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There has been an increasing interest and awareness of the effects of prescription and illicit drugs on pilot performance with the concomitant rise in the use of prescription medications and the frequency of air travel. Aviation toxicology addresses the effects of prescription and illicit drugs on pilot performance as well as the contribution of these agents to the cause or manner of death in aviation fatalities. Specimen collection, specimen suitability and analytical techniques for the investigation of the role of carbon monoxide, hydrogen cyanide, ethanol, drugs of abuse and so on in aviation accidents are discussed. The prevalence of use and impairing effects of commonly encountered drugs such as ethanol, antihistamines, antidepressants, cannabinoids and opiates are outlined. Issues in toxicological interpretation, including the delineation of post‐mortem from ante‐mortem ethanol, the analysis of glucose and post‐mortem drug redistribution, are presented. Some unique challenges in aviation toxicology, such as the identification of admixed specimens and the genetic variability in the degree of drug‐induced impairment, as well as future opportunities for research, are discussed in the concluding portion of the chapter.
There has been an increasing interest and awareness of the effects of prescription and illicit drugs on pilot performance with the concomitant rise in the use of prescription medications and the frequency of air travel. Aviation toxicology addresses the effects of prescription and illicit drugs on pilot performance as well as the contribution of these agents to the cause or manner of death in aviation fatalities. Specimen collection, specimen suitability and analytical techniques for the investigation of the role of carbon monoxide, hydrogen cyanide, ethanol, drugs of abuse and so on in aviation accidents are discussed. The prevalence of use and impairing effects of commonly encountered drugs such as ethanol, antihistamines, antidepressants, cannabinoids and opiates are outlined. Issues in toxicological interpretation, including the delineation of post‐mortem from ante‐mortem ethanol, the analysis of glucose and post‐mortem drug redistribution, are presented. Some unique challenges in aviation toxicology, such as the identification of admixed specimens and the genetic variability in the degree of drug‐induced impairment, as well as future opportunities for research, are discussed in the concluding portion of the chapter.
Safety pharmacology satisfies a key requirement in the process of drug development. Safety pharmacology studies are required to assess the impact of a new chemical entity (NCE) or biotechnology-derived product for human use on vital systems, such as those subserving auditory function. Safety pharmacology studies accordingly are defined as those studies that investigate the potential undesirable effects of a substance on auditory functions in relation to exposure in and above the therapeutic range. Auditory safety studies should be designed with the primary objective of determining how administration of a compound influences normal hearing. If an effect on hearing is identified, then it is necessary to determine through histopathology the underlying mechanism for the observed hearing loss. Since the auditory system contains a heterogeneous mixture of structural and cellular components that are organized in a very complex and integrated manner, it is necessary to clearly identify the underlying primary mechanism or target of the new chemical entity that produced the hearing loss. This chapter will highlight major components of auditory function with regard to potential opportunities for drug interaction. Aspects of designing ototoxicity studies will be discussed with an emphasis on standards deemed necessary by the US Food and Drug Administration. Additionally, classes of ototoxic compounds and their proposed mechanisms of action are described in depth.
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