Page 170 - 2025 Ranger Medic Handbook

FENTANYL – CONTROLLED SUBSTANCE II
Class: CNS agent – potent narcotic (opiate) agonist
Action: Action similar to that of morphine with more rapid and less prolonged analgesia and sedation, but less emetic
effect
Dose: 800mcg/dose (max 1600mcg/day); lozenge on a stick to be placed in mouth between cheek and lower gum and
sucked, not chewed (have opioid antagonist [naloxone] immediately available!) IV: For severe pain 50–100mcg IV/IO/IM
(consider doubling IV/IO dose for IM) q1–2hr prn
Onset/Peak/Duration: TD: Onset 15 minutes; peak 20–40 minutes; duration 2–3 hours. IV/IO: Onset immediate; peak
30–60 minutes; duration 2–4 hours
Indications: For moderate to severe pain management
Contraindications: MAOIs; myasthenia gravis; pregnancy category consider alternative during pregnancy and may
use while breastfeeding (caution advised in patients trying to conceive)
Adverse/Side-effects: Sedation, euphoria, dizziness, diaphoresis, delirium, convulsions, bradycardia, hypotension,
SECTION 4 circulatory depression, cardiac arrest; miosis, blurred vision; nausea, vomiting, constipation, ileus; muscle and tho-
racic muscle rigidity; urinary retention, rash; laryngospasm, bronchoconstriction, respiratory depression or arrest
Interactions: Alcohol and other CNS depressants potentiate effects; MAOIs may precipitate hypertensive crisis
Mission Impact: GROUNDING medication for personnel on flight status

FEXOFENADINE (ALLEGRA)
Class: ENT agent – H 1 -receptor antagonist; nonsedating antihistamine
Action: Competitively antagonizes histamine at the H 1 -receptor site; does not bind with histamine to inactivate it; not
associated with anticholinergic or sedative properties; inhibits antigen-induced bronchospasm and histamine release
from mast cells
Dose: 60mg PO bid or 180mg PO qd
Indications: For symptom relief from seasonal allergic rhinitis (nasal congestion and sneezing, watery or red eyes,
itching nose, palate, or eyes) and chronic urticaria
Contraindications: Fexofenadine hypersensitivity; pregnancy category may use during pregnancy and caution ad-
vised while breastfeeding
Adverse/Side-effects: Headache, drowsiness, fatigue, nausea, dyspepsia, throat irritation
Interactions: No clinically significant interactions established

156 SECTION 4 RANGER MEDIC PHARMACOLOGY & FORMULARY