Page 153 - PJ MED OPS Handbook 8th Ed

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Acetaminophen – PO (Tylenol ), IV (Ofirmev )
• Description: non-narcotic analgesic and antipyretic, blocks generation of pain impulses in the
CNS by preventing sensitization of pain receptors
• Indications: mild pain or fever, febrile reactions from blood transfusions
• Dose: 325–650mg PO q4–6hr; or 1g PO/IV q6–8hr
Contraindications: Individuals with hypersensitivity to drug or chronic liver damage. Caution
in use with patients diagnosed with a history of excess alcohol use.
• Side-effects: rash, urticaria
• Adverse reactions: hemolytic anemia, liver damage

Acetazolamide (Diamox)
GROUNDING medication for personnel on flight status
Waiver: If approved by MAJCOM protocol – Combat Rescue Officers, Pararescue, Combat
Control, and TAC-P are waived (No DNIF) upon completion of 3 day ground test.
• Description: non-diuretic antihypertensive (carbonic anhydrase inhibitor)
• Indications: Prevention and/or amelioration of symptoms associated with acute mountain sick-
ness in climbers attempting rapid ascent and/or those who are very susceptible to acute moun-
tain sickness despite gradual ascent. For maximum benefit begin regimen 7 days prior to as-
cent. Of minimal benefit in Rx of AMS, HACE, or HAPE. Treatment of acute high altitude illness.
• Dose (Human):
○ 125mg bid: prevention of Acute Mountain Sickness, 24 hours prior to ascent, continuing for
48 hours after ascent. Prevention and/or amelioration benefits are nominal once ascent has
commenced. If the 500mg sustained release tablet is used, dose is 500mg q24hr.
○ 250mg bid: treatment of existing Acute Mountain Sickness
• K9 dose: 250mg bid 24 hours prior to ascent, continuing for 48 hours after ascent. If the
500mg sustained release tablet is used, dose is 500mg q24hr.
Contraindications: sulfa allergy, pregnancy
• Side-effects: paresthesias in extremities (very common in fingers/toes); hearing dysfunction/
tinnitus; loss of appetite; taste alterations; polyuria; drowsiness; confusion; increased fluid
intake is required with use of diamox: although diamox is not in the general drug class of
“ diuretics”; it has diuretic effects and can result in serious dehydration unless great care is
taken to maintain proper hydration.
• Adverse reactions: transient myopia; urticaria; melena; photosensitivity; convulsions

Adenosine (Adenocard)
GROUNDING medication for personnel on flight status.
• Description: antiarrhythmic agent
• Indications: Used to convert PSVT, WILL NOT convert atrial flutter, atrial fibrillation, or VT.
• Adult dose: 6mg rapid IV bolus (1–3 sec) followed by 10mL flush. Two additional doses of
12mg can be administered following the same rapid push sequence.
• Pediatric dose: 0.1–0.2mg/kg IV rapid push, if IO up to 6mg
Contraindications: 2nd/3rd degree AV block, sick sinus syndrome, pregnancy

Chapter 9. Pararescue Drug Formulary n 151