AME AME Pharmacology & Medication Policies 3 — Questions and Answers
Question 1: Which thyroid replacement medication is generally acceptable for FAA medical certification when thyroid function is well-controlled?
- Levothyroxine (Synthroid) (Correct answer)
- Liothyronine (Cytomel) at high doses
- Desiccated thyroid at any dose
- No thyroid medications are acceptable
Correct answer: Levothyroxine (Synthroid)
Levothyroxine is accepted under the CACI program when the pilot's TSH is stable and within normal range, indicating well-controlled hypothyroidism.
Question 2: Which non-sedating antihistamine is generally acceptable for FAA medical purposes when treating allergies?
- Diphenhydramine (Benadryl)
- Loratadine (Claritin) (Correct answer)
- Chlorpheniramine (Chlor-Trimeton)
- Hydroxyzine (Atarax)
Correct answer: Loratadine (Claritin)
Loratadine is a second-generation antihistamine with minimal CNS sedation and is generally considered acceptable for use by pilots with no observed performance impairment.
Question 3: Which statin medication used for hyperlipidemia is generally acceptable for FAA medical certification?
- Statins are all disqualifying
- Atorvastatin (Lipitor) (Correct answer)
- Statins require Special Issuance regardless of type
- Only rosuvastatin is accepted
Correct answer: Atorvastatin (Lipitor)
Atorvastatin and most other statins are accepted under the CACI program because they have no CNS effects and a well-established cardiovascular safety profile.
Question 4: What is the minimum wait time after a sedating medication dose before a pilot may act as pilot-in-command?
- Until the sedating effects wear off plus an additional safety margin (Correct answer)
- Exactly 8 hours regardless of medication
- 12 hours for all drugs
- 24 hours for all prescription drugs
Correct answer: Until the sedating effects wear off plus an additional safety margin
The FAA's principle is that a pilot must wait until all sedating or impairing effects have resolved plus an additional safety margin, which varies by specific drug pharmacokinetics.
Question 5: A pilot taking insulin for Type 1 diabetes wishes to fly commercially. What is the FAA's current position?
- Insulin-dependent diabetes is absolutely disqualifying for all classes
- First and Second Class certificates are prohibited; Third Class is allowed under SI
- All classes are allowed under strict Special Issuance with CGMS monitoring (Correct answer)
- Insulin is permitted under CACI without Special Issuance
Correct answer: All classes are allowed under strict Special Issuance with CGMS monitoring
As of 2015, the FAA allows insulin-treated diabetes under Special Issuance for all three certificate classes, requiring continuous glucose monitoring and strict hypoglycemia protocols.
Question 6: What must an AME advise when a pilot discloses recreational use of alcohol within 8 hours before a scheduled examination?
- Proceed with the exam; alcohol is legal
- Defer the exam and reschedule to ensure no impairment during testing (Correct answer)
- Issue the certificate but note the disclosure
- Report the pilot to law enforcement
Correct answer: Defer the exam and reschedule to ensure no impairment during testing
The AME should defer the examination until sufficient time has passed, as FAA regulations prohibit acting as a crewmember within 8 hours of alcohol consumption and an accurate exam cannot be conducted.
AME AME Pharmacology & Medication Policies 3
Which thyroid replacement medication is generally acceptable for FAA medical certification when thyroid function is well-controlled?