Page 187 - 2022 Ranger Medic Handbook

RIZATRIPTAN (MAXALT)
Class: CNS agent – sumatriptan; autonomic nervous system agent; adrenergic antagonist; serotonin 5-HT(1B/1D) re-
ceptor agonist
Action: Selective (5-HT1B/1D) receptor agonist reverses the vasodilation of cranial blood vessels associated with mi-
graine headache
Dose: 5–10mg PO (may repeat 1 dose in 2 hours prn); max dose of 30mg/24hr
Indications: Acute migraine headache with or without aura
Contraindications: Hypersensitivity; coronary artery disease or CAD risk factors of hypertension, hypercholesterol-
emia, obesity, diabetes, smoking or strong family history; concurrent administration of ergotamine drugs, sumatrip-
tan, or MAOIs; basilar or hemiplegic migraine, pregnancy category consider alternative during pregnancy and while
breastfeeding
Adverse/Side-effects: Asthenia; fatigue; pain; pressure sensation; paresthesia; throat pressure; warm/cold sensa-
tions; dizziness; headache; decreased mental acuity; euphoria; tremor; coronary artery vasospasm; transient myocar-
dial ischemia; myocardial infarction; ventricular tachycardia; ventricular fibrillation; chest pain/tightness; palpitations;
dry mouth; nausea; vomiting; diarrhea; dyspnea; flushing; hot flashes
Interactions: Propranolol; dihydroergotamine; methysergide; other 5-HT 1 agonists; Gingko; Ginseng; echinacea; St.
John’s wort SECTION 4
Mission Impact: GROUNDING medication for personnel on flight status

SCOPOLAMINE (TRANSDERM SCOP)
Class: Autonomic nervous system agent – parasympatholytic; anticholinergic, antimuscarinic, antispasmodic
Action: Alkaloid of belladonna with peripheral action resembling those of atropine, but in contrast, produces CNS
depression with marked sedative and tranquilizing effects for use in anesthesia; potent mydriatic and cycloplegic
action inhibiting secretions of salivary, bronchial, and sweat glands with less prominent effect on heart, intestines,
and bronchial muscles
Dose: For motion sickness, 0.25–0.6mg PO 1 hour before travel OR topical transdermal disc patch applied to dry
surface behind ear q72hr starting 12 hours before travel
Indications: Prophylactic agent for motion sickness; used as mydriatic and cycloplegic in ophthalmology; preanes-
thetic agent to control bronchial, nasal, pharyngeal and salivary secretions; control of spasticity and drooling in para-
lytic and spastic states
Contraindications: Anticholinergic, belladonna, or barbiturate hypersensitivity; asthma; hepatitis; narrow angle glau-
coma; GI or GU obstructive diseases; myasthenia gravis; pregnancy category caution advised during pregnancy and
while breastfeeding
Adverse/Side-effects: Fatigue, dizziness, drowsiness, disorientation, restlessness, hallucinations, toxic psychosis;
dry mouth and throat, constipation; urinary retention; decreased heart rate; dilated pupils, photophobia, blurred vision,
follicular conjunctivitis; depressed respiration; local irritation, rash
Interactions: Amantadine, antihistamines, TCAs, quinidine, disopyramide, procainamide add to anticholinergic ef-
fects; decreases levodopa effects; methotrimeprazine may precipitate extrapyramidal effects; decreases absorption
and antipsychotic effects of phenothiazines

2022 RANGER MEDIC HANDBOOK 173