航空醫學

美國聯邦航空總署(FAA)藥物相關規範

有關FAA於航空醫學體檢指南(Guide for Aviation Medical Examiners)藥物治療部分內容摘述如后:

一、Pharmaceuticals (Therapeutic Medications) 治療藥物

 

二、Do Not Issue – Do Not Fly. 「勿發證-勿飛行」

https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/dni_dnf/
#此表無法涵蓋所有資訊,僅列出最常見的議題#

(一) Do Not Issue. 「勿發證」

飛行員使用以下藥物時,航空體檢醫師若未經FAA核可,不應核發體檢證。

  • Angina medications心絞痛藥物
    nitrates (nitroglycerin, isosorbide dinitrate, imdur),
    ranolazine (Ranexa).
  • Anticholinergics (oral) 抗乙醯膽鹼類
    e.g: atropine, benztropine (Cogentin)
  • Cancer treatments癌症治療 including chemotherapeutics, biologics, radiation therapy, etc., whether used for induction, "maintenance," or suppressive therapy.
  • Controlled Substances 管制藥物 (Schedules I - V). An open prescription for chronic or intermittent use of any drug or substance.
  • Diabetic medications糖尿病藥物
  • Dopamine agonists used for Parkinson's disease or other medical conditions用於帕金森病或其他疾病的多巴胺受體促進劑:
    bromocriptine (Cycloset, Parlodel),:pramipexole (Mirapex), ropinirole (Requip), and rotigotine (NeuPro)
  • FDA (Food and Drug Administration) approved less than 12 months ago. FDA美國食品及藥物管理局批准上市不到12個月之新藥
  • Hypertensive (centrally acting) 高血壓藥物including but not limited to clonidine, nitrates, guanabenz, methyldopa, and reserpine
  • Malaria medication –抗瘧疾藥物  mefloquine (Lariam)
  • Over-active bladder (OAB)/Antimuscarinic medications過動性膀胱(OAB/抗毒蕈鹼藥物 as these carry strong warnings about potential for sedation and impaired cognition.
    e.g.: tolterodine (Detrol), oxybutynin (Ditropan), solifenacin (Vesicare).
  • Psychiatric or Psychotropic medications精神科或精神疾病藥物, (even when used for something other than a mental health condition) including but not limited to:
    antidepressants (certain SSRIs may be allowed - see SSRI policy)
    antianxiety drugs - e.g.: alprazolam (Xanax)
    antipsychotics
    attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) medications
    mood stabilizers
    sedative-hypnotics
    stimulants
    tranquilizers
  • Seizure medication抗癲癇藥物s, even if used for non-seizure conditions such as migraines
  • Smoking cessation aid輔助戒菸藥物 - e.g.: varenicline (Chantix)
  • Steroids, high dose 類固醇,高劑量(greater than 20 mg prednisone or prednisone-equivalent per day)
  • Weight loss medications 減肥藥- ex: combinations including phentermine or naltrexone.

(二) Do Not Fly. 「勿飛行」

為了飛航安全,機師若服用以下藥物後,若沒有超過「*特定時間」,則不應從事飛行。(以下藥物可能導致鎮靜(昏昏欲睡),影響認知功能,嚴重妨礙飛行表現。)
*最大藥理半衰期五倍的時間,或是
*若無最大藥理半衰期資訊,則是五倍最大給藥間隔。

有警示的藥物
機師若服用任何處方藥或成藥,藥物有提醒或警示其「可能造成服藥者昏昏欲睡」或是「建議服藥者若開車或是操作機械時必須小心」,則機師不應從事飛行,即使機師先前服用過此藥而無任何不適。

  • Allergy medications. 抗過敏藥物
  • Sedating Antihistamines. 鎮靜性抗組織胺These are found in many allergy and other types of medications and may NOT be used for flight. This applies to both nasal and oral formulations.
  • Nonsedating antihistamines. 非鎮靜性抗組織胺Medications such as loratadine, desloratadine, and fexofenadine may be used while flying, if symptoms are controlled without adverse side effects after an adequate initial trial period.
  • Muscle relaxants肌肉鬆弛劑: This includes but is not limited to carisoprodol (Soma) and cyclobenzaprine (Flexeril).
  • Over-the-counter active dietary supplements 某些保健營養補充品such as Kava-Kava and Valerian.
  • Pain medication止痛藥:
    Narcotic pain relievers. 嗎啡類止痛劑 This includes but is not limited to morphine, codeine, oxycodone (Percodan; Oxycontin), and hydrocodone (Vicodin, etc.).
    Non-narcotic pain relievers 非嗎啡類止痛劑such as tramadol (Ultram).
  • "Pre-medication" or "pre-procedure" drugs 術前或程序前給藥. This includes all drugs used as an aid to outpatient surgical or dental procedures.
  • Sleep aids. 助眠藥All the currently available sleep aids, both prescription and over-the-counter (OTC), can cause impairment of mental processes and reaction times, even when the individual feels fully awake.
  • Diphenhydramine (Benadryl) - Many OTC sleep aids contain diphenhydramine as the active ingredient. The wait time after diphenhydramine is 60 hours (based on maximum pharmacologic half-life)