Page 150 - PJ MED OPS Handbook 8th Ed

Transportation of Controlled Substances:
• Include a statement authorizing personnel to carry professional gear, e.g., medical kits con-
taining various medications including controlled substances, in the remarks section of admin-
istrative orders.
• It is best to list an inventory of specific medications actually transported. If this is not possi-
ble, list “Narcotics Courier” on the orders of all personnel potentially able to carry controlled
substances. Also note that some countries are concerned about illegally manufactured drugs
from over-the-counter medications (e.g., Sudafed).
Destruction of Controlled Substances:
• Two disinterested individuals of equal or greater rank will witness the destruction. The fol-
lowing witness statement will be placed on the controlled substance registrat (AF 579) and
signed by the PJ and two witnesses: “I have witnessed on this date the destruction of the
materiel described on this document, in the quantity and manner indicated.”
• Material will be destroyed in a manner that precludes the re-use of any portion of the item for
any purpose. Items such as needles and syringes must be unrecognizable as well as unusable.

The following factors can influence the therapeutic effects of medications:
• Age
• Body Weight
• Sex
• Route of administration
• Time of administration
• Rate of inactivation and excretion
• Tolerance
• Pathological state – poor perfusion, hypothermia
• Genetic factors
• Drug interaction

Allergy and Hypersensitivity:
Hypersensitivity reactions can vary in presentation. Antibiotics are the most common cause; how-
ever, any medication may be at fault. Allergic reaction to any antigen, e.g., snake envenomation,
insect stings, pollens, etc., can cause similar symptoms.

Reactions may include, but are not limited to:
• Allergic rhinitis, reactive airway/asthma or profound hypotension
• Local reactions may include GI distress (nausea, vomiting, cramps, and diarrhea) and/or der-
mal presentation (pruritic (itchy) skin, urticaria (hives), local rash.
• Life threatening reactions (anaphylaxis) can occur within minutes and may include:
○ Tightness in the chest and wheezing
○ Skin changes: diffuse redness, hives and flushing
○ Angioedema or red, swelling of the face
○ Rapidly progressive respiratory distress due to laryngeal edema, bronchospasm and fluid
accumulation in the lungs
○ Hypotension/overt signs of shock

148 n Pararescue Medical Operations Handbook / 8th Edition