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European Awancn Safety Agency
European Aviation Safety Agency
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USE
USE 0F
OF MEDICATION
MEDICATION
IN
IN THE
THE AVIATION
AVIATION
ENVIRONMENT
ENVIRONMENT
Guidance material for the
use of médication in aviation
environment

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INTRODUCTION
INTRODUCTION
+
►)- Guidance material
Guidance material for;
for:
General Medical
General Practitioners, consultants,
Medical Practitioners, consultants, spedalists
Specialists and
and Aeromedical
Aeromedical Examinées
Examiners (AMEs)
(AMES)

>>- Connecting the

Connecting choice of
the choice of médication
medication t0
to working conditions:
working conditions;
Mitigate risk factors through the right
Mitigate risk factors through the decisions and
right decisions and treatment
treatment

+ Use of
Use of médication;
medication:
Familiarization
Familiarization with
with drugs
drugs and
and their side effects
their side effects

4- Developing Trust
Developing Trust and
and Confidence
Confidence between
between pilot/air traffic Controller
pilot/air traffic controller (ATCO)and
(ATCO)and his/her
his/her
AME
AME

4- Educate pilots/ATCOS
Educate on the
pilots/ATCOs on potential risks
the potential risks of
of medication including self-medication
médication including self-medication and
and
the
the need
need to seek help
to seek help

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Guidance material for the
use of médication in aviation
environment

Main principles
Main of médication
principles of use in
medication use aviation
in aviation
Médication is used
Medication is used to treat aa variety
to treat of medical
variety of conditions or
medical conditions to relieve
or to relieve Symptoms. Many drugs
symptoms. Many drugs
are also available from pharmacists, supermarkets or on—line for self-medication‘
are also available from pharmacists, supermarkets or on-line for self-medication.

9.
•)- Evidence-based should evaluate
AMES should
prescription: AMEs
Evidence—based prescription: evaluate that the correct
that the i5
medication is
correct médication
prescribed to the right patient.
prescribed to the right patient.

Collaboration with patient

Collaboration with patient.

>>- Use of médication:

Use of Take into
medication: Take consideration the
into considération side effects
the side and the
effects and importance of
the importance of them in
them in
the aviation domain.
the aviation domain.

Balance benefit
•> Balance benefit and risk ratio:
and risk AMEs should
ratio: AMEs assess the
should assess illness itself,
the illness impact of
the impact
itself, the the
of the
and the
medication and
médication the risk and benefits
risk and for the
benefits for patient in
the patient his/her working
in his/her environment.
working environment.

►f Sources: Use official

Sources: Use official sources for information
sources for information on medication.
on médication.

MEDIBATION
MEDICATIOH
SIDE
SIDE EFFECTS
EFFECTS
Guidance material for the
use of médication in aviation
environment
/////////////////Z^////////ZA

guidance
prescribing guidance
General prescribing
General
I? 1
Key points:
Key points:

+ the kind
Identify the
+ Identify kind and severity of
and severity of the disease.
the disease.

Assess the
M} Assess
-f of the
risk of
the risk itself to
disease itself
the disease working
the working
to the
environment.
environment.

+ Consider
►f working conditions
the working
Consider the (such as
conditions (such altitude,
as altitude,
cabin pressure, stress...) in relation with the
cabin pressure, stress...) in relation with the disease and
disease and
treatment‘
treatment.
Scan QR code
the QR
Scan the code
+ Examine the
Examine effects of
side effects
the side drugs.
of drugs. to download
to download
the guidance
the guidance
+ Decide on
Décidé of grounding
period of
on aa period needed depending
if needed
grounding if depending material regarding
material regarding
on the
on type of
the type the kind
disease, the
of disease, of drug
kind of the
and the
drug and medication
médication
familiarisation with any possible side effects.
familiarisation with any possible side effects.

+ Helpful
+ questions to
Helpful questions yourself:
ask yourself:
to ask
Does the
c• Does medical condition
the medical preclude the
itself preclude
condition itself the safe
safe
Operation of
operation of the activity?
flying activity?
the flying
Which is
•o Which the right
is the for this
medication for
right médication disease?
this disease?
the potential
Are the
•0 Are side effects
potential side more of
effects more of aa risk than
risk than
the medical condition?
the medical condition?
•- Efficacy of the
Ef‘ficacy of medication? Individual
the médication? sensitivity?
Individual sensitivity?
 l’p

Guidance material for the

use of médication in aviation
environment

ASSESSMENT 0F
ASSESSMENT FITNESS
OF FITNESS
„y A pilot/ATCO
A should not
pilot/ATCO should fly or
not fly or operate
operate if
if

- The condition
The itself makes
condition itself makes the
the pilot/ATCO unfit.
pilot/ATCO unfit.
' The medication
The médication could have side
could hâve side effects
effects that
that could
could affect
affect the performance or
the performance or increase
increase
the risk
the risk of
of incapacitation.
incapacitation

In case
In case of
of common diseases:
common diseases;
lf
If there is no
there is no evidence
evidence for
for adverse effects and
adverse effects the medication
and the is ef'ficacious,
médication is efficacious, the
the pilot
pilot might fly
might fly
while being
while being under
under treatment.
treatment.

