ABSTRACT
Acetazolamide is a sulphur-based drug that is often used to prevent or treat acute mountain sickness (AMS). Use of this drug has gained popularity especially as high altitude travelling increases and trekkers want to increase the speed of acclimatisation. (Krasney, 1993). The pharmacological effect of acetazolamide is the inhibition of carbonic anhydrase. Carbonic anhydrase is the enzyme that catalyses the conversion of carbon dioxide (CO2) and water (H2O) to carbonic acid (H2CO3). Thus, when acetazolamide is administered, there is interference with CO2 transport. Renal excretion of bicarbonate occurs, causing intracellular acidosis, which stimulates respiration. (Hultgren, 1997; Ward et al.,1995; Pollard & Murdoch, 1997). The drug stimulates ventilation, which brings greater volumes of air into the lungs and therefore oxygen into the body and aids acclimatisation. Prevention of AMS involves sensible acclimatisation through gradual ascent. The use of the prophylaxis, acetazolamide is also effective for the first 4-6 days at high altitude. (Hultgren,1997). The effectiveness of acetazolamide in the prevention and treatment of AMS has been clearly established in adults in a number of well-controlled studies since the mid 1960’s. (Greene et al, 1981; Grissom et al., 1992). No clinical trials of acetazolamide have been conducted
on children or the effects of the drug on physiological parameters; however, there is no reason to suggest that its use would not be effective. (Pollard & Murdoch, 1997). Most scientific research at altitude has involved adults, mostly male and there is a dearth of research on teenagers at altitude. The purpose of the investigation is to look at effect of carbonic anhydrase inhibitor, acetazolamide on following physiological responses; resting heart rate (RHR), resting blood pressure (RBP), haemoglobin and hematocrit in 15-year-olds on a high altitude (HA) trek in Ladakh, India. The effectiveness of the prophylaxis, acetazolamide, as an aid to acclimatisation will also be investigated.
