Page 163 - 2022 Ranger Medic Handbook

CLINDAMYCIN (CLEOCIN)
Class: Antimicrobial – antibiotic
Action: Suppresses protein synthesis by binding to 50S subunits of bacterial ribosomes; effective against strains of
anaerobic streptococci, Bacteroides (especially B. fragilis), Fusobacterium, Actinomyces israelii, Peptococcus, Clos-
tridium sp., and aerobic gram-positive cocci, including Staphylococcus aureus, Staphylococcus epidermidis, strepto-
cocci (except S. faecalis), and pneumococci
Dose: 600–1,800mg/d in 2–4 divided doses; up to 2,400mg/d in 4 divided doses may be given for severe infections.
Cleocin T: topically AAA bid
Indications: For moderate to severe infections; topical applications used in treatment of acne vulgaris
Contraindications: Clindamycin or lincomycin hypersensitivity; history of regional enteritis, ulcerative colitis, or
antibiotic–associated colitis; pregnancy category may use during pregnancy and while breastfeeding
Adverse/Side-effects: Fever, serum sickness, sensitization, swelling of face, generalized myalgia, superinfections,
proctitis, pain, induration, sterile abscess; thrombophlebitis; hypotension, cardiac arrest (rapid IV); diarrhea, abdominal
pain, flatulence, bloating, nausea, vomiting, pseudomembranous colitis; esophageal irritation, loss of taste, medicinal
taste (high IV doses), jaundice, abnormal liver function tests; leukopenia, eosinophilia, agranulocytosis, thrombocyto-
penia; skin rashes, urticaria, pruritus, dryness, contact dermatitis, gram-negative folliculitis, irritation, oily skin
Interactions: Chloramphenicol and erythromycin are possibly antagonistic; neuromuscular blocking action enhanced SECTION 4
by neuromuscular blocking agents (atracurium, tubo curarine, pancuronium)
Mission Impact: GROUNDING medication for personnel on flight status.
K9 Dosage: DO NOT GIVE

CYCLOBENZAPRINE (FLEXERIL)
Class: Autonomic nervous system agent – central acting; skeletal muscle relaxant
Action: Structurally and pharmacologically related to TCAs; relieves skeletal muscle spasm of local origin without
interfering with muscle function; believed to act primarily within CNS at brain stem with some action at spinal cord
level; depresses tonic somatic motor activity, although both gamma and alpha motor neurons are affected; increases
circulating norepinephrine by blocking synaptic reuptake, thus producing antidepressant effect; has sedative effect
and potent central and peripheral anticholinergic activity
Dose: 5–10mg PO tid prn muscle spasm (max: 60mg/d); do not use longer than 2–3 weeks
Indications: As adjunct to rest and physical therapy for short-term relief of muscle spasm associated with acute
musculoskeletal conditions
Contraindications: Recovery phase of MI; cardiac arrhythmias, heart block or conduction disturbances; CHF, hyper-
thyroidism; pregnancy category caution advised during pregnancy and consider alternative while breastfeeding
Adverse/Side-effects: Tongue and face edema, sweating, myalgia, hepatitis, alopecia; toxic potential of TCAs; tachy-
cardia, syncope, palpitation, vasodilation, chest pain, orthostatic hypotension, dyspnea; arrhythmias; dry mouth, in-
digestion, unpleasant taste, coated or discolored tongue, vomiting, anorexia, abdominal pain, flatulence, diarrhea,
paralytic ileus; drowsiness, dizziness, weakness, fatigue, asthenia, paresthesia, tremors, muscle twitching, insomnia,
euphoria, disorientation, mania, ataxia; pruritus, urticaria, rash; increased or decreased libido, impotence
Interactions: Alcohol, barbiturates, other CNS depressants enhance CNS depression; potentiates anticholinergic
effect of phenothiazine and other anticholinergics; MAOIs may precipitate hypertensive crisis
Mission Impact: GROUNDING, Causes drowsiness in most people.
K9 Dosage: DO NOT GIVE

2022 RANGER MEDIC HANDBOOK 149