Page 168 - 2022 Ranger Medic Handbook

ERYTHROMYCIN OPHTHALMIC OINTMENT
Class: Macrolide antibiotic
Dose: One-half inch ribbon of ointment q3–4hr or 2–6 × daily.
Indications: For superficial ocular infections of the cornea and conjunctiva
Contraindications: Hypersensitivity, astemizole, cisapride, pimozide, terfenadine therapy, pregnancy category may use
during pregnancy and while breastfeeding
Adverse/Side-effects: Minor ocular irritations and redness
Interactions: Terfenadine, atorvastatin, lovastatin, pravastatin, simvastatin, carbamazepine, digoxin, diltiazem, midaz-
o lam, oral contraceptives, ototoxic drugs, penicillins, warfarin
Mission Impact: Blurred vision

ESZOPICLONE (LUNESTA) – CONTROLLED SUBSTANCE IV
SECTION 4 Class: Sedative-hypnotic
Action: May potentiate effects of inhibitory neurotransmitter γ-aminobutyric acid (GABA) by binding close to or with
benzodiazepine receptors
Dose: 2mg up to 3mg immediately at bedtime. Maintenance dose 3mg
Indications: Insomnia
Contraindications: Hypersensitivity, pregnancy category consider alternative during pregnancy and avoid use while
breastfeeding
Adverse/Side-effects: Agitation, anxiety, confusion, depression, dizziness, hallucinations, HA, nervousness, neural-
gia, unusual dreams, chest pain, peripheral edema, dry mouth, gynecomastia, diarrhea, indigestion, hepatitis, nausea,
vomiting, decreased libido, dysmenorrhea, UTI, asthma, respiratory tract infection, pruritus, rash, or heat stroke
Interactions: Clarithromycin, ketoconazole, itraconazole, rifampin, and alcohol
Mission Impact: Grogginess. Puts patient at higher risk for heat injury. GROUNDING medication for per-
sonnel on flight status

FENTANYL – CONTROLLED SUBSTANCE II
Class: CNS agent – potent narcotic (opiate) agonist
Action: Action similar to that of morphine with more rapid and less prolonged analgesia and sedation, but less emetic
effect
Dose: 800mcg/dose (max 1600mcg/day); lozenge on a stick to be placed in mouth between cheek and lower gum and
sucked, not chewed (have opioid antagonist [naloxone] immediately available!) IV: For severe pain 50–100mcg IV/IO/IM
(consider doubling IV/IO dose for IM) q1–2hr prn
Onset/Peak/Duration: TD: Onset 15 minutes; peak 20–40 minutes; duration 2–3 hours. IV/IO: Onset immediate; peak
30–60 minutes; duration 2–4 hours
Indications: For moderate to severe pain management
Contraindications: MAOIs; myasthenia gravis; pregnancy category consider alternative during pregnancy and may
use while breastfeeding (caution advised in patients trying to conceive)
Adverse/Side-effects: Sedation, euphoria, dizziness, diaphoresis, delirium, convulsions, bradycardia, hypotension,
circulatory depression, cardiac arrest; miosis, blurred vision; nausea, vomiting, constipation, ileus; muscle and tho-
racic muscle rigidity; urinary retention, rash; laryngospasm, bronchoconstriction, respiratory depression or arrest
Interactions: Alcohol and other CNS depressants potentiate effects; MAOIs may precipitate hypertensive crisis
Mission Impact: GROUNDING medication for personnel on flight status

154 SECTION 4 RANGER MEDIC PHARMACOLOGY & FORMULARY