Page 158 - PJ MED OPS Handbook 8th Ed

• Side-effects/precautions: extravasation may cause tissue damage and necrosis; rapid injec-
tion may cause vasodilation, hypotension, bradycardia, cardiac dysrhythmia, syncope, and
cardiac arrest.

®
Ciprofloxacin (Cipro )
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: 2nd generation gram negative antimicrobial – antibiotic; quinolone
• Indications: infections of lower respiratory tract, skin and skin structures, bone and joints,
GI tract, urinary tract and prostate; nosocomial pneumonia; acute sinusitis; post-exposure
prophylaxis for anthrax
• Adult Dose: 250–750mg PO bid or 200-400mg IV q8–12hr
Note: Not first line treatment
Contraindications: quinolone hypersensitivity, syphilis, viral infection, tendon inflammation,
tendon pain
• Side-effects: nausea, vomiting, diarrhea, cramps, gas
• Adverse Reactions: pseudomembranous colitis, tendon rupture, headache vertigo, malaise,
peripheral neuropathy, seizures
• Other Notes:
○ May increase theophylline levels; antacids, sulcralfate, iron decreases absorption; may
increase PT for patients on warfarin; may cause false positive on opiate screening tests

Dexamethasone (Decadron )
®
GROUNDING medication for personnel on flight status
• Description: parenteral steroid (glucocorticoid)
• Indications: emergency treatment of AMS, HACE, when tactical conditions preclude descent
or acclimatization; inflammatory conditions; allergic conditions and anaphylaxis
• Dose (Human): AMS 4mg PO q6hr, HACE 8mg IV/IM, then 4mg IV/IM q6hr, anaphylaxis 10mg
IV/IM
• K9 dose: 4mg IV/IM/PO q6hr
Contraindications: pregnancy, caution in patients with a Hx of: diabetes, hypertension, ulcers
• Side-effects: edema
• Adverse effects usually dose related: psychotic behavior, congestive heart failure; hyperten-
sion; hypokalemia; hyperglycemia

Diphenhydramine HCl (Benadryl )
®
GROUNDING medication for personnel on flight status
• Description: antihistamine; prevents (but does not reverse) histamine-mediated responses,
H1 blocker
• Indications: allergic symptoms and/or allergic reactions, sleeping aid in non-aircrew members
• Adult dose: 25–50mg IM/IV/PO q6hr; max dose 400mg/day
• Pediatric dose: (Children <12 years): 5mg/kg/day in divided doses qid PO/IM/IV

156 n Pararescue Medical Operations Handbook / 8th Edition