Spaceflight medical countermeasures: a strategic approach for mitigating effects from solar particle events

Figures & data

Figure 1. Trajectory for the crewed Artemis 2 lunar flyby mission (credit: NASA).

Table 1. Solar particle event indications and treatment recommendations.

Symptom	MCM Recommendation
Nausea/Vomiting	Ondansetron (Zofran®), Granisetron (Kytril^®) Dexamethosone (Decadron^®) Palonosetron (Aloxi^®), Dolasetron (Anzemet^®) Prochlorperazine (Compro^®)
Diarrhea	Imodium^®
Dehydration	Intravenous (IV) normal saline
Infections	Penicillins, cephalosporins, macrolides, ciprofloxacin
Hematopoietic	G-CSF (Neupogen^®) Peg-G-CSF (Neulasta^®), GM-CSF (Leukine^®)
Burns	Silver sulfadiazine, sterile gauze, parenteral opioid analgesics, crystalloid solutions, corticosteroid cream

Table 2. Comparison of Storage, Shelf-Life and Delivery for H-ARS Treatments.

	Form	Storage	Delivery	Shelf-life	Dose	**Additional supplies
G-CSF	Liquid	2 °C–8 °C	Subcutaneous injection	Room temperature 24 h Refrigerated 30 months	Single-dose vials containing 300 mcg/mL or 480 mcg/1.6 mL OR Single-dose, prefilled syringe with a 27 gauge, ½ inch needle containing 300 mcg/0.5 mL or 480 mcg/0.8 mL	1 mL syringe with a 25 to 30 gauge 5/8-inch needle sterile alcohol swabs
Peg-GCSF	Liquid	2 °C–8 °C	Subcutaneous injection	Room temperature 48 h Refrigerated 3 years	* 6 mg/0.6 mL solution in a single-dose prefilled syringe for manual administration	1 mL syringe with a 25 to 30 gauge 5/8-inch needle sterile alcohol swabs
GM-CSF	Liquid OR Lyophilized powder	2 °C–8 °C	Subcutaneous injection	Room temperature 1 week Refrigerated 3 years	250 mcg single-dose vials of lyophilized powder OR 500 mcg/mL multiple-dose vial of liquid	Sterile or Bacteriostatic water to reconstitute lyophilized powder 1 mL syringe with a 25 to 30 gauge 5/8-inch needle sterile alcohol swabs

*The on-body injector delivery method for peg-GCSF is not recommended for treating H-ARS.

**Mass and volume of supplies will depend on packaging and design reference mission requirements