The Relief Band for Nausea Relief

On 12/27/07 5:01 PM, in article
, "Dan G"
wrote:

On Dec 27, 6:54 pm, danlj wrote:

2: scopalamine is a prohibited medication per FAA aeromedical rules,
so if you have an incident and are found to have been using it, be
aware that your insurance may not cover you, and you may face
enforcement action on your licence if you survive. The non-requirement
of medical certification for glider pilots is not permission to fly
impaired. Every pilot is required by FARs to refrain from flying with
any unsafe condition.

You piqued my interest in the US rules so I went looking for them. As
far as I can see there is no such thing as a "prohibited" medications
list in FAA regs. I did find, in Title 14 Part 91, the following:

91.17 Alcohol or drugs.

(a) No person may act or attempt to act as a crewmember of a civil
aircraft--

(1) Within 8 hours after the consumption of any alcoholic beverage;

(2) While under the influence of alcohol;

(3) While using any drug that affects the person's faculties in any
way contrary to safety

Also on the FAA website a guidance note on OTC medicines:


http://www.faa.gov/pilots/safety/pilotsafetybrochures/media/Meds_flying_web.pd
f

Which makes it clear that a pilot should not fly if using a drug that
lists drowsiness as a side-effect.

All the new-generation "non-sedating" antihistamines list "drowsiness"
as a side-effect and I personally know several pilots who use them for
hay-fever relief :-/.


Dan

The FAA allows a lot of medications to be used by pilots that have potential
side effects. Then again, there are certain medications that are prohibited
outright, whether or not the pilot has side effects.

Examples of ones that can be used if there are no side effects after a 48
hour ground test (this assumes that the underlying condition itself would
not prevent safe performance of crew duties):
Motrin and other NSAIDs
Antibiotics
Non-sedating antihistamines (Allegra, Claritin, and Clarinex if no side
effects after 48 hours, but not Zyrtec)
Blood pressure meds (there are some additional rules with this one.)
Etc. etc. There are many like this.

Examples of meds that can't be used at all, regardless of side effects, or
effects of the underlying disorder:
Antidepressants
Antipsychotics
Muscle relaxers
Antiseizure meds (whether or not there is a seizure disorder)
Sleeping pills (duh!)
Narcotic pain killers
etc. etc. There are many like this, also. Sometimes history of use of
these meds requires a waiver ("special issuance", in FAA lingo), sometimes
just a waiting period after the last dose.

For what it's worth, you should get competent advice from someone who knows
before flying after use of any meds.

But the truth of the matter is, FAR 61.53 makes you your own flight surgeon,
by placing the responsibility for medically grounding and ungrounding,
squarely on you. Even power pilots who require a medical can determine
(between their medicals) for themselves if they can safely perform their
crew duties. AME's only perform the medical exam, they don't ground and
unground the way a military flight surgeon does, between medicals.

Again, I recommend you make this kind of decision only after seeking
competent advice (which, in some cases is not your local AME: many of them
do so few medicals and have such little aviation medicine expertise that
they just don't know, no matter how well meaning they are).

Respectfully,
Bullwinkle
Also a physician, board certified in Aerospace Medicine

On Dec 28, 12:30*am, Bullwinkle wrote:
Examples of meds that can't be used at all, regardless of side effects, or
effects of the underlying disorder:
* * Antidepressants
* * Antipsychotics
* * Muscle relaxers
* * Antiseizure meds (whether or not there is a seizure disorder)
* * Sleeping pills (duh!)
* * Narcotic pain killers
* * etc. etc. There are many like this, also. Sometimes history of use of
these meds requires a waiver ("special issuance", in FAA lingo), sometimes
just a waiting period after the last dose.

Can you or anyone else link to this list please?


