Use in aviation personnel: Airman duties contraindicated for 2 days after parenteral use; for 24 hours after local use. Medical condition would often preclude duty.
VITAMIN K PREPARATIONS menadione (Kanone; Kappaxin; Kayklot; Kayquinone; Thyloquinone) menadione sodium bisulfite (Hykinone) phytonadione (Konakion; Mephyton) vitamin K, oxide Undesirable effects in aviation: Relatively nontoxic in adults.
Use in avlation personnel: Airman duties not contraindicated by the toxic effects from the agents.
12. ALIMENTARY AGENTS
ANTACIDS aluminum hydroxide gel (Alcid; Alokreen; Amphogel; Creamalin; Flungel; Gelumina; Hydroxal) aluminum phosphate (Phosphaljel) basic aluminum carbonate (Basaljel) calcium carbonate dihydroxyaluminum amino acetate (Alglyn; Alkam; Alminate;
Aspogen; Dimothyn; Robalate) gastric mucin magnesium oxide magnesium trisilicate (Chooz; Magmasil; Salicyl; Trimax;
Trinesium; Trisomin) polyamine-methylene resin (Exorbin) sodium bicarbonate Undesirable effects in aviation: Minor constipation or diarrhea.
At high altitudes, the CO, liberated by sodium bicarbonate may give dangerously increased intragastric pressure.
Use in aviation personnel: Airman duties not contraindicated by most of the agents. However, use of sodium bicarbonate should be limited to ground personnel.
ANTICHOLINERGICS (see under PARASYMPATHETIC DEPRESSANTS)
EMETICS apomorphine syrup of ipecac zinc sulfate Undesirable effects in aviation: Nausea and vomiting.
Use in aviation personnel: Airman duties contraindicated within 24 hours of use by the effects of the drug itself. The underlying medical condition would presumably contraindicate duty for a longer period.
CHOLERETICS bile acids bile salts (Chobile; Glycotauro; Plebilin) 31
dehydrocholic acid (Decholin; Dehychol; Dilabil; Hykolex;
Oxycholin; Procholon) florantyrone (Zanchol) ox bile extract sodium dehydrocholate Undesirable effects in aviation: Adverse effects unlikely.
Use in aviation personnel: Airman duties not contraindicated by use.
CATHARTICS: LUBRICANTS, SOFTENERS AND BULKY
SUBSTANCES calcium-bis-dioctyl sulfosuccinate (Surfak) dioctyl sodium sulfosuccinate (Colace) emulsion of liquid petrolatum (Agarol; Cremagol; Nivea Cream;
Petrogalar) liquid petrolatum (Albolene; Nujol; Saxol; Petronol) methylcellulose (Cellothyl) plantago ovata coating (Konsyl) poloxalkol (Polykol) psyllium hydrophilic mucilloid (Metamucil) sodium carboxymethyl cellulose (Almelose; Apergel; Carbethox;
Carmethose; Cethylose; Natulose) Undesirable effects in aviation: Leakage of oil from anus;
inspissation of fecal mass.
Use in aviation personnel: Airman duties not contraindicated by use.
CATHARTICS: SALINE, VEGETABLE AND OTHER aloe aromatic fluid extract of cascara bisacodyl (Ducolax) cascara castor oil diacetyldihydroxyphenylisatin (Isacen) magnesia magma (Milk of Magnesia) magnesium citrate magnesium sulfate mild mercurous chloride (Calomel) phenolphthalein rhubarb senna sodium phosphate sodium sulfate 32
36 tetanus antitoxin scarlet fever immune serum poliomyelitis immune globulin pertussis immune serum immune serum globulin hyperimmunized gamma-globulin gas gangrene antitoxin (various types) diphtheria antitoxin antivenin (various types)
IMMUNE SERA vaccine and smallpox vaccine which do not contraindicate duty.
hours or longer if reaction persists, except after oral poliovirus Use in aviation personnel: Airman duties contraindicated for 24 lassitude, aching to varying degrees.
