Page 169 - 2022 Ranger Medic Handbook

FEXOFENADINE (ALLEGRA)
Class: ENT agent – H 1 -receptor antagonist; nonsedating antihistamine
Action: Competitively antagonizes histamine at the H 1 -receptor site; does not bind with histamine to inactivate it; not
associated with anticholinergic or sedative properties; inhibits antigen-induced bronchospasm and histamine release
from mast cells
Dose: 60mg PO bid or 180mg PO qd
Indications: For symptom relief from seasonal allergic rhinitis (nasal congestion and sneezing, watery or red eyes,
itching nose, palate, or eyes) and chronic urticaria
Contraindications: Fexofenadine hypersensitivity; pregnancy category may use during pregnancy and caution ad-
vised while breastfeeding
Adverse/Side-effects: Headache, drowsiness, fatigue, nausea, dyspepsia, throat irritation
Interactions: No clinically significant interactions established

FLUCONAZOLE (DIFLUCAN)
Class: Antifungal SECTION 4
Action: Damages fungal cells by interfering with a cytochrome P450 enzyme needed in cell membrane synthesis
Dose: Skin infection: 150mg, 1 pill per week × 4 weeks. Oropharyngeal candidiasis: The recommended dosage of
fluconazole for oropharyngeal candidiasis is 200mg on the first day, followed by 100mg once daily. Clinical evidence
of oropharyngeal candidiasis generally resolves within several days, but treatment should be continued for at least
2 weeks to decrease the likelihood of relapse. Vaginal candidiasis: The recommended dosage of fluconazole for
vaginal candidiasis is 150mg as a single oral dose
Indications: Vaginal candidiasis (vaginal yeast infections due to Candida), oropharyngeal and esophageal candidiasis,
fungal skin infections
Contraindications: Hypersensitivity to fluconazole, pregnancy category avoid use during pregnancy and may use
while breastfeeding
Adverse/Side-effects: Exfoliative skin disorders including Stevens-Johnson syndrome and toxic epidermal necrosis
Interactions: Erythromycin; heart medications
Mission Impact: Aviation personnel are grounded for the initial 24 hours of antifungal therapy and until the medical
condition no longer interferes with safely performing aviation duties and the patient is free of side-effects

FLUTICASONE (FLONASE)
Class: Anti-inflammatory corticosteroid; skin and mucous membrane agent
Action: Inhibits cells involved in the inflammatory response of asthma (mast cells, eosinophils, basophils, and lympho-
cytes). Also inhibits secretion of chemical mediators such as histamines
Dose: 1 spray in each nostril bid OR 2 sprays in each nostril daily
Indications: For management of nasal symptoms of seasonal and perennial allergic and nonallergic rhinitis in adults
and children > 4 years old
Contraindications: Hypersensitivity, pregnancy category consider alternative during pregnancy and may use while
breastfeeding
Adverse/Side-effects: Irritation of nasal mucous membranes, blood in nasal mucous, runny nose, abdominal pain,
diarrhea, dizziness, flulike symptoms
Interactions: Drugs with immunosuppressive properties, other steroid drugs, suspected chickenpox or measles,
anti viral drugs

2022 RANGER MEDIC HANDBOOK 155