Critical Care Medicine-Neurologic Disorders>>>>>Other Parenchymal Disease and pulmonary edema
Question 7#

Which among the following medications is indicated for treatment of high-altitude pulmonary edema, in absence of oxygen while awaiting for descent?

A. Dexamethasone
B. Salmeterol
C. Nifedipine
D. Sildenafil

Correct Answer is C

Comment:

Correct Answer: C

Sustained release oral nifedipine is the drug of choice in high-altitude pulmonary edema (HAPE) (Grade 1C). Other drugs reduce pulmonary vasoconstriction and thus might be useful in treatment of HAPE. However, their clinical efficacy has not been proven. While phosphodiesterase inhibitors have a strong biological rationale, data from prospective studies are missing. Use of inhaled beta-agonist is reported in literature, but there is not enough data to support these drugs. Dexamethasone has been proved to reduce the incidence of HAPE in a placebo-controlled trial, yet its role in treating the established acute disease has not been validated. 

References:

1. Bartsch P, Swenson ER. Clinical practice: acute high-altitude illnesses. N Engl J Med. 2013;368(24):2294-2302.
2. Pennardt A. High-altitude pulmonary edema: diagnosis, prevention, and treatment. Curr Sports Med Rep. 2013;12(2):115-119.