A 32-year-old mountaineer presents to the high-altitude medical clinic with symptoms of severe headache, confusion, and ataxia. He has been climbing at an altitude of 4,500 meters for the past three days.
You suspect high-altitude cerebral oedema (HACE) based on the clinical presentation. Which of the following is the most appropriate initial pharmacological treatment?
A
Acetazolamide 250 mg orally, twice daily
B
Nifedipine 30 mg extended-release, once daily
C
Dexamethasone 8 mg intramuscularly, followed by 4 mg every 6 hours
D
Sildenafil 50 mg orally, three times daily
E
Furosemide 40 mg orally, once daily