Page 348 - ATP-P 11th Ed

Side-effects:
• Cardiovascular – angina pectoris, chest pain, hypotension, myocardial infarction, pos-
tural hypotension, tachycardia
• Digestive – dry mouth, dysphagia, esophagitis, gastritis
• Ophthalmologic – blurred vision, conjunctivitis (including conjunctival hyperemia), eye
pain
Warnings:
• Alpha blockers: coadministration may potentiate the blood pressure-lowering effects of
alpha blockers.
• Antihypertensive: coadministration may potentiate the blood pressure-lowering effects
of alpha blockers.
• Antacids: simultaneous administration of antacids reduces the absorption of Cialis.
• Ritonavir and HIV protease inhibitors: Increased tadalafil absorption.
TMEP use: Altitude Illness Protocol
SECTION 3 Sodium Bicarbonate
GROUNDING medication for personnel on flight status
Description: Alkalinizing agent, electrolyte
Action:
• Sodium bicarbonate combines with hydrogen ions to form water and carbon dioxide.
• Buffers metabolic acidosis
• Forces an intracellular shift of excess potassium in hyperkalemia.
• Increased pH
Indications:
• Severe metabolic acidosis in cardiac arrest refractory to ventilation
• Tricyclic antidepressant overdose
• Hyperkalemia
• Alkalinization agent for specific toxins (salicylates, phenobarbital)
Dose: 1mEq/kg IV
Contraindications:
• Metabolic or respiratory alkalosis
• Hypocalcemia
• Hypokalemia
• Hypernatremia
Pregnancy Category C
Side-effects/precautions:
• Metabolic alkalosis may occur.
• Precipitates when mixed with calcium chloride or gluconate.
• May increase intracellular acidosis.

338 SECTION 3 RECOMMENDED DRUG LIST (RDL)