Page 183 - 2022 Ranger Medic Handbook

OMEPRAZOLE (PRILOSEC)
Class: GI agent – proton pump inhibitor (PPI)
Action: Antisecretory compound that is a gastric acid pump inhibitor; suppresses gastric acid secretion by inhibiting
the H + , K + –ATPase enzyme system (the acid [proton H + ] pump) in the parietal cells, which relieves gastrointestinal
distress and promotes ulcer healing
Dose: 20mg PO qd × 4–8 weeks
Indications: Duodenal ulcer, gastroesophageal reflux disease (GERD), heartburn, and erosive esophagitis; used in
conjunction with clarithromycin and metronidazole to treat duodenal ulcers associated with Helicobacter pylori
Contraindications: PPI hypersensitivity, pregnancy category caution advised during pregnancy and may use while
breastfeeding
Adverse/Side-effects: Headache, dizziness; rash; abdominal pain, diarrhea, nausea, vomiting, constipation; hema-
turia, proteinuria
Interactions: May increase diazepam, phenytoin, and warfarin levels

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ONDASETRON (ZOFRAN) SECTION 4
Class: GI agent – 5-HT 3 antagonist, antiemetic
Action: Selective serotonin (5-HT 3 ) receptor antagonist, acting centrally in the chemoreceptor trigger zone and pe-
ripherally on the vagal nerve terminals; serotonin is released from the wall of the small intestine, stimulates the vagal
efferents through the serotonin receptors, and initiates the vomiting reflex
Dose: 4–8mg PO q4hr prn; 4–8mg slow IVP or IM q4hr prn
Onset/Peak/Duration:
IV – Onset in 10–30 minutes/Duration 8 hours
Indications: Prevention of nausea and vomiting
Contraindications: Hypersensitivity to ondansetron; pregnancy category caution advised during pregnancy and while
breastfeeding
Adverse/Side-effects: Dizziness, light-headedness, headache, sedation; diarrhea, constipation, dry mouth, fatigue,
fever, hypoxia
Interactions: Rifampin may decrease ondansetron levels; use with antimalarial drugs may cause decreased efficacy
or increased blood toxicity; caution when dosing in conjunction with prolonging QTc medications
Mission Impact: GROUNDING medication for personnel on flight status

OXYMETAZOLINE (AFRIN)
Class: ENT agent – vasoconstrictor (decongestant), sympathomimetic
Action: Sympathomimetic agent that acts directly on alpha receptors of sympathetic nervous system. No effect on
β-receptors.
Dose: Spray into each nostril 2 times, twice daily. Not to exceed 3 consecutive days due to rebound congestion. Do
not tilt head backward while spraying.
Indications: Epistaxis, Use as an adjunct to Valsalva maneuver to clear ears and sinuses during compression and
decompression, nasal congestion.
Contraindications: Severe damage to tympanic membrane/sinuses from barotrauma, lactation, pregnancy category
may use during pregnancy and while breastfeeding
Adverse/Side-effects: Sneezing, burning and stinging of nasal mucosa, rhinitis, rebound congestion

2022 RANGER MEDIC HANDBOOK 169