Page 158 - 2022 Ranger Medic Handbook

ATROPINE SULFATE
Class: CNS agent – anticholinergic parasympatholytic, antidysrhythmic, antimuscarinic belladonna alkaloid
Action: Blocks acetylcholine at parasympathetic neuroeffector sites; increases cardiac output and heart rate by block-
ing vagal stimulation in heart; dries secretions by blocking vagus
Dose: Organophosphate poisoning (CBRN nerve agent):1–6mg IV/IM q3–5min PRN × 2–12hr. Bradycardia: 0.5mg
IV/IM q3–5min (max 3mg)
Indications: Bradycardia, organophosphate poisoning, reversal of anticholinesterase agents, and decreasing secre-
tions before surgery
Contraindications: Hypersensitivity to belladonna alkaloids, glaucoma, GI obstructions, ulcerative colitis, tachycar-
dia/tachydysrhythmias, asthma, acute hemorrhage, myocardial ischemia, pregnancy category caution advised during
pregnancy and while breastfeeding
Adverse/Side-effects: Headache, dizziness, involuntary movements, confusion, psychosis, anxiety, drowsiness, in-
somnia, hypotension, blurred vision, photophobia, pupil dilation, dry mouth, nausea, vomiting, constipation, abdomi-
nal distention, rash, urticaria, dry skin, urine retention.
SECTION 4 Interactions: increase anticholinergic effects of tricyclics, decreased absorption with ketoconazole, decreased effect
of atropine with antacids

AZITHROMYCIN (ZITHROMYCIN, Z-Pak)
Class: Antimicrobial – antibiotic; macrolide
Action: Reversibly binds to 50S ribosomal subunit of susceptible organisms inhibiting protein synthesis; effective
against mild to moderate infections caused by pyogenic streptococci, Streptococcus pneumoniae, Haemophilus in-
fluenzae, Mycobacterium avium intracellulare, and Staphylococcus aureus
Dose: Pneumonia: 500mg PO on day 1, then 250mg qd × 4 days; 500mg PO qd × 3 days; or suspension 2g single
dose. STI (gonococcal): 1g PO × 1 in adjunction with ceftriaxone.
Indications: For pneumonia, lower respiratory tract infections, pharyngitis, tonsillitis, gonorrhea, nongonococcal urethri-
tis, skin infections, otitis media, and acute bacterial sinusitis
Contraindications: Macrolide hypersensitivity; pregnancy category may use during pregnancy and while breastfeeding
Adverse/Side-effects: Headache, dizziness; nausea, vomiting, diarrhea, abdominal pain; hepatotoxicity
Interactions: Antacids may decrease peak level; may increase toxicity of ergotamine; food will decrease the amount
of azithromycin absorbed by 50%
Mission Impact: GROUNDING medication for personnel on flight status

BACITRACIN
Class: Antimicrobial – antibiotic
Action: Polypeptide derived from Bacillus subtilis culture; bactericidal/bacteriostatic that appears to inhibit cell wall
synthesis; activity similar to penicillin; active against many gram-positives including Streptococcus, Staphylococcus,
Pneumococcus, Corynebacteria, Clostridia, Neisseria, Gonococcus, Meningococcus, Haemophilus influenzae, and
Treponema pallidum; ineffective against most other gram-negatives
Dose: Topical ointment to AAA bid–tid, clean affected area prior to application
Indications: For topical treatment of superficial skin infections
Contraindications: Atopic individuals; pregnancy category may use during pregnancy and while breastfeeding
Adverse/Side-effects: Bacitracin hypersensitivity (erythema, anaphylaxis)
Interactions: No clinically significant interactions established when given topically

144 SECTION 4 RANGER MEDIC PHARMACOLOGY & FORMULARY