CFI-to-CFI Newsletter - Volume 12 Issue 4 - 11

LEAd
pneumonia, skin infections, sinus infections, and
urinary tract infections. Quinolone antibiotics
that are commonly prescribed are Levofloxacin
(Levoquin®), ciprofloxacin (Cipro®), and
ofloxacin (Floxin®). Verapamil (Verelan PM®) is
a calcium channel blocking agent used to control
heart rate in patients with atrial fibrillation and
blood pressure in patients with hypertension.
Phencyclidine (PCP) is a hallucinogen found in
a street drug called Angel Dust. Medications
that may cause a falsely elevated PCP level
are Dextromethorphan, diphenhydramine,
doxylamine, ibuprofen, and tramadol.
Diphenhydramine (Benadryl®) is an OTC longacting
antihistamine found in many different
combination products for seasonal allergies.
In my humble opinion, no pilot should ever
use diphenhydramine for seasonal allergies
or for sleep (Tylenol PM). It is on " Larry's
NEVER to take list. " The sedative effect of this
antihistamine ( " hangover effect " ) is a no-go
for flight. Diphenhydramine takes 60 hours
to be eliminated from the body. Doxylamine
(Unisom®) is an OTC sleep aid that is on the FAA
no-fly list. Ibuprofen (Motrin®) is an NSAID
used for pain and inflammation. Tramadol
(Ultram®) and tramadol with acetaminophen
(Ultracet®) are pain medications that work on
the same receptors as opiates. Please see the FAA
medication database on aopa.org for specific
prescribing criteria and the 48-hour wait period
before flying after taking tramadol.
Tricyclic antidepressants (TCAs) are the first
generation of medications used for depression
and are rarely used in healthcare nowadays.
This category of medications caused many
side effects that included cardiac arrhythmias.
Diphenhydramine can cause a false elevation
urine test for TCA.
BEST PRACTICES
My recommendations are to only take the
medications that are prescribed for you. Do
not take medications that are prescribed
for someone else. Always have your updated
medication record available that can be supplied
to your primary care provider and all specialists.
Inform your provider of all OTC medications
you are taking. Ensure that all of your currently
prescribed and OTC medications are included
when renewing your medical.
I hope you never have to be the receiver of a
falsely positive urine drug test. The impact on
your license and medical can be significant.
There is an alternate testing method to
distinguish if a urine test is a true false positive
or true positive result. Gas chromatographymass
spectrometry (GCMS) or highperformance
liquid chromatography (HPLC) are
more sensitive than the typical urine tests.
Pilots know that knowledge is power and this
rarely studied phenomenon is another tool in
your pilot toolbox. Be well and be safe.
Larry Diamond has a Doctor of Pharmacy
Degree and has been a pharmacist for 37 years.
Larry's pharmacy practice has been as a Clinical
Pharmacy Specialist in Cardiology, Orthopedic
Surgery Specialist and most recently Clinical
Pharmacy Coordinator. He is a CFII, a pilot for 33
years and has been an AOPA member since 1984.
This article was first published online as a twopart
article June 2021 and August 2021, for
AOPA Pilot Protection Services.
http://www.aopa.org https://pilot-protection-services.aopa.org/ https://pilot-protection-services.aopa.org/
CFI-to-CFI Newsletter - Volume 12 Issue 4

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