Page 155 - 2022 Ranger Medic Handbook

ACETAMINOPHEN (TYLENOL) *
Class: CNS agent – nonnarcotic, analgesic, antipyretic
Action: Analgesia action possibly through peripheral nervous system; fever reduction through direct action on hypo-
thalamus heat-regulating center resulting in peripheral vasodilation, sweating, and dissipation of heat; has minimal
effect on platelet aggregation, bleeding time, and gastric bleeding
Dose: 325–975mg PO q6hr (max: 4g qd)
Onset/Peak/Duration: onset varies/peak 1–3 hours/duration 3–4 hours
Indications: For mild to moderate pain management, headache, fever reduction
Contraindications: Acetaminophen hypersensitivity; use with alcohol; pregnancy category drug of choice
Adverse/Side-effects: Negligible with recommended dose; rash, acute poisoning, anorexia, nausea, vomiting, diz-
ziness, lethargy, diaphoresis, chills, epigastric or abdominal pain, diarrhea, hepatotoxicity: elevation of liver function
tests, hypoglycemia, hepatic coma, acute renal failure; chronic ingestion: neutropenia, pancytopenia, leukopenia,
thrombocytopenic purpura, renal damage
Interactions: Cholestyramine may decrease absorption; barbiturates, carbamazepine, phenytoin, rifampin, and ex-
cessive alcohol use may increase potential for hepatotoxicity
Mission Impact: None to minimal mission impact SECTION 4
K9 Dosage: DO NOT GIVE

ACETAZOLAMIDE (DIAMOX)
Class: CNS agent – carbonic anhydrase inhibitor; diuretic, anticonvulsant
Action: Diuretic effect due to inhibition of carbonic anhydrase activity in proximal renal tubule, preventing formation of
carbonic acid; anticonvulsant action effect thought to involve inhibition of CNS carbonic anhydrase, retarding abnor-
mal paroxysmal discharge from CNS neurons, decreases production of aqueous humor
Dose: Altitude Illness: PREVENTION: PO 125mg bid; begin the day before the ascent, may discontinue if staying
at same altitude for 2–3 days or if descending. Treatment: PO 250mg bid; Note: With high altitude cerebral edema,
dexamethasone is the primary treatment; however, acetazolamide may be used adjunctively with the same treatment
dose
Indications: For acute high-altitude sickness, seizures, drug-induced edema, and for CHF edema
Contraindications: Sulfonamide and thiazide hypersensitivity; marked renal and hepatic dysfunction; adrenocortical
insufficiency; hyponatremia, hypokalemia, hyperchloremic acidosis; pregnancy category may use during pregnancy
and caution advised while breastfeeding
Adverse/Side-effects: Paresthesia, sedation, malaise, disorientation, depression, fatigue, muscle weakness, flaccid
paralysis, anorexia, nausea, vomiting, weight loss, dry mouth, thirst, diarrhea, agranulocytosis, bone marrow depres-
sion, hemolytic anemia, aplastic anemia, leukopenia, pancytopenia, hyperglycemia, hyperuricemia, increased cal-
cium, potassium, magnesium, sodium excretion, gout exacerbation, dysuria, glycosuria, urinary frequency, polyuria,
hematuria, crystalluria, metabolic acidosis, hepatic dysfunction
Interactions: Renal excretion of amphetamines, ephedrine, flecainide, quinidine, procainamide, TCAs may be de-
creased, thereby enhancing or prolonging their effects; renal excretion of lithium and phenobarbital is increased;
amphotericin B and corticosteroids may accelerate potassium loss; increased risk for salicylate and digitalis toxicity
Mission Impact: GROUNDING medication for personnel on flight status
K9 Dosage: Give only if indicated/directed for human use. 250mg q12hr beginning 24 hours prior to ascent OR
500mg q24hr

2022 RANGER MEDIC HANDBOOK 141