Undesirable effects in aviation: Local pain, nausea, vomiting, yellow fever vaccine typhoid and paratyphoid vaccine (various forma) tuberculosis vaccine (BCG) smallpox vaccine rabies vaccine poliomyelitis virus vaccine (killed and attenuated) plague vaccine pertussia vaccine (various forms) mumps virus vaccine influenza virus vaccine epidemic typhus vaccine cholera vaccine adenovirus vaccine
VACCINES Use in aviation personnel: Work not contraindicated after use.
Undesirable effects in aviation: Local pain and soreness.
tetanus toxoid (various forms) diphtheria toxoid (various forms)
TOXINS AND TOXOIDS
14. AGENTS FOR IMMUNOLOGY AND ALLERGY
cular twitching, rare hyperpyresia. The drowsiness can be a particular hazard because it may not be recognized by the patient, and because it may recur after seeming alertness.
Use in avlation personnel: Airman duties contraindicated for 24 hours after administration of usual dose; for 12 hours after one-half of the smallest adult dose listed in USP or NND.
ANTIMOTION SICKNESS AGENTS cinnarazine (Mitronal) cyclizine (Marezine) meclizine (Bonamine; Bonine) phenglutaramide (Aturban) Undesirable effects in aviation: Similar to those for antihistamines.
Use in aviation personnel: Contraindications same as those for antihistamines.
Undesirable effects in aviation: Mild and severe hypersensitivity reactions.
Use in aviation personnel: Airman duties contraindicated for 24 hours after use, and in presence of any later effects.
ALLERGENIC AND DIAGNOSTIC PREPARATIONS allergenic preparations (danders, dusts, plants and many othere) skin test antigens (diphtheria, streptococcus, mumps, tuberculins) Undesirable effects in aviation: Local whealing and urticaria.
Use in avlation personnel: Airman duties contraindicated for 6 hours after use or in presence of any later adverse effects.
ANTIHISTAMINES antazoline (Antistine) antergan carbinoxamine (Clistin) chlorcyclizine (Perizil) chlorothen (Tagathen) chlorpheniramine (Chlor-Trimeton) chlorphenoxamine (Systiral) clemizole (Allercur) cyproheptadine (Periactin) dimethpyridene (Forhistal) diphenhydramine (Benadryl) diphenylpraline (Diafen) doxylamine (Decapryn) methapheniline (Diatrine) methapyrilene (Histadyl) methdilazine (Tacaryl) phenindiamine (Thephorin) pheniramine (Trimeton) promethazine (Phenergan) proxamine pyrathiazine (Pyrrolazote) pyrilamine maleate (Antamine; Antihist; Diamidide; Neoantergan; Renstamin; Thylogen) pyrrobutamine (Pyronil) thenalidine (Sandostene) thenyldiamine (Thenfadil) thonzylamine (Anahist; Neo-hetramine) tripellenamine (Pyribenzamine) triprolidine (Actidil) Undesirable effects in aviation: Drowsiness (excitement with phenindiamine), dizziness, dry mouth, headaches, nausea, mus- 37
Undesirable effecta in aviation: Allergic reactions and dermatitis; agranulocytosis.
Use in aviation personnel: Airman duties contraindicated until the drug effect is stabilized, and without the presence of adverse symptoms; thereafter it may be permissible for certain types of duty. Periodic medical examinations are indicated during the course of therapy.
IODIDES sodium iodide strong iodide solution (Lugol's) Undesirable effects in aviation: Iodism, characterized by dermatitis, bronchitis, stomatitis and mental depression.
Use in avlation personnel: Airman duties not contraindicated by iodides in usual dosage if no adverse effects are present.
ESTROGENS benzestrol (Octofollin) chlorotrianisene (Tace) dienestrol (Restrol) diethylstilbestrol (Stilbestrol) estradiol (Aquagen; Dimenformon; Diogyn; Estraldine; Ovocyclin; Progynon) estriol (Theedol) estrogenic substances, conjugated (Ammestrogen; Cogenat;
Conestron; Estrifol; Konogen; Premarin) estrone (Crystogen; Menagen; Menformin; Theelin; Thelestrin) ethinyl estradiol (Diogyn E; Esteed; Estinyl; Eticyclol; Inestra;
Novestrol; Orestralyn) hexestrol methallenestril (Vallestril) piperazine estrone sulfate (Sulestrex) Undesirable effects in aviation: Anorexia, nausea, vomiting, headache.
