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Summary NRCME EXAM FINAL STUDY GUIDE / 70+

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Medications That May Be Disqualifying or Need Review

These meds can impair alertness, judgment, or motor coordination, which are critical for
driver safety.

1. Controlled Substances / Schedule I & II Meds

🛑 Generally disqualifying unless cleared by the prescribing provider and deemed safe to drive.

 Opioids: Oxycodone, Hydrocodone, Morphine, Fentanyl
 Benzodiazepines: Diazepam, Lorazepam, Clonazepam, Alprazolam
 Barbiturates: Phenobarbital
 Stimulants: Amphetamines, Methylphenidate (e.g., Adderall, Ritalin)
 Medical Marijuana: Always disqualifying under DOT regardless of state legality

2. Anticonvulsants / Antiepileptics

 Phenytoin (Dilantin), Carbamazepine, Valproate
➡️ Used to treat seizure disorders (may be disqualifying unless well-documented and
seizure-free for 10 years without meds)

3. Antipsychotics / Mood Stabilizers

 Haloperidol, Risperidone, Lithium, Olanzapine
➡️ Review mental health stability and potential sedative effects

4. Antidepressants

 SSRIs (e.g., Sertraline, Fluoxetine) – May be okay if stable
 TCAs (e.g., Amitriptyline) – Caution due to sedation

5. Antihypertensives

 Beta-blockers, ACE inhibitors, ARBs, Calcium channel blockers
➡️ Not disqualifying, but monitor BP control and side effects like dizziness

6. Insulin & Hypoglycemics

 Insulin-treated diabetics must have an MCSA-5870 form from their treating clinician
 Sulfonylureas (e.g., Glyburide) – monitor for hypoglycemia risk

7. Sleep Aids

 Zolpidem (Ambien), Eszopiclone (Lunesta)
➡️ Can impair alertness if taken the night before driving

, ✅ Medications That Are Common & Generally Acceptable

 Inhalers for asthma/COPD (e.g., Albuterol, Fluticasone)
 NSAIDs (e.g., Ibuprofen, Naproxen)
 Thyroid meds (e.g., Levothyroxine)
 Proton pump inhibitors (e.g., Omeprazole)



💡 What You Should Do as a DOT Examiner

 Always ask about medications and side effects.
 Review if meds may impair driving ability.
 Use Form MCSA-5875 to document medications and treating provider’s note if needed.
 If unsure, request a note from the prescribing provider stating the driver is safe to
operate a commercial vehicle.


WHAT ARE SOME REGULATIONS I NEED TO KNOW BEFORE TAKING THE DOT
EXAM?
ChatGPT said:


Great question, Before taking the FMCSA/NRCME DOT medical examiner certification
exam, it's crucial to be familiar with the core federal regulations that guide your responsibilities
as a certified medical examiner.

Here’s a high-yield breakdown of the key DOT regulations and concepts you should know
before taking the exam:



🧠 Must-Know FMCSA Regulations (49 CFR – Code of Federal Regulations)

✅ 1. 49 CFR § 391.41 – Physical Qualifications for Drivers

This is THE most important section. It outlines the 13 mandatory driver qualification
standards. Drivers must:

 Have distant visual acuity of at least 20/40 in each eye (corrected or uncorrected).
 Be able to recognize red, green, and amber colors.
 Hear a forced whisper at 5 feet, with or without hearing aid.
 BP under 140/90 for 2-year card. Elevated BP = time-limited cert.
R189,43
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