All travelers should be up-to-date on routine vaccinations and inquire about region-specific vaccinations as soon as possible after deciding upon an expedition location. Climbers should acquire needed medications prior to departure. Prescription medications should stay in their original packaging to prove they are prescribed by a physician for the person carrying them during customs and border checks. Despite this, be prepared for a routine practice of confiscation in some countries, whether legal or illegal. While medications can be cheaper in the developing world, they may also be substandard in quality. All personal medications should be carried onto airlines, and once in-country separated into two different bags in case of loss or damage of baggage.
Basic field kits should include elements of the following drug groups:
Analgesics relieve pain and antipyretics reduce fever. Drugs that relieve pain can be classified as mild, moderate, or strong. Strong analgesics and codeine are controlled substances in the United States, and a prescription is needed to obtain them. Strong analgesics should only be given when required for severe pain and for no longer than two weeks. A less potent analgesic should be started once the pain has been reduced.
Epinephrine is used for anaphylaxis. For non-anaphylactic reactions, antihistamines are usually used.
Antacids are drugs that neutralize acids in the stomach for the treatment of indigestion, peptic ulcers, heartburn, and GERD. For long-term maintenance, a proton pump inhibitor, such as omeprazole, Prevacid®, Protonix®, Nexium®, or Zantac® are good choices.
A broad-spectrum antifungal agent can be used topically for fungal skin infections. There are multiple over-the-counter (OTC) brands available.
These agents block histamine, which is a substance that is released in the body during an allergic or inflammatory reaction. These medications are also used to reduce motion sickness. An example of this drug class is Benadryl®.
Antimicrobials kill or reduce the spread of microorganisms that include bacteria, viruses, protozoa, and parasites that can cause infection. Note that the specific term “antibiotic” only refers to antimicrobials that kill bacteria (and sometimes protozoa and parasites). Antibiotics are not effective against viruses.
Climbers traveling to malaria-endemic regions must get the most current recommendations, as effective drugs change frequently. For self-treatment of malaria, a therapeutic dose of the appropriate antimalarial drug should be given, but only when a significant fever accompanied by systemic illness occurs. This is a last resort and the goal is to prevent death. Medical attention should be sought within twenty-four hours.
Antimotility drugs are used to control diarrhea through reduction of intestinal motility. The most commonly used example of this type of drug is loperamide (Imodium®). These agents should be used sparingly, if at all, in individuals with dysentery or fever (see Chapter 7). Antiemetic medications are used to reduce vomiting. A common example of this type of drug is ondansetron (Zofran®), which comes in a convenient oral dissolving tablet (ODT). This means that the medication need not be swallowed, in case of severe vomiting.
Antiseptics are used to kill microorganisms on contact, and are useful for cleaning a wound or disinfecting contaminated water. Alcohol swabs are lightweight and easy to carry.
Better known as cough drops, these drugs help minimize coughing and aid in the relief of a sore throat.
Decongestants aid with congestion in the upper respiratory tract. This class of drugs functions by causing the blood vessels in the nasal mucosa to contract, thus promoting sinus drainage related to a cold, hay fever, or sinusitis.
These medications are used for constipation, which can occur from dehydration or as a side effect from the taking of pain medications.
Antihistamines are the most commonly used medications for motion sickness. Sedation is a common side effect of these medications. There are non-sedating medications available or non-pharmacological interventions that can help manage motion sickness. Nonmedical solutions to motion sickness include: driving a vehicle instead of riding, sitting in the front seat of a vehicle rather than the back, sitting over the wing of an aircraft, or sitting in the central cabin on a ship. Lying prone with eyes closed or sitting and focusing on the horizon also works for some individuals.
These solutions can be used for travelers suffering from dehydration occurring due to strenuous activity, vomiting, and/or diarrhea. See Chapter 13.
Sedation or sleeping medications are used for insomnia or anxiety. These drugs should not be taken above 3,000 meters (10,000 feet) because respirations are decreased, which can lead to hypoxemia and an increased risk of AMS. Certain sedating medications such as benzodiazepines may cause persistent drowsiness and should only be given if there is adequate time for the drug to wear off. These medications should not be given to individuals with head injuries or central nervous system diseases. Alcohol should not be consumed, as the depressive effects of the medication are enhanced. Some antihistamines that are sold over the counter have a sedating effect and can be utilized to assist in sedation.
The following list of vaccinations and preventive medications/measures should be considered for overseas travel in addition to the basic field kit. Consult a physician to receive the latest guidance on needed vaccinations and preventive medications as disease locales can change rapidly (e.g., Zika virus in 2015–2016).
Yellow fever vaccine and antimalarial medications should be considered. As of the summer of 2016, Zika virus is a growing concern in Brazil, although no vaccination is currently available.
Hepatitis A, B, and typhoid vaccinations, and for some travelers, the rabies vaccination should be included. Antimalarial drugs should be taken. Mosquito precautions should be taken, as dengue fever could be a concern. Cutaneous leishmaniasis can be a concern when walking barefoot on contaminated beaches.
Antimalarial medications should be considered.
Hepatitis A, B, typhoid, and possibly rabies vaccinations should be acquired prior to travel. Mosquito precautions should be taken, as dengue and Zika virus are a risk. Vaccination against yellow fever is recommended for certain areas.
Consider vaccines for hepatitis A, B, typhoid, Japanese encephalitis (JE), and rabies vaccinations prior to travel. Antimalarial medications should be considered.
Hepatitis A, B, typhoid, and yellow fever vaccinations should be given prior to travel. Antimalarial drugs should be considered depending on the time of travel. Tick bites caused by rickettsial species can be fatal, and measures should be taken to avoid exposure (“Tick Bite” sidebar on pages 180–181). HIV is a concern in this region, and appropriate caution is advised. Ebola is generally only seen in certain West African countries, not in Southern or East African regions, but preventive measures should be taken to avoid exposure if traveling in those countries.
Hepatitis A, B, rabies, and typhoid vaccinations are recommended. Japanese encephalitis (JE) vaccine should be considered for climbers traveling for extended periods in certain locations. Antimalarial medications should also be considered. Mosquito precautions should be taken, as dengue fever and chikungunya are an issue, particularly at the end of the monsoon season.
Hepatitis A, B, rabies, and typhoid vaccinations are recommended. Mosquito precautions should be taken, as dengue fever is a concern. Antimalarial medications should be considered depending on the location of travel. Flea and tick bites should be avoided, as rickettsial disease, including Rocky Mountain spotted fever and flea-borne typhus, can occur (“Tick Bite” sidebar on pages 180–181).
Hepatitis A, B, rabies, typhoid, and Japanese encephalitis vaccinations are recommended. Antimalarial medications should be considered depending on the location of travel.
Hepatitis A, B, and typhoid vaccinations are recommended. Antimalarial medications should be taken.