Use in aviation personnel: Airman duties contraindicated only if adverse effects are present.
PROGESTINS allylestrenol (Gestanon) ethisterone (Lucorteum; Lutocyclol; Lutoral; Ora-Lutin; Pranone; Progestoral; Tyrosinone) haloprogesterone (Prohalone) hydroxyprogesterone (Delantin) 41
medroxyprogesterone (Provera) norethindrone (Norlutin) norethynodrel (component of Enovid) normetandrone (Orgasteron) progesterone (Colprosterone; Lipo-Lutin; Lucocorteum; Lutocyclin; Syngesterone) Undesirable effects in aviation: Minor nausea.
Use in aviation personnel: Airman duties contraindicated only if adverse effects are present.
NONSTEROID LUTEAL FACTORS relaxin (Cervilaxin) lututrin (Lutrexin) Undesirable effects in aviation: Rare allergic sensitivity.
Use in aviation personnel: Work contraindicated only if adverse effects are present.
ANDROGENS dromostanolone (Drolban) fluoxymesterone (Halotestin; Ora-Testryl; Ultrandren) methalone methandrostenolone (Dianabol) methylandrostenediol (Androdiol; Methostan; Nabadial; Neostene; Stenediol) methyltestosterone (Dumogran; Masenone; Metandren; Oreton- M; Testra) nandrolone (Durabolin) norethandrolone (Nilevar) oxymetholone (Aldroyd) stanolone (Androlone; Neodrol) stanozolol (Winstrol) testosterone (Androlin; Mertestate; Neo-Hombreol; Oreton-F;
Synandrol; Testobase; Testry!)
Undesirable effects in aviation: Acne, baldness, testicular inhibition, priapism, hepatic damage (methyltestosterone, norethandrolone), sodium and water retention, hypercalcemia.
Use in avlation personnel: Airman duties contraindicated only if adverse effects are present.
GONADOTROPINS chorionic gonadotropin (Antuitrin; APL; Chorioginin; Follutein; Pregny!)
15. HORMONES
ADRENAL MINERAL CORTICOIDS desoxycorticosterone (Cortate; Cortenil; Cortiron; DCA; Syncort) Undesirable effects in aviation: Excessive retention of sodium with edema and hypertension; excessive depletion of potassium with muscular weakness.
Use in aviation personnel: Airman duties not contraindicated by the drug in the absence of side effects and when clinical condition is stable. However, underlying medical disease is ordinarily a contraindication to duty.
ADRENAL GLUCOSTEROIDS betamethasone (Celestone) chlorprednisone cortisone (Cortogen; Cortone) dexamethasone (Decadron) fludrocortisone (Alflorone) fluocinolone (Synalar) fluoxolonate (Oxylone) hydrocortisone (Cortef; Cortifan; Cortril; Heb-Cort; Hycortole; Hydrocortone) methy|prednisolone (Medrol; Wyacort) prednisolone (Cotolone; Delta-Cortef; Hydeltra; Meticortelone;
Ulacort) prednisone (Deltasone; Deltra; Listacort; Metasone; Meticorten;
Paracort) triamcinolone (Aristocort) Undesirable effects in aviation: Cushing's syndrome with edema, muscle wasting, osteoporosis, potassium loss and hypertension being particularly relevant to aviation. Also, aggravation of peptic ulcer and diabetes, masking of myocardial infarction, non-restraint of infections, mental changes, euphoria and psychotic reactions. Sudden withdrawal may produce prolonged mental depressions.
Use in aviation personnel: Airman duties contraindicated for 3 days after systemic use in customary dosage, or in the presence of any side effects. Topical use not a contraindication to duty.
Small, (physiologic) replacement, doses do not contraindicate duty, but the underlying medical state (adrenal insufficiency) ordinarily would.
ADRENAL CORTICAL HORMONE ANTAGONISTS mepyrapone (Metopirone) Undesirable effects in aviation: Vertigo; precipitation of adrenal insufficiency.
Use in aviation personnel: Airman duties contraindicated within 3 days of use.
