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Maryland Transit Administration Prescription & Over-the Over the-Counter Counter Drug Policy Have your Doctor complete this portion of form 1C1. RELEASE TO WORK FORM FO R PRE SCRI PT I ON ME DI CAT I ONS Phys icia n's Se c tio n: As the at tendi ng p hys ician, I have pres cribed the follow ing medica tions t o be t aken from _ ____ to _____. ________ _______ __ __________ _______ Name o f Medica tion Dos age ________ _______ __ __________ _______ Name o f Medica tion Dos age A. E mployee may not per for m s afe ty s ens i tive d utie s whi le ta king this me dic a tion. (E m ployee - turn in f or m to your s u pervis or) B . E mployee releas ed to perf orm s afe ty s ens itive du ties while taki ng t his med icatio n. (E mpl oyee-keep for m on your pers on while at wor k) __________ _______ ______ __________ _______ Phys icia n’s Pr i nted Name T e le phone N o. __________ _______ ______ __________ _______ Phys icia n’s Sig nat ure Date Maryland Transit Administration Prescription & Over-the Over the-Counter Counter Drug Policy Safety Sensitive Employee’s responsibility before taking a PRESCRIPTION medication. VBe sure your Doctor understands t he safety sensit ive nat ure of your job. VBe sure t o tell your Doct or of any side affect s you may have experienced when using medicat ion in t he past . Maryland Transit Administration Prescription & Over-the Over the-Counter Counter Drug Policy Safety Sensitive Employee’s responsibility before taking a PRESCRIPTION medication. If your Doct or approves you to continue working while taking t he prescript ion medication simply keep form 1C1 on your person while at work.
Maryland Transit Administration Prescription & Over-the Over the-Counter Counter Drug Policy Safety Sensitive Employee’s responsibility before taking a PRESCRIPTION medication. If your Doctor prohibits you from working while on Prescription medication VComplete your standard sick leave application. VAttach form 1C1 to the application, indicating that your Doctor does not permit you to work while taking the Prescription medication. Í Maryland Transit Administration Prescription & Over-the Over the-Counter Counter Drug Policy Safety Sensitive Employee’s responsibility before taking a PRESCRIPTION medication. If your Doctor prohibits you from working while on Prescription medication. VFollow standard sick leave policy VMeet all standard requirements for returning to work after an extended illness. Maryland Transit Administration Over-The-Counter Medication
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U.S. Department of Transportation F
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REPORT DOCUMENTATION PAGE Form Appr
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Introduction The National Transport
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Policy The “Dear Colleague” let
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Policy System Name: Utah Transit Au
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UTA Management Drug & Alcohol Polic
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POLICY Number 1C1 Effective Date: 3
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Release To Work Form 1C1 Maryland T
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ALCOHOL AND DRUG POLICY 2001 Revisi
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ALCOHOL AND DRUG POLICY Alcohol Pos
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OVER-THE-COUNTER MEDICATION To be C
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Subject: Substance Abuse- Drug Free
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SECTION XXX MEDICATION Applicants -
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Policy System Name: ATC/Vancom of N
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PROCEDURES
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In the third approach, the employer
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MEDICATION APPROVAL FORM (For Safet
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Procedures System Name: Maryland Tr
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Maryland Transit Administration SAF
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Procedures System Name: Orange Coun
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OVER-THE-COUNTER MEDICATION To be C
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Subject: Substance Abuse- Drug Free
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Disadvantages: Neither employees no
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Los Angeles County Metropolitan Tra
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Asendin Tablets X Aspirin X Astemiz
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Training The “Dear Colleague” l
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OVER-THE-COUNTER MEDICINES What’s
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ADVICE FOR AMERICANS ABOUT SELF-CAR
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Fact is, today’s OTC med icines
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You can help yourself read the labe
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■ Do not use laxatives when you h
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PREGNANCY AND BREAST-FEEDING Drugs
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■ Never call medicine candy to ge
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For free bulk quantities, write: CO
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Training Aid Name: How to Read a Dr
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InteliHealth: Page 2 of 3 © 2002,
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Training Aid Name: Prescription Med
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Health Care: Prescription Medicines
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Training Aid Name: Quick Tips -When
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When you pick up your medicine at t
