Page 157 - PJ MED OPS Handbook 8th Ed

Contraindications: atrial fibrillation, atrial flutter, glaucoma; use extreme caution in patients
with Type II AV block and in 3rd degree block, pregnancy
• Side-effects: dilated pupils, increase heat rate, ventricular tachycardia, ventricular fibrilla-
tion, dry mouth
• Adverse reactions: hypotension, CNS anticholinergic effects

Azithromycin (Zithromax , Z-Pak )
®
®
Aviation personnel are grounded for the initial 24 hours of antibiotic therapy and until the
medical condition no longer interferes with safely performing aviation duties and the patient is free
of side-effects.
• Description: Macrolide antibiotic
• Indications: acute bacterial sinusitis, mild community-acquired pneumonia, chancroid (Gen-
ital ulcer disease), pharyngitis/tonsillitis as alternative drug choice to first line therapy, un-
complicated skin infections, urethritis.
• Adult Dose:
○ For most bacterial infections: 500mg as single dose on day 1, then 250mg daily on days
2 through 5.
○ For gonorrhea: 2g PO as a single dose
• Pediatric Dose: (6 months of age or older)
○ Z-Pak® is not indicated for children. The oral suspension is the only dose approved for use
in children, and is dosed on a mg/kg basis.
n 10mg/kg up to 500mg the first day; then 5mg/kg up to 250mg for the next 4 days
Contraindications: known allergy to azithromycin, pregnancy, Z-pak® in children, patients
receiving:
○ Astemizole (Hismanal®) - antihistamine taken off of the U.S. market)
○ Cisapride (Propulsid®) - GI medication taken off of the U.S. market)
• Side-effects: nausea, vomiting, diarrhea, abdominal pain
○ Generally mild and reversible upon discontinuation of therapy
• Adverse Reactions: Hypersensitivity
○ Rare: Angioedema (swelling of the larynx), Cholestatic jaundice
• Other Notes:
○ Can be taken with or without food
○ Continue regimen for duration of prescription
Calcium Gluconate
GROUNDING medication for Army personnel on flight status
• Description: Calcium salt
• Action: Increased calcium levels; has a role in the release of neurotransmitters and hor-
mones; increased cardiac contractile state; may increase ventricular automaticity
• Indications: Acute hypocalcemia (possible complication from a fresh whole blood transfusion
bag not fully filled); acute hyperkalemia (CRUSH syndrome, rhabdomyolysis, kidney failure in
patients not receiving dialysis in time); calcium channel-blocker overdose.
• Dose: 1g (10mL of a 10% solution); 2.25–14mEq IV repeated in 1 to 2 minutes
Contraindications: hypercalcemia

Chapter 9. Pararescue Drug Formulary n 155