Page 180 - 2022 Ranger Medic Handbook

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MOXIFLOXACIN (AVELOX)
Class: Antimicrobial – antibiotic; fluoroquinolone. All fluoroquinolones now have a US Black Box Warning due to
serious adverse reactions including tendonitis and tendon rupture, peripheral neuropathy and CNS effects.
However, in some rare cases, benefits may outweigh the risks of fluoroquinolone use. Fluoroquinolones re-
quire prior approval from unit physician or physician assistant.
Action: Broad spectrum bactericidal agent that inhibits DNA-gyrase topoisomerase II, an enzyme necessary for bac-
terial replication, transcription, repair and recombination; effective against gram-positive and gram-negative organ-
isms, Staphylococcus aureus, Streptococcus pneumonia, Haemophilus influenzae, Klebsiella pneumoniae, Moraxella
catarrhalis, Chlamydia pneumoniae, Mycoplasma pneumoniae, and other microbes
Dose: 400mg PO/IV qd × 5–10 days
Indications: For acute bacterial exacerbation of chronic bronchitis, acute sinusitis, community-acquired pneumonia,
skin infections
Contraindications: Quinolone hypersensitivity; hepatic insufficiency; syphilis; arrhythmias; myocardial ischemia or
infarction; hypokalemia, or those receiving class IA or class III antiarrhythmic drugs; pregnancy category avoid use
during pregnancy and caution advised while breastfeeding
Adverse/Side-effects: Tendon rupture; QT c prolongation; dizziness, headache, peripheral neuropathy, nausea, di-
SECTION 4 arrhea, abdominal pain, vomiting, taste perversion, abnormal LFTs, dyspepsia, tendon rupture
Interactions: Iron, zinc, antacids, aluminum, magnesium, calcium, sucralfate decrease absorption; atenolol, erythro-
mycin, antipsychotics, TCAs, quinidine, procainamide, amiodarone, may cause false positive on opiate screening
tests
Mission Impact: GROUNDING medication for personnel on flight status.

MUPIROCIN (BACTROBAN)
Class: Antimicrobial – antibiotic; pseudomonic acid
Action: Inhibits protein synthesis by binding with bacterial transfer RNA; effective against Staphylococcus aureus
(including methicillin-resistant [MRSA] and β-lactamase– producing strains], Staphylococcus epidermidis, Staphylo-
coccus saprophyticus, and Staphylococcus pyogenes
Dose: Topically apply tid–qid × 1–2 weeks; reevaluate for response after 3–5 days
Indications: For impetigo or nasal carriage due to Staphylococcus aureus, β-hemolytic streptococci, and Strepto-
coccus pyogenes; superficial skin infections
Contraindications: Hypersensitivity to any of its components; pregnancy category may use during pregnancy and
while breastfeeding
Adverse/Side-effects: Headache, burning, stinging; pruritis, erythema, dry skin, tenderness, swelling, rash; nausea;
local pain; rhinitis, congestion, pharyngitis
Interactions: None
Mission Impact: None

166 SECTION 4 RANGER MEDIC PHARMACOLOGY & FORMULARY