Page 167 - 2025 Ranger Medic Handbook

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DIPHENHYDRAMINE (BENADRYL)
Class: ENT agent – H 1 -blocker; antihistamine
Action: H1-receptor antagonist and antihistamine as it competes for H 1 -receptor sites on effector cells; significant
central anticholinergic activity as it prolongs action of dopamine by inhibiting its uptake and storage, thus decreasing
Parkinsonism and drug-induced extrapyramidal symptoms
Dose: 25–50mg IV/IM/PO q4–6hr
Onset/Peak/Duration:
IV – Onset immediate/Peak in 1–3 hours/Duration 6–8 hours
IM – Onset 30 minutes/Peak 1–3 hours/Duration 6–8 hours
PO – Onset 15–60 minutes/Peak in 1–3 hours/Duration 6–8 hours
Indications: For allergic conditions; treatment or prevention of motion sickness or vertigo; blood or plasma reactions;
treatment of Parkinsonism and drug-induced extrapyramidal reactions; also used with epinephrine for anaphylaxis;
may be used as a cough suppressant, a sedative-hypnotic or for intractable insomnia
Contraindications: Antihistamine hypersensitivity, lower respiratory tract symptoms, asthma; narrow-angle glaucoma,
prostatic hypertrophy, bladder neck obstruction, GI obstruction, pregnancy category may use during pregnancy and SECTION 4
consider alternative while breastfeedings
Adverse/Side-effects: Drowsiness, dizziness, headache, fatigue, disturbed coordination, tingling, heaviness and
weakness of hands, tremors, euphoria, nervousness, restlessness, insomnia, confusion, excitement, fever, palpita-
tion, tachycardia, hypo- or hypertension, cardiovascular collapse, tinnitus, vertigo, dry nose/mouth, nasal stuffiness,
blurred vision, diplopia, photosensitivity, dry eyes, nausea, epigastric distress, anorexia, vomiting, constipation, diar-
rhea, urinary frequency or retention, dysuria, thickened bronchial secretions, wheezing, chest tightness
Interactions: Alcohol, other CNS depressants, and MAOIs compound CNS depression
Mission Impact: GROUNDING, Sedative effects on patient should be considered in tactical situation
K9 Dosage: 50mg IM/SQ/PO. Impacts sense of smell

DOCUSATE (COLACE)
Class: GI agent – stool softener
Action: Anionic surface-active agent with emulsifying and wetting properties; detergent action lowers surface tension,
permitting water and fats to penetrate and soften stools for easier passage
Dose: 50–500mg/d PO divided qd–qid
Indications: For treatment of constipation associated with hard and dry stools, also used prophylactically in patients
taking narcotics or patients who should avoid straining during defecation
Contraindications: Atonic constipation, nausea, vomiting, abdominal pain, fecal impaction, structural anomalies of
colon and rectum, intestinal obstruction or perforation; patients on sodium restriction or with renal dysfunction; con-
comitant use of mineral oil; pregnancy category may use during pregnancy and while breastfeeding
Adverse/Side-effects: Mild abdominal cramps, diarrhea, nausea, bitter taste; rash
Interactions: Increases systemic absorption of mineral oil

2025 RANGER MEDIC HANDBOOK 153