Page 159 - PJ MED OPS Handbook 8th Ed

Contraindications: asthma, pregnant or lactating females, pregnancy
• Side-effects: sedation, blurred vision
• Adverse reactions: insomnia, vertigo, palpitations, dry mouth, constipation, dysuria, urine
retention

Doxycycline (Doxy )
®
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: antimicrobial – antibiotic; tetracycline
• Indications: suppression and chemoprophylaxis of chloroquine-resistant malaria, short term
prophylaxis and treatment of traveler’s diarrhea caused by enterotoxigenic strains of Esch-
erichia Coli, chlamydial and mycoplasmal infections, gonorrhea, syphilis in penicillin-allergic
patients, rickettsial diseases, acute exacerbations of chronic bronchitis, treatment of acne
• Adult Dose:
○ As antimalarial: 100mg PO qd starting 1–2 days prior to 4 weeks after exposure
○ As antimicrobial: 100mg PO q12h on day 1, then 100mg qd
○ For traveler’s diarrhea: 100mg PO qd during risk period
○ For gonorrhea: 200mg PO immediately, followed by 100mg bid × 3 days
○ For syphilis: 100mg PO tid x 10 days
○ For acne: 100mg PO qd-bid
Contraindications: tetracycline hypersensitivity, use during period of tooth development in-
cluding last half of pregnancy (causes permanent yellow discoloration of teeth, enamel hypo-
plasia and retardation of bone growth)
• Side-effects: nausea, vomiting, diarrhea, anorexia
• Adverse Reactions: interference with color vision, enterocolitis, esophageal irritation, rashes,
photosensitivity reaction, superinfections
• Other Notes:
○ Antacids (Pepto Bismol, Kaopectate, Mylanta, etc.), iron preparation, calcium, magne-
sium, zinc, kaolin-pectin and sodium bicarbonate can significantly decrease absorption
○ Effects of both doxycycline and desmopressin antagonized
○ Increases digoxin absorption and risk of toxicity
○ Methoxyflurane increases risk of renal failure

Epinephrine
GROUNDING medication for personnel on flight status
• Description: alpha and beta adrenergic sympathomimetic
• Indications: anaphylaxis, asthma, pressor for distributive shock not responding to fluids, ACLS
• Adult dose (Epinephrine):
○ 0.3–0.5mg (0.3–0.5mL of 1:1,000 dilution) IM
○ ACLS: 1mg (1:10,000)
○ Infusion: 1mg (1:1000 or 1:10,000) placed in 500mL NS (2mcg/mL) and administered at
2–10mL/min for septic/neurogenic/cardiogenic shock
• Pediatric dose: 0.01mg/kg SQ/IM. Not to exceed 0.5mg

Chapter 9. Pararescue Drug Formulary n 157