Clinical Pharmacology of Spaceflight

Eleanor A. O'Rangers, PharmD

Disclosures

January 03, 2011

In This Article

Medical Events During Spaceflight

The majority of documented space-related medical events have thus far been self-limited and non-life-threatening, and medication use is commonplace for many routine conditions. What events could occur during spaceflight that might require medical intervention, including prescribing of medications?

Tables 1 and 2 show unanticipated in-flight and postflight medical events that occurred among 29 astronauts who participated in Project Apollo (1967-1972) during the early days of the US spaceflight program. Of note, many of these events were not necessarily benign and may have required pharmacologic intervention as part of their care.[7]

Table 1. In-flight Medical Problems in Apollo Crews[7]

Symptom/Finding Etiology Number of Cases
Barotitis Barotrauma 1
Cardiac arrhythmias Undetermined, possibly linked to potassium deficit 2
Eye irritation Spacecraft atmosphere 4
  Fiberglass 1
Dehydration (Apollo 13) Reduced water intake during emergency 2
Flatulence Undetermined 3
Genitourinary infection with prostatic congestion Pseudomonas aeruginosa 1
Headache Spacecraft environment 1
Nasal congestion Zero gravity 2
Pharyngitis Undetermined 1
Rhinitis Oxygen, low relative humidity 2
Respiratory irritation Fiberglass 1
Rash, facial, recurrent inguinal Contact dermatitis) 1
  Prolonged wearing of urine collection device (Apollo 13) 1
Skin irritation Biosensor sites 11
  Fiberglass 2
  Undetermined 1
Seborrhea Activated by spacecraft environment 2
Shoulder strain Lunar core drilling 1
Subungual hemorrhage Glove fit 5
Stomach awareness Labyrinthin 6
Nausea, vomiting Labyrinthin 1
Stomatitis Aphthous ulcers 1
Excoriation, urethral meatus (Apollo 13) Prolonged wearing of urine collection device 2
Urinary tract infection Undetermined 1
Dysbarism (bends)*   1


Table 2. Postflight Medical Findings in Apollo Mission Crews

Diagnosis Etiology Number of Cases
Barotitis media Eustachian tube blockage 7
Folliculitis, right anterior chest Bacterial 1
Gastroenteritis Bacterial 1
Herpetic lesion, lip Herpes virus 1
Influenza syndrome Influenza B virus 1
Undetermined 1
Influenza A2 virus 1
Laceration of the forehead Trauma 1
Rhinorrhea, mild Fiberglass particle 1
Papular lesions, parasacral Bacterial 1
Prostatitis Undetermined 2
Pulpitis of the seventh tooth   1
Pustules, eyelids   1
Rhinitis Viral 3
Acute maxillary sinusitis Bacterial 1
Ligamentous strain, right shoulder   1
Urinary tract infection Pseudomonas 1
Vestibular dysfunction, mild   1
Rhinitis and pharyngitis Influenza B virus 1
  Beta-hemolytic Streptococcus (not group A) 1
Rhinitis and secondary bronchitis Influenza B virus 1
Contact dermatitis Fiberglass 1
Beta cloth 1
Micropore tape 6
Subungual hemorrhages, fingernails Trauma 3
* Also occurred during the Gemini 10 mission; later incidences were reported by the same crew member 5 years after his Apollo 11 mission.

A more recent and expanded retrospective review of astronaut health records focused on severe medical events and illness from Project Mercury through the space shuttle and Shuttle-Mir programs (Table 3). Several documented in-flight events from the more recent space programs could have resulted in significant morbidity, possibly requiring emergency medical procedures and pharmacologic intervention. These included fire, vehicular collision, temporary loss of environmental controls, and depression.[8,9]

Table 3. Summary of Nonfatal Spaceflight Severe Medical Events, 1961-1999[8]

Type of Event Number of Events
Trauma  
Ophthalmology 1
Second-degree burns 1
Cardiopulmonary  
Arrhythmias 2
Pneumonitis 4
Reactive airways 1
Internal medicine  
Chronic headaches 1
Cellulitis of arm 1
Other unspecified 1
Genitourinary  
Renal stone 1
Urinary retention 1
Prostatitis 1
Urosepsis 2

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