Medication for pilots

Introduction

Medication or medicine can be defined is a pharmaceutical drug that has been chemically manufactured for the intended use of a medical diagnosis, cure, treatment, prevention of illness or disease.

As a pilot, it is important to be fit to fly. This means being free of all physical illness, so as to be mentally, physically and emotionally ready for any task. However it is not uncommon for pilots to fall ill and be prescribed over the counter drugs by their family physician. Thus for aviation professionals, usage of medication should be accompanied with a close understanding of the characteristics a drug has, especially its half-life and its effect on performance (Hawkins & Orlady, 1993). The half-life of a drug is the time it takes for the drug to lose half its original concentration or activity after being introduced into the body (National Library of Medicine). This affects the body and may be incompatible with flying or managing air traffic control towers. Thus aviation professionals need to be aware of how side effects may be important in relation to their jobs. (Campbell & Bagshaw, 2002). Common side effects of medication on the human body may include depression of sensory function, decreased co-ordination, drowsiness and impaired judgment (Campbell & Bagshaw, 2002). Some side effects however may be minor in the ground environment, but maybe less predictable at altitude.

Medical certification for pilots

International Civil Aviation Organisation (ICAO) sets the medical standards and requirements for aviation licenses across the world, but each state is able to interpret these guidelines in their own way. As accruing to ICAO, o become a professional pilot, any applicant must be in "normal good health including normal hearing, normal vision and normal color perception".

There are three types of medical certificates granted to pilots on the basis that they pass the medical checks.

  • Third Class Medical Certificate: necessary to exercise the privileges of a private pilot license or certificate. You can also exercise the privileges of a recreational pilot certificate, student pilot certificate, or flight instructor certificate with this medical certification. In the United States, it expires after 60 calendar months for someone under the age of forty years, or 24 calendar months for someone over forty.
  • Second Class Medical Certificate: necessary to exercise the privileges of a commercial pilot license or certificate. In the United States, it expires after 12 calendar months.
  • First Class Medical Certificate: necessary to exercise the privileges of an airline transport pilot license or certificate. In the United States, it expires after (12 calendar months Under 40) (6 months over 40) for those operations requiring a First-Class Medical Certificate; 12 calendar months for those operations requiring only a Second-Class Medical Certificate; or 24 or 36 calendar months, as set forth in 61.23, for those operations requiring only a Third-Class Medical Certificate.

(Adopted from wikipedia Medical certifications for pilots)

When a certificate is expired, it may still be used to exercise the privileges of the highest level that would not yet have expired. For example, a nine month old American first class certificate could be used as a second class certificate.

Prevalence in General Aviation

A study done by the Federal Aviation Administration (FAA) in 1994 estimated that 14000 US pilots flew while using illegal substances, prohibited medication or even with significant unreported medical conditions. Toxicological results from investigated accidents by the National Transportation Safety Boards (NTSB's) have shown that although rare, pilots have taken medication or illicit substances and that some of these substances have caused or are a factor in fatal aviation accidents.

Common minor ailments and their treatment

If a pilot encounters any discomforting symptoms or illness, he or she should not try to self medicate, chiefly if they are a flying a plane full of passengers. The best course of action a pilot could take when ill is to see a doctor before attempting to fulfill his job obligations. There are some cases where pilots would try to relieve some of their symptoms through the use of over-the-counter drugs. Keep in mind though that these self-medicating pills will only prevent the symptoms from appearing for a short amount of time. Only a doctor will be able to prescribe medication that will have the potential to cure those symptoms. Otherwise, the pilot will not be able to function at his/her best ability.

The list below describes the common off-the-shelf-drugs or over-the-counter-medication that are can be used to cure common illnesses.

