Page 175 - 2022 Ranger Medic Handbook

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LOPERAMIDE (IMODIUM) DO NOT ALLOW OPEN ACCESS
Class: GI agent – antidiarrheal
Action: Synthetic piperidine derivative that inhibits GI peristaltic activity by direct action on circular and longitudinal
intestinal muscles; prolongs intestinal content transit time, increases consistency of stools, and reduces fluid and
electrolyte loss
Dose: 4mg PO, followed by 2mg after each unformed stool (max: 16mg/d)
Indications: For acute nonspecific diarrhea, chronic diarrhea associated with inflammatory bowel disease
Contraindications: Conditions in which constipation should be avoided, severe colitis, acute diarrhea caused by
broad-spectrum antibiotics (pseudomembranous colitis) or from organisms that penetrate the intestinal mucosa (toxi-
genic Escherichia coli, Salmonella, or Shigella); pregnancy category caution advised during pregnancy and may use
while breastfeeding
Adverse/Side-effects: Rash; fever; drowsiness, fatigue, dizziness, CNS depression with overdose; abdominal disten-
sion, discomfort or pain, bloating, constipation, nausea, vomiting, anorexia, dry mouth; toxic megacolon in patients
with ulcerative colitis
Interactions: Caution when dosing in conjunction with prolonging QTc medications.
Mission Impact: GROUNDING medication for personnel on flight status SECTION 4

LORATADINE (CLARITIN)
Class: ENT agent – H 1 -receptor antagonist – nonsedating antihistamine
Action: Long–acting histamine antagonist with selective peripheral H 1 -receptor sites that blocks histamine release;
disrupts capillary permeability, edema formation, and constriction of respiratory, GI, and vascular smooth muscle
Dose: 10mg/d PO, take on an empty stomach
Indications: Symptom relief from seasonal allergic rhinitis; idiopathic chronic urticaria
Contraindications: Loratadine hypersensitivity; pregnancy category may use during pregnancy and caution advised
while breastfeeding
Adverse/Side-effects: Dizziness, dry mouth, fatigue, headache, somnolence, altered salivation and lacrimation,
thirst, flushing, anxiety, depression, impaired concentration; hypo- or hypertension, palpitations, syncope, tachy-
cardia; nausea, vomiting, flatulence, abdominal distress, constipation, diarrhea, weight gain, dyspepsia; arthralgia,
myalgia; blurred vision, earache, eye pain, tinnitus; rash, pruritus, photosensitivity
Interactions: No clinically significant interactions established

2022 RANGER MEDIC HANDBOOK 161