CORTICOTROPIN corticotropin (ACTH; Acthar; Acthotrop; Cortrophin; Solacthyl) Undesirable effects in aviation: Allergic symptoms possible;
otherwise effects similar to, but milder than, adrenal glycosteroids.
Use in aviation personnel: Airman duties contraindicated for 2 days after use.
THYROID PREPARATIONS levothyroxine, sodium (Synthroid) liothyronine, sodium (Cytomel) thyroid thyroxin (see also Agents in Atherosclerosis under CARDIOVASCULAR
AGENTS) Undesirable effects in aviation: Signs and symptoms of hyperthyroidism: nervousness, tremor, sleeplessness, weakness, exophthalmos.
Use in aviation personnel: Airman duties not contraindicated when used in dosage adequate to control hypothyroidism without producing any significant hyperthyroidism; administration not permitted for the purpose of inducing hyperthyroidism
(e.g. in the treatment of obesity).
ANTITHYROID SUBSTANCES carbimazole (Neomercazole) iothiouracil (Itrumil) methimazole (Tapazole) methylthiouracil (Methiocil; Muracil) propylthiouracil thiouracil thiourea 40
Undesirable effects in aviation: Adverse effects unlikely.
Use in aviation personnel: Airman duties not contraindicated.
INSULINS insulin (all forms) Undesirable effects in aviation: Hypoglycemia with sweating, dizziness, impaired judgment, unconsciousness, convulsions;
rare allergic hypersensitivity.
Use in aviation personnel: Airman duties contraindicated by Federal Aviation Regulation for any patient taking any amount of insulin. However, if exceptions are made in the future for personnel with ground duty of noncritical nature, the following will provide a guide: Work may be permitted when the patient requires only small doses (less than 15 units) and has been under satisfactory medical control, without laboratory or clinical hypoglycemia, for 3 months.
INSULIN SUBSTITUTES chlorpropamide (Diabinese) phenformin (DBI) tolbutamide (Orinase) Undesirable effects in aviation: Chlorpropamide and tolbutamide may produce, variously: indigestion, urticaria, nausea, vomiting, flushing after alcohol, cholestatic jaundice, hypoglycemia (chlorpropamide), neurological disturbances (chlorpropamide), thrombocytopenia, agranulocytosis. Phenformin may produce severe gastrointestinal effects, acidosis and ketosis.
Use in aviation personnel: Airman duties contraindicated by Federal Aviation Regulation for a patient taking any amount of such drugs. However, if exceptions are made in the future for personnel with ground duty of noncritical nature, the following will provide a guide: Work may be permitted when the patient has been under satisfactory medical control, without laboratory or clinical hypoglycemia, for 3 months.
PARATHYROID parathyroid injection (Parathormone) Undesirable effects in aviation: Excessive dosage may produce hypercalcemia; little therapeutic application.
Use in aviation personnel: Airman duties contraindicated for 48 hours after use. Underlying medical condition would ordinarily preclude duty.
16. BLOOD, FLUIDS AND ELECTROLYTES
BLOOD AND BLOOD PRODUCTS albumin, normal human serum human albumin normal human plasma plasma protein fraction, human (Plasmanate) whole blood Undesirable effects in aviation: Incompatibility and other immune reactions; serum hepatitis.
Use in aviation personnel: Airman duties contraindicated for 8 days after use. Medical reason for use would ordinarily provide further contraindication.
PLASMA SUBSTITUTES dextran (Expandex; Gentran) gelatin solution, special intravenous (Plazmoid) polyvinyl pyrrolidone (Periston; PVP) Undesirable effects in aviation: Toxicity negligible, but immunnological type reactions may occur.
Use in aviation personnel: Airman duties contraindicated for 3 days after use. Medical reason for use would ordinarily provide further contraindication.
INORGANIC SALTS calcium gluconate calcium lactate calcium salts potassium chloride sodium bicarbonate sodium chloride sodium lactate Undesirable effects in aviation: Oral use in customary dosage unlikely to produce troublesome effects. Parenteral use may produce electrolyte disturbances.
Use in aviation personnel: Airman duties not contraindicated after usual oral dosages (except, potassium chloride contraindicates for 24 hours). Work contraindicated after parenteral use for 24 hours. Medical indication would ordinarily preclude duty.