Search found 922 matches

by Robert Swotinsky MD
Mon Apr 20, 2020 7:53 pm
Forum: Fitness-for-duty (e.g., preplacement) exams, non-DOT
Topic: Preemployment lab test requirements for pharmacy technicians
Replies: 1
Views: 3270

Re: Preemployment lab test requirements for pharmacy technicians

I am not aware that there is a federal regulation or guideline about preemployment laboratory testing for pharmacy tech work.
by Robert Swotinsky MD
Mon Apr 13, 2020 6:04 am
Forum: DOT Physicals
Topic: Sublocade (bupronorphine extended release) and DoT Physical
Replies: 2
Views: 3999

Re: Sublocade (bupronorphine extended release) and DoT Physical

Buprenorphine is prescribed to treat opioid dependence. A person with opioid dependence is at increased risk in highly safety-sensitive activities like driving a truck. This is one of the primary reasons that FMCSA put methadone as a recommended disqualifier in the Medical Advisory Criteria that, wh...
by Robert Swotinsky MD
Wed Mar 25, 2020 9:31 pm
Forum: Drug and Alcohol Testing
Topic: Breath alcohol testing during coronavirus
Replies: 1
Views: 2384

Re: Breath alcohol testing during coronavirus

DOT's requirements for breath alcohol testing remain in place. A recent announcement from DOT (see the ink below) acknowledges that employers may find fewer service agents open and ready to perform such testing. DOT also acknowledges that patients may raise Covid 19 as a concern, and thus DOT expect...
by Robert Swotinsky MD
Wed Mar 25, 2020 8:04 am
Forum: Drug and Alcohol Testing
Topic: Methamphetamine
Replies: 9
Views: 8126

Re: Methamphetamine

A donor who is currently using both methamphetamine and amphetamine would likely test positive for both methamphetamine and amphetamine. This type of dual-positive result does not prove the use of both drugs. Methamphetamine is metabolized to amphetamine. So, I don't know that there is a test that w...
by Robert Swotinsky MD
Fri Mar 13, 2020 1:20 pm
Forum: DOT Physicals
Topic: Stroke and antiplatelet therapy
Replies: 1
Views: 4839

Re: Stroke and antiplatelet therapy

You are likely already familiar with the FMCSA Medical Examiner Handbook text from 7-1-19: Individuals with embolic or thrombotic cerebral infarctions will have residual intellectual or physical impairments. Fatigue, prolonged work, and stress may exaggerate the neurological residuals from a stroke....
by Robert Swotinsky MD
Tue Feb 25, 2020 10:10 pm
Forum: Drug and Alcohol Testing
Topic: temporary shy bladder & determining clinical evidence of illicit drug use
Replies: 1
Views: 5496

Re: Temporary shy bladder & determining clinical evidence of illicit drug use

If someone triggers the shy bladder evaluation, that evaluation looks for a medical reason for the inability to provide a urine specimen during the collection procedure. That evaluation doesn't include an evaluation for drug abuse. The case as presented is kind of like the direction in which HHS is ...
by Robert Swotinsky MD
Fri Feb 21, 2020 1:56 pm
Forum: DOT Physicals
Topic: CME for DOT medical examiners
Replies: 1
Views: 6022

Re: CME for DOT medical examiners

From a 02-20-20 email issued to medical examiners by FMCSA: Dear Medical Examiner: Certified Medical Examiners (MEs) listed on the National Registry must complete periodic training every five (5) years under 49 CFR 390.111(a)(5)(i) to maintain their National Registry certification to conduct examina...
by Robert Swotinsky MD
Sun Feb 16, 2020 9:17 pm
Forum: Drug and Alcohol Testing
Topic: Breath alcohol positive with reflux & probiotic drink
Replies: 1
Views: 3925

Re: Breath alcohol positive with reflux & probiotic drink

There are products that contain ethanol and which are said to act as probiotics. If the donor consumed an ethanol-containing product and belched between the initial and confirmatory breath tests, the ethanol could coat the inside of the mouth and potentially the test result. This is among the reason...
by Robert Swotinsky MD
Thu Feb 06, 2020 4:24 pm
Forum: DOT Physicals
Topic: Vision waiver
Replies: 1
Views: 3976

Re: Vision waiver

To rephrase (?): Can a monocular commercial motor vehicle driver work/drive in New Jersey with a Pennsylvania license and Pennsylvania waiver? If that's the correct question, then I think the correct answer is, It depends. If the driver received a federal waiver for monocular vision, then that's val...
by Robert Swotinsky MD
Fri Jan 31, 2020 6:07 am
Forum: Drug and Alcohol Testing
Topic: Possible shy bladder/Collection error
Replies: 1
Views: 3639

Re: Possible shy bladder/Collection error

- The insufficient volume could have contributed to the low temperature. A urine specimen that starts at body temperature cools slightly when it comes into contact with the room temperature specimen container. If the urine volume is lower, the amount of cooling is greater. - For a post accident test...