The drug recommended for chemoprophylaxis 1 day before induction into high altitude areas is
**Question:** The drug recommended for chemoprophylaxis 1 day before induction into high altitude areas is:
A. Aspirin
B. Acetazolamide
C. Ibuprofen
D. Dexamethasone
**Core Concept:** Chemoprophylaxis is the use of medications to prevent or reduce the risk of developing a particular disease or complication. High altitude areas can lead to altitude sickness, which is a group of symptoms caused by reduced partial pressure of oxygen. Acute Mountain Sickness (AMS) is the most common form of altitude sickness.
**Why the Correct Answer is Right:** Doxylamine is a first-generation antihistamine often used for its sedative and antiemetic properties. Aspirin (salicylic acid) is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief, fever, and inflammation management. Ibuprofen is a selective COX-2 inhibitor and NSAID, used for pain, inflammation, and fever relief. Dexamethasone is a synthetic glucocorticoid, used for its anti-inflammatory, immunosuppressive, and anti-allergic properties.
**Why Each Wrong Option is Incorrect:**
A. Aspirin is not specifically designed for altitude sickness prevention, and its use may increase the risk of thrombocytopenia and gastrointestinal bleeding.
B. Acetazolamide (an antigluconeogenesis agent) is a correct choice for prevention of altitude sickness due to its carbonic anhydrase inhibition, improving oxygen saturation and preventing fluid retention.
C. Ibuprofen is not specifically developed for altitude sickness prophylaxis and could increase the risk of gastrointestinal bleeding and kidney damage.
D. Doxylamine, a sedative and antihistamine, is not a suitable choice for altitude sickness prevention as it does not address the specific issues caused by high altitude, such as decreased oxygen availability and fluid retention.
**Clinical Pearl:**
Prophylactic acetazolamide is recommended for chemoprophylaxis against altitude sickness due to its efficacy in improving oxygen saturation, preventing fluid retention, and reducing the risk of gastrointestinal and renal side effects.