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Travel and Expedition electronic documents and medical applications

Posted May 17 2010 12:00am

Most people that know me are well aware that I use my iPOD for most everything in my life.  This includes my schedule, music, movies and medical applications.  I have been in the habit of making my own word documents with important notes and information since medical school.  A lot of these are used often and even more now that there is the Adventure Doc Clinic and I see more travelers.  A few of my friends have asked about getting copies of some relevant “adventure doc” documents and how I am running them on my iPOD. 

I use a document reader called “Documents to Go” which can be found at the DataViz website.  Here are a few of the documents I am referring to more frequently: 

Malaria PPX 

ADULTS: 

chloroquine phosphate (Aralen) 

250mg, 2 tabs/wk - 500mg/wk 

ok for long term(6yrs) use (risk of retinopathy) and ok for preg. 

hydroxychloroquine (Plaquenil) check retinas 

200 mg, 2 tabs/wk 

Mefloquine (Lariam) dreams, $ 

250mg/wk (1 tab) best for resistent 

Doxycycline sun exposure, food 

100mg, 1 tab/day (second to mefloquine for resist areas) 

Atovaquone/proguanil (Malarone) 

250/100mg, 1 tab/day 

Primaquine (used as radical cure) 

30mg base/day 

Proguanil (Paludrine) with chloroquine weekly 

100mg, 2 tabs/day 

Fansidar (folate metabolism) (pyrimethamine/sulfadoxine) 

1 tab weekly 

Maloprim (folate metabolism) 

(pyrimethamine/dapsone) 

may cause anemia/neutropenia with >1 month of use, check cbc 

  

CHILDREN: 

chloroquine phosphate 

8.3 mg/kg PO 

Mefloquine (Lariam) 

15-19 kg – 1/4 tab per wk PO 

20-30kg - 1/2 tab per wk PO 

31-40kg - 3/4 tab per wk PO 

Proguanil (Paludrine) with chloroquine weekly 

<2 years old – 50mg/day PO 

2-6 y/o – 100mg/day PO 

7-10 y/o – 150mg/day PO 

>10 y/o – 200mg/day PO 

Atovaquone/proguanil (Malarone pediatric) 62.5mg/25mg 

11-20 kg – 1 tab daily 

21-30 kg – 2 tabs daily 

31-40 kg – 3 tabs daily 

>40 kg – 4 tabs daily (same as adult 250/100 mg tab) 

  

Malaria treatment 

CHLOROQUINE SENSIT 

chloroquine 600mg base initial then 300 mg base at 6,24, 48 hrs 

PEDS- 10mg/kg base then 5mg/kg at same hours 

MDR 

mefloquine 15mg/kg stat dose 

peds-same (not for those <15kg) 

MDR/mefloquine resistant 

quinine sulfate 10mg/kg TID plus tetracycline 4mg/kg qid or doxy 1.5mg/kg qday for 7 days OR artesunate 200mg stat then 100mg daily plus mefloquine 

if at rural facility/no PO by patient 

chloroquine 3.5mg base/kg q6 IM or sub-q until PO tolerated 

quinidine 20mg salt/kg by IM to thigh (split dose into each thigh) then 10mg/kg q8 

  

Radical cure for vivax and ovale 

primaquine at last dose of chloroquine (exoerythocytic stage) 

mefloquine safe in pregnancy 

STAND BY 

quinine plus: 

650mg po tid for 7 days quinine 

250mg po qid for 7 days tetracycline 

n/v/headache, tinitus 

doxy 100 bid 7 days 

halofantrine 

And for our paramedics in the field I have a list of medications that have been slightly modified from the following list and are the basics of the advanced medical kits carried by Adventure Doc Paramedics: 

Proficient and Always Carried: 

Acetaminophen (Tylenol) 325-650 mg PO q 4-6 hours max 4 gr/day 

Dexamethasone 0.25-4 mg BID-QID 8-16 mg IM/IV q 1-3 weeks 

Diphenhydramine (Benadryl) 25-50 mg IV/IM/PO q 4-6 hours 

Epinephrine 0.1-0.5 mL SC/IM q 10-15 min (1:1000 soln = 1mg/ml) 

Ertapenem (Invanz) 1 gram IV/IM q 24 hours 

Fentanyl Oral Lozenges (Actiq) 400-800 mcg (max 1600 mcg/day) 

Gatifloxacin (Tequine) 400 mg IV/PO daily 

Hetastarch (Hextend) 500-1000 ml IV 

Ibuprofen (Motrin, Advil) 400-800 mg PO TID/QID (max 3200 mg/day) 

Ketorolac (Toradol) 15-30 mg IV/IM q 6 hours 

Lidocaine (Xylocaine) 0.5% – 2% 

Meloxicam (Mobic) 7.5-15 mg PO daily 

Morphine Sulfate 5-15 mg slow IV push 

Moxifloxicin 400 mg PO/IV daily 

Naloxone (Narcan) 0.4-2.0 mg IV repeat q 2-3 minutes up to 10 mg PRN 

Promethazine (Phenergan) 12.5-25 mg PO/IM/IV q 4-6 hours PRN 

Sodium Chloride 0.9% 500-1000 ml IV; 5-50 ml IV for med dilution or flush 

 

Proficient: 

Acetazolamide (Diamox) 125-250 mg PO BID (1-2 days prior ascent) 

ASA 325-650 mg PO/PR q 4 hours 

Albuterol (Proventil) MDI 2 puffs q 4-6 hours 

Bacitracin topical ointment 

Benzonatate (Tessalon Perles) 100-200 mg PO TID/PRN 

Ceftriaxone (Rocephin) 1-2 grams IV/IM q 12-24 hours (max 4 grams/day) 

Cetrizine (Zyrtec) 5-10 mg PO q day 

Cimetidine (Tagamet) 300 mg IV/IM/PO q 6-8 hours or 400mg PO BID 

Clindamycin (Cleocin) 150-450 mg PO q 6 hours or 600-900mg IV/IM q 6-8 hours 

Dextromethomorphan (Robitussin DM) 10-20 mg PO q 4 hours 

Dextrose (D50) 0.5-1 gram/kg up to 25 grams 

Doxycycline 100 mg PO qday 

Fexofenadine (Allegra) 60 mg PO BID or 120 mg q day 

Guaifenesin 100-400 mg PO q 4-6 hours 

Hydrocortisone topically q day to qid 

Hydromorphone (Dilaudid) 1-4 mg PO/SC/IM/IV q 4-6 hours 

Lactate Ringers (LR) 500-1000 ml 

Lovofloxacin (Levaquin) 250-750 mg PO/IV q day 

Loperamide (Immodium) 4 mg PO then 2 mg with each loose BM (max 16 mg/day) 

Loratadine (Claratin) 10 mg PO q day 

Meclizine (Antivert) 25-50 mg PO 1 hour before travel 

Mefloquine (Larium) 250 mg PO once/week from 1 week prior to travel and 4 weeks after 

Ondanstron (Zofran) 8-16 mg PO q 8 hours or 4 mg slow IVP or IM q 8 hours 

Primaquine 30 mg base PO daily for 14 days after malaria exposure 

Psuedoephedrine (Sudafed) 30-60 

 

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