Travel Reference
In-Depth Information
drugs), but absorption is slower and thirty to sixty minutes are required for the drug to take
effect.
Following intramuscular injection, analgesia can be expected after ten to fifteen
minutes; the onset following intravenous injection is almost immediate. Individuals with
previous experience with intravenous drug administration should use the intravenous route
of administration for persons in shock. The drug must be injected slowly over a period of
severalminutesandtheinjection shouldbestoppedifpainreliefisachievedbeforethefull
dose is administered.
Hydromorphone
Hydromorphone (Dilaudid®) is an opiate that has properties similar to morphine. Oral
and injectable forms are available.
Precautions: The precautions that should be followed when administering hydro-
morphone are essentially identical to those for morphine.
Lidocaine
Lidocaine (Xylocaine®) is an injectable local anesthetic that is widely used for dental
procedures and for minor surgery, including suturing lacerations. Lidocaine jelly is a pre-
parationofthesamedrugthatcanbeapplieddirectlytothesitewhereanesthesiaisneeded.
Although the ointment can provide temporary relief from the pain and discomfort of many
minor disorders, it is used most commonly for hemorrhoids and related anal problems.
Precautions: For the uncommon individuals who are allergic to lidocaine, this drug
must not be used. Adverse reactions include anaphylaxis ( Chapter 23: Allergies ) and con-
vulsions.
MEDICATIONS FOR SLEEP OR SEDATION
Conventionalsleepingmedicationsshouldnotbetakenataltitudesabove10,000feet(3000
m). Under the influence of these drugs, respirations can be slowed to such an extent that
the blood oxygen level falls drastically, aggravating the symptoms of acute mountain sick-
ness. Acetazolamide is the drug of choice for promoting sleep at higher elevations where
most sleep disturbances are related to periodic breathing. Zolpidem (Ambien®) is safe and
effective at high altitude. Benzodiazepines also seem safe in low doses, but have more po-
tential for producing side effects.
Sleep-promotingmedicationsmaybeusefulforindividualswhohavedifficultysleeping
the first night or two away from the comfort of a warm, soft bed but should not be taken
routinely. Persistent insomnia may be the result of a psychiatric disorder and should be
treated only by a physician.
Benzodiazepines
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