Page 161 - 2022 Ranger Medic Handbook

CEFAZOLIN SODIUM (ANCEF)
Class: Antimicrobial – first-generation cephalosporin
Action: Inhibits susceptible bacterial cell wall synthesis rendering cell wall osmotically unstable. Activity against gram-
negative organisms is limited
Dose: 1–2g IM/IV q8hr (max 12g/d)
Indications: Open bone fractures or joint disruptions as presurgical prophylaxis
Contraindications: Hypersensitivity to any cephalosporin and related antibiotics; lactation; pregnancy category may
use during pregnancy and while breastfeeding
Adverse/Side-effects: Anaphylaxis, fever, diarrhea, anorexia, abdominal cramps, maculopapular rash, urticaria
Interactions: Minimal prehospital interactions
Mission Impact: GROUNDING medication for personnel on flight status
K9 Dosage: 0.5–1g (25mg/kg) IV daily; give over 5 minutes

CEFTRIAXONE (ROCEPHIN) SECTION 4
Class: Antimicrobial – antibiotic; third-generation cephalosporin
Action: Preferentially binds to penicillin-binding proteins (PBPs) and inhibits bacterial cell wall synthesis; effective
against most
Enterobacteriaceae, gram-positive aerobic cocci, Neisseria meningitides, and gonorrhoeae; some effect against
Treponema pallidum
Dose: For moderate to severe infections, 1–2g IV/IM q12–24hr (max: 4g/d); for meningitis, 2g IV/IM q12hr; for uncom-
plicated gonorrhea 250mg IM × 1; dilute in 1% lidocaine for IM
Indications: For infections of the middle ear, lower respiratory tract, skin and skin structures, bones and joints, men-
ingitis, intra-abdominal, urogenital tract, pelvis, septicemia; used for surgical prophylaxis
Contraindications: Cephalosporin hypersensitivity; pregnancy category may use during pregnancy and while
breastfeeding
Adverse/Side-effects: Pruritus, fever, chills, pain, induration at IM site, phlebitis at IV site, diarrhea, abdominal
cramps, pseudomembranous colitis, biliary sludge
Interactions: Probenecid decreases renal elimination; alcohol produces disulfiram reaction
Mission Impact: GROUNDING medication for personnel on flight status
K9 Dosage: 1g IV/IM qd

CETIRIZINE (ZYRTEC)
Class: ENT agent – H 1 -receptor antagonist; nonsedating antihistamine
Action: Potent H 1 -receptor antagonist and antihistamine; low lipophilicity and H 1 - receptor selectivity and thus no
significant anticholinergic or CNS activity; reduces local and systemic effects of histamine release
Dose: 5–10mg PO qd
Indications: Seasonal and perennial allergic rhinitis and chronic idiopathic urticaria
Contraindications: H 1 -receptor antihistamine hypersensitivity; pregnancy category may use during pregnancy and
caution advised while breastfeeding
Adverse/Side-effects: Constipation, diarrhea, dry mouth; drowsiness, sedation, headache, depression
Interactions: Theophylline may decrease clearance leading to toxicity; do not use in combination with OTC
antihistamines
Mission Impact: GROUNDING medication for personnel on flight status

2022 RANGER MEDIC HANDBOOK 147