Pharmaceutical use by US astronauts on space shuttle missions

We evaluated in-flight use of medications from astronaut debriefings after 79 U.S. Space Shuttle missions. From the 219 records obtained (each represe nting one person-flight), 94% included some medication being taken during f light; of that number, 47% were for space motion sickness, 45% for sleep di sturbances, and smaller percentages for headache, backache, and sinus conge stion. Drugs were taken most often orally, followed in decreasing order of frequency by intranasal, intramuscular, and rectal routes. Drugs for space motion sickness were taken mostly during the first 2 d of flight, drugs for pain during the first 4 d, and drugs fur sleeplessness and sinus congestio n were taken consistently for 9 flight days. About 85% of all doses had no reported side effects, and most of the side effects that were reported happ ened during the first mission day. About 80% of the drug-dose events were p erceived effective by the recipients; most of the reports of ineffectivenes s occurred during the first mission day. Promethazine, the only drug given by three different routes (orally, intramuscularly, and rectally), was most effective and had minimal side effects when taken intramuscularly. This in formation, although useful, should be expanded to include objective measure s of effectiveness so that therapeutic efficacy can be assessed during flig ht.