactic AZ use for the attenuation of AMS. This review finds that AZ treated cohorts experience a reduction in time to exhaustion during both submaximal and maximal exercise performance at sea level. At altitude, AZ treated cohorts' recorded widely variable submaximal and maximal exercise performance. At sea level, AZ impairs submaximal and maximal exercise performance. Due to the wide variation of findings of previously published studies, the effects of AZ on submaximal and maximal exercise performance at altitude remain unknown.Copyright © 2018 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

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