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Training Aid Name: A Guide to Manag
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Speak up The more information your
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Rx & OTC Medications Safety-sensiti
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Legal drugs can be a problem Legal
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Employee Substance Abuse Training
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Transit Employees Responsibility Pr
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PRESCRIPTION AND OVER-THE-COUNTER D
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Summary of Do's and Don'ts Medicati
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Training Aid Name: Public Transport
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MODULE 8: PRESCRIPTION DRUGS Notes
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View Graph 8-3 Since each of these
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Notes to the Instructor MODULE 9: O
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Other Substances View Graph 9-4 Bes
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Notes to the Instructor MODULE 10:
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Many times a marijuana joint is use
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Module 8: Prescription Drugs Exerci
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Module 9: Over-the-Counter Drugs Ex
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Prescription Drugs 8-1 MODULE 8: PR
Page 132 and 133: Prescription Drugs 8-3 TRANSIT EMPL
Page 134 and 135: Prescription Drugs 8-5 DRIVING SKIL
Page 136 and 137: Over-the-Counter Drugs 9-2 OVER-THE
Page 138 and 139: Over-the-Counter Drugs 9-4 COMMONLY
Page 140 and 141: Over-the-Counter Drugs 9-6 MODULE 9
Page 142 and 143: Combining Drugs 10-2 EFFECTS OF COM
Page 144 and 145: Combining Drugs 10-4 MODULE 10 DISC
Page 146 and 147: MODULE 8: PRESCRIPTION DRUGS Prescr
Page 148 and 149: Notes Prescription Drugs 41
Page 150 and 151: MODULE 9: OVER-THE-COUNTER DRUGS Ma
Page 152 and 153: Notes Over-the-Counter Drugs 45
Page 154 and 155: MODULE 10: COMBINING DRUGS Each of
Page 156 and 157: Notes Combining Drugs 49
Page 158 and 159: Module 8: Prescription Drugs Exerci
Page 160 and 161: Prescription & Over-the-Counter (OT
Page 162 and 163: Anti-Motion Sickness: Can cause; dr
Page 164 and 165: Antidepressants: Can cause; seizure
Page 166 and 167: Muscle Relaxers: Can cause; drowsin
Page 168 and 169: Points to Remember Every one is an
Page 170 and 171: RETENTION TIMES OF DRUGS IN URINE G
Page 172 and 173: MARYLAND TRANSIT ADMINISTRATION OVE
Page 174 and 175: Maryland Transit Administration Pre
Page 190 and 191: PRESCRIPTION AND OVER-THE- COUNTER
Page 192 and 193: NTSB Directive The National Transpo
Page 194 and 195: Definitions (Rx) • Prescription d
Page 196 and 197: Definitions (OTC) • Over-The-Coun
Page 198 and 199: FTA Recommended Policy Elements FTA
Page 200 and 201: Suggested Elements of an Rx/OTC Pol
Page 202 and 203: Suggested Management/ Supervisor Re
Page 204 and 205: Suggested Employee Roles and Respon
Page 206 and 207: Employee Warnings • Do not take l
Page 208 and 209: Employee Warnings (Cont.) • Chang
Page 210 and 211: Suggested Employer Physician/MRO Re
Page 212 and 213: Medical Review Procedural Model 2 (
Page 214 and 215: Suggested Employee Awareness Traini
Page 216 and 217: Summary • The primary objective o
Page 218 and 219: Common Anti-inflammatory and Pain M
Page 220 and 221: Common Antihistamines* (List not al
Page 222 and 223: Common Muscle Relaxants* (List not
Page 224 and 225: Common Stimulants* (List not all-in
Page 226 and 227: Possible Side Effects of Common OTC
Page 228 and 229: Possible Side Effects of OTC Cold a
Page 230 and 231: Common OTC Stimulants (List not all
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Post-Accident Documentation for Det
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17) If no alcohol test occurred bec
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1a) Name of medication: 1b) How muc
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APPENDICES
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BY ORDER OF THE SECRETARY OF THE AI
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AFI48-123 22 MAY 2001 163 A7.32.4.
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Rx and OTC Medication Lists Name: A
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MEDICATION WAIVERS - 134 -
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DISCUSSION: Medication side effects
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CLASS 2A: NO WAIVER ACTION REQUIRED
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CLASS 2B: INFORMATION ONLY , CHRONI
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CLASS 3: CHRONIC USE REQUIRING WAIV
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- 144 -
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Rx and OTC Medication Lists Name: V
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a result, Glaxo-Wellcome has volunt
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ACIP Influenza Recommendations - AF
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stopped. Note that the nasal spray
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in completing the FAA required docu
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Heart/cardiac medications: The FAA
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containing cocaine ("TAC"). There i
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Rx and OTC Medication List Name: Me
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NOTE: 1. Mouthwashes - Scope, Liste
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HOW DO THESE MEDICATIONS AFFECT YOU
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Internet Resources/Reference Materi
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