Symptom Medication Description Side effect
Cold / flu Antihistamines Often used to combat colds and hay fever (Robson, 2008) symptoms. Antihistamines work by preventing the actions of a bodily substance called histamine that is produced naturally to defend the human body. Antihistamines block histamine receptors, thus reducing the reactions that cause itching (Marshall, 2011). Drowsiness, headaches, blurred vision, constipation, dry mouth, dizziness, confusion, difficulty passing urine
Decongestants Used for the interim relief of stuffy nose, sinus or other breathing sickness such as hay fever and bronchitis; decongestants work by narrowing blood vessels to decrease swelling and congestion. Nausea, vomiting, trouble sleeping, dizziness, headache or nervousness.
Cough suppressants Cough suppressants affect the chemicals in the brain that disrupt the triggers for a cough reflex. Severe dizziness, anxiety, nervousness, confusion, hallucinations, slow breathing, stomach upset.
Pain / fever Aspirin This common over the counter drug is an effective fever reducer and pain reliever that also stops swelling. Aspirin is also an Unique NSAID (Ogbru, 2012), as it is the only NSAID that inhibits blood from clotting making it an ideal drug that prevents heart attacks and strokes. Nausea, hyperventilation, stomach ulceration, ringing in ears, angioedema (swelling of skin tissues).
Nonsteroidal Anti-inflammatory drugs (NSAIDs) COX enzymes produce prostaglandins that in turn “promote inflammation, pain and fever while supporting the blood clotting function of platelets while protecting the lining of the stomach from the damaging effects of acid.” (Ogbru, 2012) Nausea, vomiting, diarrhea, constipation, decreased appetite, rash, dizziness, headache and drowsiness.
Tylenol Suggested as the safest medication to reduce fever and relieve pain, and is even available for children as young as 2 months. Liver damage when taken in large doses.
Bowel preparations Laxatives Helps you empty your bowels if you are having problems using the toilet. Bloating, flatulence, abdominal pain, nausea, skin rash, dizziness, fainting.
Anti-diarrheal agents Anti-diarrheal agents help manage diarrhea. Diarrhea is when one’s bowel movements become more frequent than usual and the stool is thin and watery. By slowing the movement of stools through the intestines, Anti-diarrheal drugs allows the body more time to absorb water, minerals and salt back into the body. Constipation, bloating, fullness, skin rash, drowsiness, dizziness, tiredness, dry mouth, nausea, vomiting, swelling and pain in the abdomen.

This is not a comprehensive list, but an overview of easily available over the counter drugs.

References

  1. American Federal Aviation Authority Retrieved from http://www.faa.gov/.
  2. Campbell, R.D. & Bagshaw, M. (2002). Human performance and limitations in aviation (2nd ed.). Oxford, United Kingdom: Blackwell Science.
  3. FAA Toxicological Findings of Pilots Involved in Aviation Accidents Operated Under Title 14 CFR Part 135. Retrieved from http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA506749
  4. Hawkins, F.H. (1993). Human factors in flight (2nd ed.). Farnham, England: Ashgate.
  5. ICAO Aviation Medicine FAQ's. Retrieved from http://legacy.icao.int/icao/en/med/MEDfaq_en.html#1
  6. Marshall, H. (2011, November 07). Antihistamines. Retrieved from http://www.netdoctor.co.uk/skin_hair/eczema_antihistamines_003764.htm.
  7. Medical Certification for pilots Retrieved from http://en.wikipedia.org/wiki/Medical_certifications_for_pilots.
  8. U.S. National Library of Medicine Retrieved from http://www.nlm.nih.gov/.
  9. Ogbru, O. (2012, February 10). Nonsteroidal antiinflammatory drugs (nsaids). Retrieved from http://www.medicinenet.com/nonsteroidal_antiinflammatory_drugs/article.htm.
  10. Robson, D. (2008). Human being pilot: Human factors for aviation professionals. Cheltenham, Australia: Aviation Theory Centre.

Want to know more?

FAA Accepted Medication List
The following list of FAA accepted medication was developed by Pilot Medical Solutions through communication with the Federal Aviation Administration

FAA 2012 Guide for Medical Examiners : This online PDF document provides access to information regarding regulations, medical history, examination procedures, dispositions, and protocols.


Contributors to this page

Authors / Editors

Russell KwaRussell Kwa


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