Dan

On 12/27/07 5:49 PM, in article
, "Dan G"
wrote:

On Dec 28, 12:30*am, Bullwinkle wrote:
Examples of meds that can't be used at all, regardless of side effects, or
effects of the underlying disorder:
* * Antidepressants
* * Antipsychotics
* * Muscle relaxers
* * Antiseizure meds (whether or not there is a seizure disorder)
* * Sleeping pills (duh!)
* * Narcotic pain killers
* * etc. etc. There are many like this, also. Sometimes history of use of
these meds requires a waiver ("special issuance", in FAA lingo), sometimes
just a waiting period after the last dose.

Can you or anyone else link to this list please?


Dan

The FAA doesn't publish a list of approved and disapproved meds: they say it
would change too frequently to keep current (probably true).

Good approximations of the current meds list can be found at either:
Www.aviationmedicine.com
Www.leftseat.com

Respectfully,
Bullwinkle

On Dec 27, 6:30 pm, Bullwinkle wrote:
For what it's worth, you should get competent advice from someone who knows
before flying after use of any meds.

But the truth of the matter is, FAR 61.53 makes you your own flight surgeon,
by placing the responsibility for medically grounding and ungrounding,
squarely on you.

Again, I recommend you make this kind of decision only after seeking
competent advice (which, in some cases is not your local AME: many of them
do so few medicals and have such little aviation medicine expertise that
they just don't know, no matter how well meaning they are).

Amen.

I wasn't going to take the time to add anything to this thread, but
can't resist a summary.

Pilots may be:
1: Unimpaired
1B: Unaware of impairment (feels the same as unimpaired)
1C: "Potentially" impaired (by meds, fatigue, etc.)
2: Impaired and aware of it.
2B: Able to compensate or escape to safety
2C: Unable to compensate or escape

Advice-givers should generally refrain from recommending anything that
could be associated with potential impairment (see elsewhere in this
thread for instances of such).

Pilots are responsible for self-assessment, but as this is difficult
(impossible to do objectively), should seek and welcome observations
and counsel of others in the decision not to fly.

Example of "medical" impairment: Simply stay sober while watching
other people consume ("medical") alcohol at a social gathering. If
you're watching carefully, just ONE drink changes the verbal and motor
performance of everyone except a daily-drinker. They s-l-o-w d-o-w-n
mentally, physically, verbally.

Example of physical impairment relevant to this thread: motion
sickness and the sopite syndrome (motion-induced drowsinesss): I get
very sleepy before I get sick; vomiting on my shirt on final (which
I've done) is not as distracting, in my experience, as experiencing
micro-sleep while thermaling (which I've done). I realized this
spring that this is getting worse for me; one April day at 3000 agl, I
forced myself to make 2 decisions: one, to return, land, and stow the
glider; two, to decide whether I should quit soaring.

My decision is relevant to the suggestion by some that motion-sickness
drugs are all right because they help, because the impairment of drug
(undetected by the user) is less than the impairment of the motion
sickness (unavoidable and distracting).

My decision was to *acclimate*, not to take medications - the
'treatment' was to take soaring flights more often, briefly, to
acclimate to motion sickness, and to drink a cup or two of coffee
before lunch (caffeine has been shown to enhance performance slightly)
on soaring days.

As an AME, physician, and opinionater, I feel quite safe in
recommending that one acclimitize. There are ways to do this other
than flying; I know of an aerobatic pilot who stood on his head
several times a day to maintain acclimation during non-flying periods;
or play that involves spinning and jumping should also help. On the
other hand, I do not feel quite safe in recommending that anyone fly
when potentially or actually impaired.

In saying this, I realize that some tasks are simple and hard to mess
up, e.g., local soaring on a sunny calm day. And other tasks are
exceedingly complex, e.g., single-pilot hand-flown IFR in IMC, at
night, in rain or snow, to minimums, in a complex turbocharged
airplane, or contest flying on the ridge with complex navigation and
planning tasks. (We just lost a colleague in NZ like this, obviously
one factor went undetected; what it was, we'll never know.)

Thus "Impairment" is relative to the task at hand.

Best wishes,

Dan Johnson