A driver is taking Lisinopril for hypertension and Simvastatin, along with Antabuse. What should the examiner do next?

The most appropriate action for the examiner in this scenario, where the driver is taking Lisinopril for hypertension, Simvastatin for cholesterol management, and Antabuse (Disulfiram) for alcohol dependence, is to disqualify the driver. This decision is grounded in the recognition that Antabuse can impair a person's ability to safely operate a commercial vehicle due to potential side effects, including drowsiness, confusion, or dizziness, especially if alcohol is inadvertently ingested.

Medications like Lisinopril and Simvastatin, while commonly prescribed and generally safe, do not raise the same level of concern regarding disqualification. However, the presence of Antabuse indicates a history of substance abuse which poses a risk for both the driver and public safety. The guidelines for medical certification require that any driver who is undergoing treatment for a substance use disorder or who is on medication that can significantly impair their functionality must be thoroughly evaluated and, in many cases, disqualified to ensure safety on the road.