Page 70 - 2021 Advanced Ranger First Responder Handbook

MOXIFLOXACIN – Combat Wound Pillpack
Class: Antimicrobial – antibiotic
Action: Broad-spectrum bactericidal agent that inhibits DNA gyrase topoisomerase II, an enzyme necessary for bac-
terial replication, transcription, repair, and recombination; effective against gram-positive and gram-negative organ-
isms: Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, Moraxella
catarrhalis, Chlamydia pneumoniae, Mycoplasma pneumoniae, and other microbes.
Dose: 400mg PO
Indications: Combat wounds that cause a break in the skin but the patient is able to take medications by mouth.
Contraindications: Poor or worsening mental status or unconsciousness.
Adverse/Side Effects: Tendon rupture, dizziness, headache, peripheral neuropathy, nausea, diarrhea, abdominal
pain, vomiting, taste perversion

TRANEXAMIC ACID (TXA)
Class: Antifibrinolytic agent; synthetic lysine amino acid derivative
Action: Displaces plasminogen from surface of fibrin by binding to high-affinity lysine site of plasminogen which
diminishes dissolution of hemostatic fibrin, which decreases bleeding.
Dose: Administer 2g of TXA IV/IO as soon as possible but not later than 3 hours after injury.
Indications: For patients anticipated to need significant blood transfusion presenting with hemorrhagic shock, one or
more major amputations, penetrating torso trauma or evidence of severe bleeding.
Adverse/Side Effects: Blurred vision or impaired color vision. Gastrointestinal disturbances (nausea, vomiting, diar-
rhea) may occur but disappear when the dosage is reduced. Transient hypotension has been observed when intra-
venous injection is too rapid.
Mission Impact: Store at 25°C (77°F); excursions permitted to 15°–30°C (59°–86°F)
Mission Specific: May predraw, under sterile conditions and kept for 7 days before mandatory disposal. All TXA will
be predrawn under Ranger Medic direct observation.
DO NOT USE IF PREDRAWN AND STORED FOR > 7 DAYS

MISC

60 SECTION 7 MISCELLANEOUS PROTOCOLS