Medications and flying

Lt Col John E. Henderson, CAPNREMT-Paramedic - Mission Check Pilot

Lt Col Jett Mayhew NHQ DDRO

How to deal with the common coldHow to deal with the common cold

• Stay home and rest!Stay home and rest!

• Don’t smoke and avoid 2nd hand smokeDon’t smoke and avoid 2nd hand smoke• Drink plenty of fluids (water, juices, clear soups)Drink plenty of fluids (water, juices, clear soups)

• NO ALCOHOL! NO ALCOHOL!

• Gargle with warm salt water to relieve a sore throat. Gargle with warm salt water to relieve a sore throat. Throat Sprays or Lozenges.Throat Sprays or Lozenges.

• Salt Water nose drops to loosen mucus and moisten Salt Water nose drops to loosen mucus and moisten tender skin in the nosetender skin in the nose

What does OTC mean?What does OTC mean?

OTC = Over the CounterOTC = Over the CounterNo prescription required by No prescription required by physicianphysician

Four common typesFour common typesPain RelieversPain RelieversAntihistaminesAntihistaminesDecongestantsDecongestantsCough MedicinesCough Medicines

How to read an OTC drug labelHow to read an OTC drug label

• Active IngredientActive Ingredient (Relieves your symptoms)(Relieves your symptoms)• Uses Uses (Approved by FDA)(Approved by FDA)• WarningsWarnings (What to avoid while on this Rx)(What to avoid while on this Rx)• DirectionsDirections (How much to take and when)(How much to take and when)• Other InformationOther Information (How to store product)(How to store product)• Inactive IngredientsInactive Ingredients (Non active ingredients)(Non active ingredients)• Questions or commentsQuestions or comments (Toll Free Phone #)(Toll Free Phone #)

OTC Drug LabelOTC Drug Label

Pain RelieversPain Relievers

• Non-steroidal anti-inflammatory drugs (NSAID’s)Non-steroidal anti-inflammatory drugs (NSAID’s)– Works in the Skin, Muscles, and JointsWorks in the Skin, Muscles, and Joints

• AspirinAspirin (Bayer, St. Joseph’s)(Bayer, St. Joseph’s)• Ibuprofen Ibuprofen (Advil, Motrin IB)(Advil, Motrin IB)• Naproxen Naproxen (Aleve)(Aleve)• KetoprofenKetoprofen (Orudis KT)(Orudis KT)

• AcetaminophenAcetaminophen– Blocks painful stimulation in the brain and spinal cordBlocks painful stimulation in the brain and spinal cord

• (Tylenol, Tempra)(Tylenol, Tempra)

AntihistaminesAntihistamines

• Block receptors that trigger itching, nasal Block receptors that trigger itching, nasal irritation, sneezing and mucus production.irritation, sneezing and mucus production.

– Types:Types:• DiphenhydramineDiphenhydramine (Banophen, Benadryl, (Banophen, Benadryl,

Diphenhist)Diphenhist)• BrompheniramineBrompheniramine (Dimetapp) (Dimetapp)• ChlorpheniramineChlorpheniramine (Aller-Chlor, Chlor-Trimeton)(Aller-Chlor, Chlor-Trimeton)

DecongestantsDecongestants

• How do decongestants work?How do decongestants work?– Narrow the blood vessels in the lining of the Narrow the blood vessels in the lining of the

nose. nose. – Less amount of blood is able to flow through Less amount of blood is able to flow through

the nasal areathe nasal area– Swollen tissue in the nose shrinksSwollen tissue in the nose shrinks

• PseudoephedrinePseudoephedrine– (Allermed, Genaphed, and Sudafed)(Allermed, Genaphed, and Sudafed)

Cough MedicinesCough Medicines

• AntitussivesAntitussives– Block the cough reflexBlock the cough reflex

• DextromethorphanDextromethorphan (Delsym, Drixoral, Pertussin (Delsym, Drixoral, Pertussin CS, Robitussin Pediatric)CS, Robitussin Pediatric)

