Antihistamines : These are one of the common drugs used very frequently either alone or in combination for treatment of motion sickness, URTI, hay fever and various other allergies. In view of drowsiness associated, flying is not permitted while taking antihistamines and thereafter for 24hrs. to 48hrs. Safer antihistamines that cause less sedation and side effects are Astemizole, Loratidine and Fexofenadine
Hypnotics : No aircrew should be permitted to carry out their duties while under the effect of any sedativc or hypnotic. It adversely affects the performance on the following day also and there is increased tendency to sleep. A hypnotic with short duration action and free of residual effects on performance at the commencement of next duty period can be used on individual merit of the case. The drug recommended by the Royal Air Force is Temazipam (10-20mg) at bedtime to induce sleep 12hrs before next sortie. It is effective in inducing sleeping and free from residual sequelae.
Tranquilizers, Antidepressants and psychotrophic drugs are not compatible with flying. Usually the reasons for which these are given will render aircrew duties inadvisable
Nasal decongestants : These usually contain antihistamines and sympathomemitic agents. If given occasionally as drops or spray, these are usually safe when given in normal recommended manner on individual merit of case when off flying for few hours. When given orally the side effects are such as to make aircrew duties unsafe and no flying is permitted within 48hrs of the last dose.
Analgesics : Analgesics like Aspirin, Paracetamol and Brufen are frequently used for minor complaints like headache, bodyache and feverishness. Gastric irritation, nausea and vomiting may result due to use of these drugs. Aircrew requiring these drugs must be thoroughly evaluated to rule out systemic illness e.g. hypertension, impaired visual acuity and sinusitis etc.
Antibiotics : Illness(Infection) for which antibiotic is prescribed, precludes from flying.However, in certain chronic benign conditions e.g Acne where longterm small dose antibiotic e.g Teramycin / Ledermycin / Doxycycline is being given without any side effects, may be permitted flying on individual merit of the case
Antihypertensive : If hypertension is controlled without any evidence of target organ involvement; the drugs like Atenolol (max up to 100 mg per day), diuretics e.g Dytide, Natrilix except Lasix (loop diuretic), ACE inhibitors e.g Enalapril (max up to 20 mg per day) and calcium channel blockers e.g Amlodepine (max up to 10 mg per day), either alone or in combination of any above two groups are permitted for flying after initial trial on ground level
Antiplatelet in IHD : Disprin in small dose for long-term prevention in CAD is permitted after initial trial without side effects in stable cases of IHD.which are asymptomatic without clinical or significant investigative abnormality.
Drugs in dyspepsia : Drugs used are antacids and H2 receptor antagonist. Simple antacids without anticolinergic action after trial on ground level without side effects may be permitted till ailment itself does not preclude from flying. Simlarly H2 antagonist for example Ranitidine in dose of 150-300mg and Omeprazole 20-40mg per day may be permitted for flying on individual merit of case if disease does not disqualify flying and enough trial on ground has been given without side effects.
Oral hypoglycemic agent and Insulin in DM : These disqualify flying except two drugs e.g. Metformin and Acarbose that have been observed in non-flying category without side effects e.g. hypoglycaemia and diabetes is controlled well without any evidence of target organ involvement
Steroids : The need to take steroids systematically would rule out flying duties. Steroids applied topically are safe.
Antimalarials : The customary antimalarial for prophylaxis e.g. Chloroquine, Pyrimethamine and Amodiaquine are safe for aircrew, preferably at weekends when off flying. Quinine should not be used in view of the danger of vertigo.
Antidiarrhoea Medication : Diarrhoea itself limits flying duty. Simple Kaolin is safe. Other antidiarrhhoeal agent has one or the other side effects. From all points of view, it is always safe to ground the aircrew with diarrhoea that cannot be controlled by simple measures without side effects.
Motion sickness : The drug required to control it, usually contains Belladona alone or antihistamines and because of their side effects one is not permitted for solo flying. These drugs are usually only permitted for limited periods to flying personnels during training.
Allopurinol in gout : This drug has very few side effects and a gouty subject well controlled on this could be fit for aircrew duties.after initial trial on ground level on individual merit of the case
Immunisation : Following usual vaccination procedures for cholera, influenza, typhoid, tetanus, rabies and hepatitis etc a minimum of 24hrs off flying is advocated.
Anaesthetics : After a local anaesthesia there should be a period of rest of one day of flying depending upon circumstances.