Page 169 - 2025 Ranger Medic Handbook

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ERTAPENEM (INVANZ)
Class: Antimicrobial – antibiotic, carbapenem, β-lactam
Action: Broad-spectrum antibiotic that inhibits cell wall synthesis of gram-positive and gram-negative bacteria by its
strong affinity for bacterial cell wall penicillin-binding proteins (PBPs); highly resistant to most bacterial β-lactamases;
effective against most Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter spp.; poorly effective
against enterococci, particularly vancomycin-resistant strains
Dose: 1g IV/IM q24hr (for IV reconstitute with 10mL NS; for IM 3.2mL 1.0% lidocaine without epinephrine)
Indications: For complicated infections of abdomen, pelvis, urinary tract, and skin; also used for community-acquired
pneumonia
Contraindications: Carbapenem, β-lactam, or amide-type local anesthetic (i.e., lidocaine) hypersensitivity; pregnancy
category may use during pregnancy and while breastfeeding
Adverse/Side-effects: Injection site phlebitis or thrombosis; asthenia, fatigue, death, fever, leg pain, anxiety, altered
mental status, dizziness, headache, insomnia; chest pain, hypo- or hypertension, tachycardia, edema; abdominal
pain, diarrhea, acid reflux, constipation, dyspepsia, nausea, vomiting, increased LFTs; cough, dyspnea, pharyngitis,
rales, rhonchi, respiratory distress; erythema, pruritus, rash SECTION 4
Interactions: Probenecid decreases renal excretion
Mission Impact: GROUNDING medication for personnel on flight status

ERYTHROMYCIN OPHTHALMIC OINTMENT
Class: Macrolide antibiotic
Dose: One-half inch ribbon of ointment q3–4hr or 2–6 × daily.
Indications: For superficial ocular infections of the cornea and conjunctiva
Contraindications: Hypersensitivity, astemizole, cisapride, pimozide, terfenadine therapy, pregnancy category may use
during pregnancy and while breastfeeding
Adverse/Side-effects: Minor ocular irritations and redness
Interactions: Terfenadine, atorvastatin, lovastatin, pravastatin, simvastatin, carbamazepine, digoxin, diltiazem, midaz-
o lam, oral contraceptives, ototoxic drugs, penicillins, warfarin
Mission Impact: Blurred vision

ESZOPICLONE (LUNESTA) – CONTROLLED SUBSTANCE IV
Class: Sedative-hypnotic
Action: May potentiate effects of inhibitory neurotransmitter γ-aminobutyric acid (GABA) by binding close to or with
benzodiazepine receptors
Dose: 2mg up to 3mg immediately at bedtime. Maintenance dose 3mg
Indications: Insomnia
Contraindications: Hypersensitivity, pregnancy category consider alternative during pregnancy and avoid use while
breastfeeding
Adverse/Side-effects: Agitation, anxiety, confusion, depression, dizziness, hallucinations, HA, nervousness, neural-
gia, unusual dreams, chest pain, peripheral edema, dry mouth, gynecomastia, diarrhea, indigestion, hepatitis, nausea,
vomiting, decreased libido, dysmenorrhea, UTI, asthma, respiratory tract infection, pruritus, rash, or heat stroke
Interactions: Clarithromycin, ketoconazole, itraconazole, rifampin, and alcohol
Mission Impact: Grogginess. Puts patient at higher risk for heat injury. GROUNDING medication for per-
sonnel on flight status

2025 RANGER MEDIC HANDBOOK 155