Page 171 - PJ MED OPS Handbook 8th Ed

• Pediatric dose:
○ 6–12 yrs: 30mg/dose PO q4–6hr
○ 2–5 yrs: 15mg/dose PO q4–6hr
Contraindications: hypersensitivity, narrow angle glaucoma, pregnancy
• Precautions: pregnancy, cardiac disorders, hyperthyroidism, diabetes mellitus, prostatic hy-
pertrophy, lactation, hypertension
• Side-effects:
○ CNS – Tremors, anxiety, insomnia, headache, dizziness, hallucinations, seizures
○ CV – Palpitations, tachycardia, hypertension, chest pain, dysrhythmias
○ EENT – Dry nose, irritation of the nose and throat
○ GI – Nausea, vomiting, anorexia, dry mouth
○ GU – dysuria

CAUTION: Do not use continuously, or more than recommended dose. Rebound congestion
may occur. Avoid taking at bedtime, stimulation may occur.

Rocuronium (Zemuron)
• Description: non-depolarizing paralytic agent
• Indications: skeletal muscle relaxant for RSI and mechanical ventilation, facilitate tracheal
intubation
• Dose:
○ Intubation: 1mg/kg IV/IO (Usual dose 100mg)
○ Maintenance: 0.1–0.2mg/kg IV/IO (usual dose 10mg) q20–30min PRN
○ Onset of 4–6 minutes and duration: 30–45 minutes
Contraindications: allergy, pregnancy
• Adverse reactions: Apnea, hypotension, hypertension, tachycardia, allergic reaction
• Note:
○ Onset of flaccid paralysis approx. 90 seconds
○ Duration 30–40 minutes
• Side-effects: residual muscular weakness
• Special Information:
○ Rocuronium has no effect on consciousness, pain threshold, or cerebration
○ Must be used after adequate sedation
○ In elderly patients, time of onset may be delayed due to slower circulation time
○ Good for 60 days after out of refrigerator

Sodium Bicarbonate
GROUNDING medication for personnel on flight status.
• Description: alkalinizing agent, electrolyte
• Action: Sodium bicarbonate combines with hydrogen ions to form water and carbon dioxide.
Buffers metabolic acidosis and forces an intracellular shift of excess potassium in hyperkale-
mia and increases pH.
• Indications: Severe metabolic acidosis in cardiac arrest, tricyclic antidepressant overdose,
hyperkalemia (crush and rhabdomyolysis), alkalization agent for specific toxins (salicylates,
phenobarbital)

Chapter 9. Pararescue Drug Formulary n 169