In case
In case Of more severe
of more SEVEI’E diseases:
diSEöSESZ

Determine the risk/benefit

Détermine the risk/benefit ratio
ratio and
and release
release pilot/ATCO
pilot/ATCO from
from duty if necessary.
duty if necessary. For
For illnesses
illnesses such
such
as diabetes, heart disease, psychiatric, gastro-intestinal and urological conditions the pilot/ATCO
as diabètes, heart disease, psychiatrie, gastro-intestinal and urological conditions the pilot/ATCO
will be
will be assessed
assessed asas unfit until the
unfit until stabilization or
the stabilization or improvement
improvement ofof the
the disease. Then, supervise
disease. Then, supervise
and re-assess
and re»assess patient.
patient.

Long—term treatments:
Long-term treatments:
For treatments
For of medical
treatments of medical conditions such as
conditions such diabetes or
as diabètes or hypertension
hypertension decide on aa grounding
décidé on grounding
period when Starting a new medication until assessing the impact of it and the performance of
period when starting a new médication until assessing the impact of it and the performance of
the patient.
the patient. If medication proved
If médication efficacious without
proved efficacious without adverse
adverse effects,
effects, allow
allow the
the pilot/ATCO
pilot/ATCO to
to
return t0 work.
return to work.

Regular
Regular sußervision of patients
supervision of patients who
who are
are under
under long
long term
term
treatment byy the same treating physician.

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 Guidance material for the
use of médication in aviation
environment

between pilots/ATCOs
Relations between
Relations treating
and treating
pilots/ATCOS and
physicians/AMEs
physidans/AMEs
p).
<)■ Development of Confidence
Development of Trust
and Trust
Confidence and

p).
Win-win relation:
Win-win relation: Listen to the
Listen to patient and
the patient and try find the
t0 find
try to best solution
the best for his/her
solution for health
his/her health
and needs
and needs

►)- Education pilots/ATCOS on

of pilots/ATCOs
Education of on the importance t0
the importance seek for
to seek help
for help

>>• Safe and honest

Safe and dialogue
honest dialogue

Knowledge of
+ Knowledge medical requirements
of medical aviation
in aviation
requirements in

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Guidance material for the
use of médication in aviation
environment
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Guidelines
Guidelines for
for treating
treating physicians and AMEs
physicians and AMEs
Accept that all médication
medication (an
can have potential side
side effects.
effects
„p

Accept that ail hâve potential

+ Educate pilots/ATCOS about

Educate pilots/ATCOs about the
the potential risks of
potential risks selfvmedication.
of self-medication.

Consider the
<)■ Consider impact of
the impact of side effects in
side effects in the
the aviation
aviation related working environment.
related working environment.

►f Do
Do not deny aircrews
not deny aircrews justified treatment but
justified treatment inform them
but inform them about
about the potential advantages
the potential advantages
and disadvantages
and disadvantages of medication.
of médication.

Always consider
>)- Always consider aa period
period of
of grounding
grounding when
when beginning new treatment.
beginning new treatment.

For treating
For treating physicians:
physicians: IfIf in
in doubt
doubt about the effects
about the effects of illness and/or
of illness and/or médication
medication consult
consult
your patient’s
your patient's AME.
AME.

For AMEs:
For AMEs: Understand the regulatory
Understand the principles, guidelines
regulatory principles, guidelines and
and regulations.
régulations.

Guidelines for
Guidelines for pilots/ATCOS
pilots/ATCOs
‚.). Do
Do not
not operate
operate if there is
if there is aa need
need to
to take medication.
take médication.

9» Be aware that medications (an have side effects which could af‘fect flight safety and work
•f Be aware that médications can hâve side effects which could affect flight safety and work
performance.
performance.

For pilots
+ For engaged in
pilots engaged in flying
flying competitions:
compétitions: be
be aware of the
aware of the doping rules.
doping rules.

Seek advice
>>- Seek from aa medical
advice from practitioner or
medical practitioner or pharmacist
pharmacist before
before taking
taking medication and inform
médication and inform
them of your occupation.
them of your occupation.

Inform the
Inform the AME when taking
AME when taking medication.
médication.

+ Be prepared to
Be prepared to be
be grounded or prevented
grounded or prevented from working when
from working when taking medication for
taking médication for the
the
first time.
first time.
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European Aviation
European Safety Agency
Aviation Safety Agency European Society
European Society of
of Aerospace
Aerospace
P.O. Box 10
P.O. Box 10 12
12 53
53 Medicine
Medicine
D-50452 Cologne, Germany
D-50452 Cologne, Germany http://www.esam.aero
http://www.esam.aero
http://www.easa.europa.eu
http://www.easa.europa.eu secretary@esam.aero
secretary (Sesam.aero

An Agency
An of the
Agency of the
European Union
European Union