AME AME Pharmacology & Medication Policies 2 — Questions and Answers
Question 1: Which antihypertensive medication class is generally acceptable for FAA medical certification in pilots with controlled hypertension?
- Central alpha-2 agonists (e.g., clonidine)
- ACE inhibitors (e.g., lisinopril) (Correct answer)
- Alpha-1 blockers (e.g., prazosin)
- Combination diuretics with potassium-sparing agents
Correct answer: ACE inhibitors (e.g., lisinopril)
ACE inhibitors are broadly accepted by the FAA for treating hypertension because they have minimal CNS side effects and a well-established safety profile in aviation.
Question 2: What should an AME advise a pilot to do before flying on a newly prescribed medication?
- Begin flying immediately to assess real-world effects
- Wait at least 5 days at the prescribed dose to evaluate side effects (Correct answer)
- Consult only a personal physician, not the AME
- Check the FAA website and self-certify
Correct answer: Wait at least 5 days at the prescribed dose to evaluate side effects
The FAA recommends pilots wait at least 5 days at the full therapeutic dose to identify any adverse side effects before exercising pilot privileges.
Question 3: Which oral diabetes medication is acceptable under FAA Special Issuance for commercial (Second Class) pilots?
- Insulin (all formulations)
- Metformin (Correct answer)
- Sulfonylureas only
- GLP-1 agonists are prohibited for all classes
Correct answer: Metformin
Metformin is accepted under the CACI program for all three medical classes because it does not cause hypoglycemia when used as monotherapy.
Question 4: How should an AME document a pilot who discloses using a medication not on the FAA's accepted list?
- Issue the certificate and note it informally
- Deny the certificate immediately without documentation
- Document the medication on Form 8500-8 and defer to AMCD for review (Correct answer)
- Ignore the disclosure if the pilot feels well
Correct answer: Document the medication on Form 8500-8 and defer to AMCD for review
When a reported medication is not on an approved list, the AME must accurately document it on Form 8500-8 and defer the application to the FAA's Aerospace Medical Certification Division for determination.
Question 5: Which common antibiotic is generally considered acceptable for pilot use during treatment of a minor infection, provided the pilot is not symptomatic?
- Ciprofloxacin
- Amoxicillin (Correct answer)
- Doxycycline
- Nitrofurantoin
Correct answer: Amoxicillin
Amoxicillin is generally accepted because it has minimal CNS side effects; however, the pilot must also be free of symptoms from the underlying infection before flying.
Question 6: A pilot reports using testosterone replacement therapy (TRT). What is the FAA's current certification position on this?
- TRT is completely disqualifying for all certificate classes
- TRT may be accepted under Special Issuance with lab monitoring (Correct answer)
- TRT is unrestricted and requires no disclosure
- TRT is only acceptable for Third Class certificates
Correct answer: TRT may be accepted under Special Issuance with lab monitoring
The FAA can issue a Special Issuance for testosterone replacement therapy provided the pilot maintains hormone levels within normal limits and submits periodic lab reports.
AME AME Pharmacology & Medication Policies 2
Which antihypertensive medication class is generally acceptable for FAA medical certification in pilots with controlled hypertension?