1. Medications and flying Major John E. Henderson, CAP NREMT-Paramedic Mission Check Pilot

2. How to deal with the common cold Stay home and rest! Stay home and rest! Don’t smoke and avoid 2 nd hand smoke Don’t smoke and avoid 2 nd 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. Throat Sprays or Lozenges. Gargle with warm salt water to relieve a sore throat. Throat Sprays or Lozenges. Salt Water nose drops to loosen mucus and moisten tender skin in the nose Salt Water nose drops to loosen mucus and moisten tender skin in the nose

3. What does OTC mean? OTC = Over the Counter OTC = Over the Counter No prescription required by physician No prescription required by physician Four common types Four common types Pain Relievers Pain Relievers Antihistamines Antihistamines Decongestants Decongestants Cough Medicines Cough Medicines

4. How to read an OTC drug label Active Ingredient (Relieves your symptoms) Active Ingredient (Relieves your symptoms) Uses (Approved by FDA) Uses (Approved by FDA) Warnings (What to avoid while on this Rx) Warnings (What to avoid while on this Rx) Directions (How much to take and when) Directions (How much to take and when) Other Information (How to store product) Other Information (How to store product) Inactive Ingredients (Non active ingredients) Inactive Ingredients (Non active ingredients) Questions or comments (Toll Free Phone #) Questions or comments (Toll Free Phone #)

5. OTC Drug Label

6. Pain Relievers Non-steroidal anti-inflammatory drugs (NSAID’s) Non-steroidal anti-inflammatory drugs (NSAID’s) Works in the Skin, Muscles, and Joints Works in the Skin, Muscles, and Joints Aspirin(Bayer, St. Joseph’s) Aspirin(Bayer, St. Joseph’s) Ibuprofen (Advil, Motrin IB) Ibuprofen (Advil, Motrin IB) Naproxen (Aleve) Naproxen (Aleve) Ketoprofen(Orudis KT) Ketoprofen(Orudis KT) Acetaminophen Acetaminophen Blocks painful stimulation in the brain and spinal cord Blocks painful stimulation in the brain and spinal cord (Tylenol, Tempra) (Tylenol, Tempra)

7. Antihistamines Block receptors that trigger itching, nasal irritation, sneezing and mucus production. Block receptors that trigger itching, nasal irritation, sneezing and mucus production. Types: Types: Diphenhydramine(Banophen, Benadryl, Diphenhist) Diphenhydramine(Banophen, Benadryl, Diphenhist) Brompheniramine (Dimetapp) Brompheniramine (Dimetapp) Chlorpheniramine(Aller-Chlor, Chlor-Trimeton) Chlorpheniramine(Aller-Chlor, Chlor-Trimeton)

8. Decongestants How do decongestants work? How do decongestants work? Narrow the blood vessels in the lining of the nose. Narrow the blood vessels in the lining of the nose. Less amount of blood is able to flow through the nasal area Less amount of blood is able to flow through the nasal area Swollen tissue in the nose shrinks Swollen tissue in the nose shrinks Pseudoephedrine Pseudoephedrine (Allermed, Genaphed, and Sudafed) (Allermed, Genaphed, and Sudafed)

9. Cough Medicines Antitussives Block the cough reflex Block the cough reflex Dextromethorphan (Delsym, Drixoral, Pertussin CS, Robitussin Pediatric) Dextromethorphan (Delsym, Drixoral, Pertussin CS, Robitussin Pediatric)Expectorants Thin mucus, make coughing more productive in cleaning mucus from the airway Thin mucus, make coughing more productive in cleaning mucus from the airway Guaifenesin (Guiatuss, Robitussin, Tusibron) Guaifenesin (Guiatuss, Robitussin, Tusibron)

10. Side Effects of Aspirin and NSAID’s GI Problems GI Problems Can range from upset stomach to GI bleeding Can range from upset stomach to GI bleeding Mostly affects the older population Mostly affects the older population Chances increase with larger doses Chances increase with larger doses Kidney damage Kidney damage High blood Pressure High blood Pressure Liver damage Liver damage

11. Side Effects of Acetaminophen Long term users = kidney disease Long term users = kidney disease Analgesic nephropathy Analgesic nephropathy Chronic kidney disease that gradually leads to end-stage renal disease and the need for permanent dialysis or a kidney transplant to restore renal function. Chronic kidney disease that gradually leads to end-stage renal disease and the need for permanent dialysis or a kidney transplant to restore renal function. After years or decades of use After years or decades of use

12. Side Effects of Antihistamines Sedation or Drowsiness Sedation or Drowsiness Increases the risk of falling Increases the risk of falling Temporary dry mouth or eyes Temporary dry mouth or eyes

13. Side Effects of Decongestants Nervousness Nervousness Dizziness Dizziness Sleeplessness Sleeplessness Loss of appetite Loss of appetite Retention of urine Retention of urine Heart Palpitations Heart Palpitations High Blood Pressure High Blood Pressure High Blood Sugar Levels High Blood Sugar Levels

14. Side Effects of Cough Medicine With codeine With codeine Nausea Nausea Sedation Sedation Constipation Constipation With dextromethorphan (Drixoral, Pertussin, and Robitussin) With dextromethorphan (Drixoral, Pertussin, and Robitussin) Lower risks of sedation and GI effects Lower risks of sedation and GI effects Feelings of confusion, agitation, nervousness, and irritability Feelings of confusion, agitation, nervousness, and irritability

15. Drug Interaction All drugs are metabolized differently All drugs are metabolized differently Drugs can have greater impacts on the body if mixed with other drugs Drugs can have greater impacts on the body if mixed with other drugs Always seek medical advice if taking multiple medications Always seek medical advice if taking multiple medications

16. Alcohol Alcohol will increase chances for: Alcohol will increase chances for: GI Bleeding GI Bleeding Alcohol will increase effects of: Alcohol will increase effects of: Drowsiness Drowsiness Impaired motor skills Impaired motor skills Sedation Sedation

17. FAA Medications www.aopa.org/members/databases/ medical/druglist.cfm www.aopa.org/members/databases/ medical/druglist.cfm www.aopa.org/members/databases/ medical/druglist.cfm www.aopa.org/members/databases/ medical/druglist.cfm What is allowed by the FAA! What is allowed by the FAA!

18. FAA Medications DO NOT ANSWER OUT LOUD!!! How many of you have taken benadryl due to a cold? That is not allowed by the FAA!!