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Antiemetics With Concomitant Sedative Use in Civil Aviation Pilot Fatalities: From 2000 to 2006
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    Final Report
  • Abstract:
    Many drugs commonly used for the treatment of various ailments can be dangerous when used in combination. Antiemetics and sedatives are two drug classes that contain compounds that may have harmful side effects when mixed. A drug such as chlorpheniramine with antiemetic properties can dramatically increase the negative side effects of numerous drugs in the sedative class. This phenomenon is especially dangerous for pilots. Although many of these compounds are considered disqualifying and are not allowed by the Federal Aviation Administration, their use does occur in the pilot community. Pilots that use these drugs may be unaware of the danger that may arise when compounds from these two drug classes are taken together. Our laboratory was interested in evaluating the circumstances surrounding accidents in which the pilot was found positive for drugs from each of these two classes. Epidemiological, toxicological, and aeromedical findings from pilots involved in such accidents were collected for a 7-year period, 2000 - 2006. Case histories, accident information, and the probable cause of the aviation accidents were obtained from the National Transportation Safety Board (NTSB). Toxicological information was obtained from the Civil Aerospace Medical Institute’s (CAMI’s) Forensic Toxicology Research Laboratory. There were 2,184 fatal aviation accidents over this time period. Of these accidents, 26 were found positive for compounds from both the antiemetic and the sedative drug classes. All 26 aircraft were operated under 14 CFR Part 91 as general aviation. All pilots involved in these accidents were male; 21 tested positive for a disqualifying substance that may have affected their ability to control the aircraft.
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