• ExpectorantsExpectorants– Thin mucus, make coughing more productive Thin mucus, make coughing more productive

in cleaning mucus from the airwayin cleaning mucus from the airway• GuaifenesinGuaifenesin (Guiatuss, Robitussin, Tusibron)(Guiatuss, Robitussin, Tusibron)

Side Effects of Aspirin and NSAID’sSide Effects of Aspirin and NSAID’s

• GI ProblemsGI Problems– Can range from upset stomach to GI bleedingCan range from upset stomach to GI bleeding– Mostly affects the older populationMostly affects the older population– Chances increase with larger dosesChances increase with larger doses

• Kidney damageKidney damage

• High blood PressureHigh blood Pressure

• Liver damageLiver damage

• GI ProblemsGI Problems– Can range from upset stomach to GI bleedingCan range from upset stomach to GI bleeding– Mostly affects the older populationMostly affects the older population– Chances increase with larger dosesChances increase with larger doses

• Kidney damageKidney damage

• High blood PressureHigh blood Pressure

• Liver damageLiver damage

Side Effects of AcetaminophenSide Effects of Acetaminophen

• Long term users = kidney diseaseLong term users = kidney disease

• Analgesic nephropathyAnalgesic nephropathy– Chronic kidney disease that gradually leads to Chronic kidney disease that gradually leads to

end-stage renal disease and the need for end-stage renal disease and the need for permanent dialysis or a kidney transplant to permanent dialysis or a kidney transplant to restore renal function. restore renal function.

– After years or decades of useAfter years or decades of use

Side Effects of AntihistaminesSide Effects of Antihistamines

• Sedation or DrowsinessSedation or Drowsiness

• Increases the risk of fallingIncreases the risk of falling

• Temporary dry mouth or eyesTemporary dry mouth or eyes

Side Effects of DecongestantsSide Effects of Decongestants

• NervousnessNervousness• DizzinessDizziness• SleeplessnessSleeplessness• Loss of appetiteLoss of appetite• Retention of urineRetention of urine• Heart PalpitationsHeart Palpitations• High Blood PressureHigh Blood Pressure• High Blood Sugar LevelsHigh Blood Sugar Levels

Side Effects of Cough MedicineSide Effects of Cough Medicine

• With codeineWith codeine– NauseaNausea– SedationSedation– ConstipationConstipation

• With dextromethorphan (Drixoral, Pertussin, and With dextromethorphan (Drixoral, Pertussin, and Robitussin)Robitussin)– Lower risks of sedation and GI effectsLower risks of sedation and GI effects– Feelings of confusion, agitation, nervousness, and Feelings of confusion, agitation, nervousness, and

irritabilityirritability

Drug InteractionDrug Interaction

• All drugs are metabolized differentlyAll drugs are metabolized differently

• Drugs can have greater impacts on the Drugs can have greater impacts on the body if mixed with other drugsbody if mixed with other drugs

• Always seek medical advice if taking Always seek medical advice if taking multiple medicationsmultiple medications

AlcoholAlcohol

• Alcohol will increase chances for:Alcohol will increase chances for:– GI BleedingGI Bleeding

• Alcohol will increase effects of:Alcohol will increase effects of:– DrowsinessDrowsiness– Impaired motor skillsImpaired motor skills– SedationSedation

FAA MedicationsFAA Medications

• www.aopa.org/members/databases/medical/druglist.cfm

• What is allowed by the FAA!What is allowed by the FAA!

FAA MedicationsFAA Medications

DO NOT ANSWER OUT LOUD!!!DO NOT ANSWER OUT LOUD!!!

How many of you have taken benadryl due to a How many of you have taken benadryl due to a cold?cold?

That is not allowed by the FAA!!That is not allowed by the FAA!!

STOP AND THINK THE LIFE YOU SAVE MAY STOP AND THINK THE LIFE YOU SAVE MAY BE YOU AND YOUR CREWBE YOU AND YOUR CREW

CAP – Cadet Programs DDR and CAP – Cadet Programs DDR and USAFUSAF