Page 160 - PJ MED OPS Handbook 8th Ed

Contraindications: Use caution in patients with a history of heart disease or over the age of
40. Do not inject epinephrine (or solutions containing Epi) into/near the fingers, toes, nose,
ears or penis. Intense vasoconstriction may cause necrosis. Pregnancy.
• Side-effects: cardiac arrhythmias, angina, hypertension
• Adverse reactions: uncontrolled effects on myocardium and arterial system

Ertapenem IV (Invanz )
®
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: carbapenem antibiotic
• Indications: drug of choice for all significant open wounds, complicated intra-abdominal in-
fections, complicated skin infections, pneumonia, complicated UTI, including pyelonephritis
• Adult dose: 1g IV/IM
○ For IV administration: Reconstitute with 10mL of .9% NS and infuse over 10 minutes in
100mL NS, or slow IV push in 1mL bumps over 10min (1mL/min, in 10mL syringe with 1g
ertapenem).
○ For IM administration only: Reconstitute 1g vial of ertapenem with 3.2mL of 1% lidocaine
(without Epi), shake. Administer by deep IM injection into large muscle mass (e.g., glute
or lateral thigh).
• Pediatric dose: 30mg/kg/day in 2 divided doses
Contraindications: hypersensitivity to ertapenem or other carbapenems, penicillin allergy
with documented severe reaction to PCN
• Side-effects: infused vein phlebitis/thrombophlebitis
• Adverse reactions: seizures
• Other notes: Visually inspect any solution of ertapenem for particulate matter and discolor-
ation prior to use when possible. Variations in color do not affect potency of the drug.
○ IV administration – must be reconstituted prior to administration
n Do not mix or co-infuse with other medications
n Do not use diluents containing dextrose
n Reconstitute the contents of a 1g vial of ertapenem with 10mL of 0.9% NaCl, or bacte-
riostatic water for injection
n Shake well to dissolve, and immediately transfer contents to 50mL of 0.9% NaCl
n Complete infusion within 6 hours of reconstitution – (goal 30 minutes)
○ IM administration – must be reconstituted prior to administration

WARNING DO NOT ADMINISTER THE RECONSTITUTED IM SOLUTION VIA IV

n Reconstitute the contents of a 1g vial of ertapenem with 3.2mL of 1% lidocaine HCl
injection (without epinephrine). Shake vial thoroughly to form solution.
n Immediately withdraw the contents of the vial, and administer by deep IM injection
into a large muscle mass (such as the gluteal muscles or lateral part of the thigh).
n Use the reconstituted IM solution within 1 hour after preparation.

158 n Pararescue Medical Operations Handbook / 8th Edition