Prescription and Over-the-Counter Medications Tool Kit ... - Home

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1a) Name of medication: 1b) How much do you take (dosage)? 1c) How often do you take it (frequency)? CONFIDENTIAL Medication Information Form 1d) How long have you been taking this medication? 1e) For prescription medications, is the prescription in your name? 1f) When was the last time you took a dose? How much did you take? 1g) Did you take a dose prior to the last one? How much did you take? 1h) How many times have you taken it in the last 7 days? 1i) Did you experience any side effects? If so, describe: When did the side effects first appear? When did the side effects disappear? 1j) Have you discussed the use and potential side effects of this prescription/OTC medications with your physician? If yes, when? Is the doctor aware of your safety-sensitive job duties? Describe: 1k) Have you discussed the use of this prescription/OTC medication with your pharmacist? If yes, who? When? Is the physician/pharmacist aware of your safety-sensitive job duties? Describe:
CONFIDENTIAL Do you have the medication with you? If yes, write down the information from the label. If not, ask for the following information: Name of medication (exactly): Expiration date: Dosage information (exactly): Note any warning labels: Form: Pill Capsule Gelcap Liquid Other Place of purchase: Pharmacist name (if applicable): Phone #:
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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
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Prescription Drugs 8-3 TRANSIT EMPL
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Prescription Drugs 8-5 DRIVING SKIL
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Over-the-Counter Drugs 9-2 OVER-THE
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Over-the-Counter Drugs 9-4 COMMONLY
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Over-the-Counter Drugs 9-6 MODULE 9
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Combining Drugs 10-2 EFFECTS OF COM
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Combining Drugs 10-4 MODULE 10 DISC
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MODULE 8: PRESCRIPTION DRUGS Prescr
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Notes Prescription Drugs 41
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MODULE 9: OVER-THE-COUNTER DRUGS Ma
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Notes Over-the-Counter Drugs 45
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MODULE 10: COMBINING DRUGS Each of
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Notes Combining Drugs 49
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Module 8: Prescription Drugs Exerci
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Prescription & Over-the-Counter (OT
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Anti-Motion Sickness: Can cause; dr
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Antidepressants: Can cause; seizure
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Muscle Relaxers: Can cause; drowsin
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Points to Remember Every one is an
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RETENTION TIMES OF DRUGS IN URINE G
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MARYLAND TRANSIT ADMINISTRATION OVE
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Maryland Transit Administration Pre
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Page 186 and 187: Maryland Transit Administration Pre
Page 188 and 189: 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
Page 232 and 233: Post-Accident Documentation for Det
Page 234 and 235: 17) If no alcohol test occurred bec
Page 238 and 239: APPENDICES
Page 240 and 241: BY ORDER OF THE SECRETARY OF THE AI
Page 242 and 243: AFI48-123 22 MAY 2001 163 A7.32.4.
Page 244 and 245: Rx and OTC Medication Lists Name: A
Page 246 and 247: MEDICATION WAIVERS - 134 -
Page 248 and 249: DISCUSSION: Medication side effects
Page 250 and 251: CLASS 2A: NO WAIVER ACTION REQUIRED
Page 252 and 253: CLASS 2B: INFORMATION ONLY , CHRONI
Page 254 and 255: CLASS 3: CHRONIC USE REQUIRING WAIV
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Page 258 and 259: Rx and OTC Medication Lists Name: V
Page 260 and 261: a result, Glaxo-Wellcome has volunt
Page 262 and 263: ACIP Influenza Recommendations - AF
Page 264 and 265: stopped. Note that the nasal spray
Page 266 and 267: in completing the FAA required docu
Page 268 and 269: Heart/cardiac medications: The FAA
Page 270 and 271: containing cocaine ("TAC"). There i
Page 272 and 273: Rx and OTC Medication List Name: Me
Page 274 and 275: NOTE: 1. Mouthwashes - Scope, Liste
Page 276 and 277: HOW DO THESE MEDICATIONS AFFECT YOU
Page 278: Internet Resources/Reference Materi
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