Contraindications

Question 1

Adrenaline

Answer 1

Hypovolaemic shock without adequate fluid replacement

Question 2

Amiodarone

Answer 2

Tryciclic Antidepressant toxicity
QTc > 500 milliseconds
VT following ondansetron administration
Pregnancy

Question 3

Aspirin

Answer 3

Hypersensitivity to aspirin/salicylates
Actively bleeding peptic ulcer
Bleeding disorders
Suspected dissecting aortic aneurysm
Chest pain associated with psychostimulant OD if SBP >160mmHg

Question 4

Ceftriaxone

Answer 4

Cephalosporin allergy
Preterm neonates (41 weeks corrected gestational age)

Question 5

Dexamethasone

Answer 5

Known hypersensitivity

Question 6

Dextrose 10%

Answer 6

Nil of significance in above indication

Question 7

Droperidol

Answer 7

Nil

Question 8

Fentanyl

Answer 8

Late second stage of labour
Serotonin syndrome
Monoamine oxidase inhibitors (MAOIs) within previous 14 days

Question 9

Glucagon

Answer 9

Known pancreatic tumours
Known pheochromocytoma (tumour of adrenal gland)

Question 10

Glyceryl Trinitrate

Answer 10

BP <100mmHg
HR > 150
HR <50 (except in autonomic dysreflexia)
Ventricular tachycardia
PDE5 inhibitors (current/recent use) (sildenafil (Viagra), tadalafil (Cialis), vardenafil (Staxyn, Levitra), avanafil (Stendra)
Riociguat (current use) (rioteph, adempas)
Bleeding in pregnancy

Question 11

Hartmann’s

Answer 11

Nil

Question 12

Heparin

Answer 12

Known allergy or hypersensitivity
Active bleeding
Oral anticoagulants
Bleeding disorders
History of Heparin-Induced Thrombocytopaenia (HIT)
Severe hepatic impairment/ disease, including oesophageal varies
Recent trauma or surgery (< 3 weeks)

Question 13

Hydrocortisone

Answer 13

Nil significant

Question 14

Ipratropium Bromide

Answer 14

Known hypersensitivity to Atropine or its derivatives

Question 15

Ketamine

Answer 15

Suspected non-traumatic brain injury with severe hypertension (SBP > 180)

Question 16

Lidocaine

Answer 16

Known hypersensitivity to lidocaine or related local anaesthetics (bupivacaine, levobupicacaine, prilocaine, ropivacaine)

Question 17

Methoxyflurane

Answer 17

Pre-existing renal disease
Known (or genetic susceptibility) to malignant hyperthermia

Question 18

Midazolam

Answer 18

Known hypersensitivity to benzodiazepines

Question 19

Morphine

Answer 19

History of hypersensitivity
Renal impairment/failure
Late second stage of labour

Question 20

Naloxone

Answer 20

Nil of significance in above indication

Question 21

Normal Saline

Answer 21

Nil of significance in above indication

Question 22

Olanzapine

Answer 22

Nil

Question 23

Ondansetron

Answer 23

Apomorphine- Reports of profound hypotension and loss of consciousness with both

Question 24

Oxytocin

Answer 24

None, provided all babies have been delivered prior to administration

Question 25

Paracetamol

Answer 25

Children < 1 month of age

Question 26

Prochlorperazine

Answer 26

CNS Depression (i.e unconscious or severely intoxicated) Patients < 21 years of age (children and young adults are more susceptible to extrapyramidal reactions)

Question 27

Salbutamol

Answer 27

Nil of significance in the above indication

Question 28

Tenecteplase

Answer 28

Major surgery in the past 3 months Significant head injury in the past 3 months Major trauma in the past 3 months Stroke/TIA in the past 3 months ICH at any time GI or genitourinary bleed in the past month Current bleeding disorder, active bleeding (excluding menses) or bleeding tendencies Anticoagulant or glycoprotein IIb/IIIa inhibitors Allergy to tenecteplase or gentamicin

Question 29

Water for Injection

Answer 29

Nil in the above indication

Question 30

Tranexamic acid

Answer 30

Injury occurred >2 hours prior to administration