Page 170 - PJ MED OPS Handbook 8th Ed

Contraindications: absence of radial pulse, obtunded, patient is taking erectile dysfunction
drugs, pregnancy
• Adverse reactions: severe hypotension, nitrate tolerance (excessive or continuous use), bra-
dycardia (paradoxical), anaphylaxis, methemoglobinemia
• Side-effects: headache, lightheadedness, dizziness, flushing, orthostatic hypotension, reflex
tachycardia, edema

®
Ondansetron (Zofran )
GROUNDING medication for personnel on flight status
Waiver: Combat Rescue Officer, Pararescue, and Combat Control following ground test
• Description: antiemetic
• Indications: nausea and vomiting
• Adult dose: 4–8mg PO/IV/IM q4hr PRN
• Pediatric dose: 2mg PO/IV/IM
Contraindications: allergy, history of congenital QT prolongation
• Side-effects: minimal and rare
• Caution: patients with history of underlying cardiac disease
• Adverse reactions: rare

Oxymetazline HCl (Afrin® Nasal Spray)
GROUNDING for Air Force personnel on flight status prior to flight; however it can be used
as a “get me down” drug for unexpected ear/sinus blocks during flight/decompressive dive duty.
• Description: vasoconstrictor (decongestant)
• Indications: Use as an adjunct to Valsalva maneuver to clear ears and sinuses during com-
pression and decompression. Sinus and nasal congestion. Adjunct for treatment for baro-
trauma to the ears (blast and dive medicine).
• Dose: spray into each nostril 2 times, twice daily; not to exceed 3 consecutive days due to
rebound congestion
Contraindications: severe damage to tympanic membrane/sinuses from barotrauma,
pregnancy
• Side-effects: sneezing and stinging of nasal mucosa
• Adverse reactions: rebound congestion

®
Pseudoephedrine (Sudafed )
GROUNDING medication for personnel on flight status.
• Description: Adrenergic class. Primary activity though α-effects on respiratory mucosal mem-
branes reducing congestion, hyperemia, edema, and minimal bronchodilation secondary to
β-effects.
• Indications: nasal decongestant and adjunct in otitis media with antihistamines, adjunct for
barotrauma to the ears
• Adult Dose: 30–60mg q4–6hr PO

168 n Pararescue Medical Operations Handbook / 8th Edition