Minnesota Flyer - Serving Midwest Aviation Since 1960

By James D. Lakin
PhD MD FACP CFI CFII MEI Airline Trans Pilot FAA Sen Aviation Med Examiner 

Medications on the Mind: Flying (or Not) with Drugs: II

 

January 1, 2019



Last month we covered things to think about before taking a medication and hopping into the cockpit.

Medications can cause a world of trouble for a pilot including idiosyncratic reactions and side-effects as well as failure to control the underlying condition for which you’re taking the drug.

Light-headedness, drowsiness, dizziness and visual disturbance are the tops of the pops for side-effects that can cause a flight into the glass mountain.

So what are some of the drugs to for-sure stay away from? The FAA lists several categories that are absolutely grounding:

• Angina medications: These are pills like nitroglycerin that you take if your coronary arteries are narrowed such that you get pain in the chest from exertion or anxiety—like hand-flying an ILS in the clag.

• Cancer treatment drugs: Let’s face it. If you’re being treated for cancer you’ve got other things to worry about than flying.

• Controlled Substances: This includes all narcotics. Again if you have something so serious that you need narcs, you shouldn’t be flying. Medical marijuana also falls into this category. Using it will ground you. Although possessing medical marijuana is legal in Minnesota, once you leave the ground and enter federal airspace, it’s not.

• Malaria medication: A lot of these drugs mess with your mind. If you are flying into a malaria infested area, don’t start your prophylaxis until you’ve landed.

• Seizure medications: Obviously they can mess with your mind. Even more important an active seizure disorder is unacceptable for flight.

• Smoking cession pills: These also have an effect on the brain beyond lowering your urge to smoke.

• Weight loss medications: Again many of these act on the brain in funny ways. The OTC weight loss aids that are not FDA regulated may contain God-knows-what! Do not take them and fly.

• Over-Active-Bladder Aids: Many of these pills can affect vision and cause drowsiness and confusion. But if you do have an over-active bladder do you really think cross-country flying is a good idea?

• Psychiatric Medications: Obviously if you have a major psychiatric disorder flying is not for you. Anti-anxiety and sleeping medications fall into this category and should only be used with your AME’s OK. Again, consider why you are taking these drugs. The reason may disqualify you from flying until things clear up.

• Medications on the market less than 12 months after FDA approval: This is a tricky one. So often when a new medication comes out a drug rep gets with your doc and convinces him it’s the latest and greatest for whatever. Then he gives him a crate of samples to try on his patients.

Although the FDA requires rigorous safety testing before a drug is released, all kinds of previously unobserved side effects can pop up after the medication gets out to the general public. That is why the FAA waits for at least a year before approving any new drug.

• Steroids in high dose: The FAA defines high dose as anything greater than 20 mg of prednisone or its equivalent per day. Tell your doc that and she can figure it out. The concern here is that high dose steroids can push up the blood sugar, especially in someone with a diabetic tendency. Some folks can experience psychiatric problems such as psychosis. That’s an unusual reaction but do you want to be the one to get it?

• Centrally Acting Hypertension Drugs: Most drugs that are used to treat high blood pressure are OK to fly with. Your AME knows exactly what. Certain anti-hypertension drugs act on the brain to lower blood pressure such as clonidine (Catapres). They are not OK because they can cause sedation and dizziness.

Those are some of the absolute don’t-go-flying drugs. There are more. When in doubt ask your AME.

Next month we’ll talk a bit more about how to avoid getting into trouble with drugs in the cockpit (aside from not taking any!)

Fly wisely. See you next month.

As always, comments, questions and suggestions are wecome: jdlakin@mnallergyclinic.com

 

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