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Paramedic Drugs > Contraindications > Flashcards

Contraindications Flashcards

(56 cards)

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1
Q

acetaminophen

A

Severe active liver disease

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2
Q

activated charcoal

A

● Unprotected airway
● Altered mental status
● Absence of a gag reflex
● Ileus
● Intestinal obstruction
● Ingestion of petroleum distillates, hydrocarbons, heavy metals, acids, alkalis,
corrosives, alcohols, iron, lithium, and solvents

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3
Q

adenosine

A

● Second- and third-degree AV blocks
● Sick sinus syndrome or other sinus node disease (unless a functioning artificial
pacemaker is present)
● Poison/drug-induced tachycardia
● Atrial fibrillation, atrial flutter, and ventricular tachycardia
● Polymorphic wide complex tachycardia
● Hemodynamically unstable tachycardia

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4
Q

albuterol

A

● Dysrhythmias (especially those caused by digitalis)
● Symptomatic tachycardias
● CHF

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5
Q

amiodorone

A

● Iodine hypersensitivity
● Cardiogenic shock
● Second- and third-degree AV blocks
● Sick sinus syndrome or other sinus node disease (unless a functioning artificial
pacemaker is present)

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6
Q

aspirin

A

●Hypersensitivity to NSAIDs
● ASA-intolerant asthma
● Bleeding disorders
● Hemolytic anemia
● Lactating mothers
● Hemorrhagic stroke
● Active bleeding (relative)

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7
Q

atropine

A

Note: all the following contraindications listed are relative
● Evolving MI
● Narrow-angle glaucoma
● GI obstruction
● Severe ulcerative colitis
● Toxic megacolon
● Bladder outlet obstruction
● Myasthenia gravis
● Hemorrhage with cardiovascular instability
Note: all the following contraindications listed are relative
● Evolving MI
● Narrow-angle glaucoma
● GI obstruction
● Severe ulcerative colitis
● Toxic megacolon
● Bladder outlet obstruction
● Myasthenia gravis
● Hemorrhage with cardiovascular instability
Note: all the following contraindications listed are relative
● Evolving MI
● Narrow-angle glaucoma
● GI obstruction
● Severe ulcerative colitis
● Toxic megacolon
● Bladder outlet obstruction
● Myasthenia gravis
● Hemorrhage with cardiovascular instability
● Thyrotoxicosis

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8
Q

calcium chloride

A

● Digoxin toxicity
● Hypercalcemia
● Suspected severe hypokalemia

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9
Q

calcium gluconate

A

●Digoxin toxicity
● Hypercalcemia
● Suspected severe hypokalemia

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10
Q

dexamethasone

A

●Systemic fungal infections
● Preterm infants
● Penetrating spinal cord injury

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11
Q

dextrose

A

●Hyperglycemia
● Severe dehydration
● Anuria
● Diabetic coma
● Intracranial or intraspinal hemorrhage
● Glucose-galactose malabsorption syndrome

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12
Q

diazepam

A

●Neurologic or respiratory depression
● Narrow-angle glaucoma
● Myasthenia gravis
● Head injury

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13
Q

diltiazem

A

●Hypotension
● Cardiogenic shock
● Wide-complex tachycardia
● Second- and third-degree AV blocks
● Sick sinus syndrome or sinus node disease (without functioning artificial
pacemaker)
● Poison/drug-induced tachycardia
● A-fib or a-flutter associated with an accessory bypass tract (i.e. WPW or LGL)
● Left ventricular systolic dysfunction
● Decompensated heart failure

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14
Q

diphenhydramine hydrochloride

A

●Newborns and premature infants
● Late stage pregnancy
● Breastfeeding mothers
● Asthma
● Narrow-angle glaucoma
● Benign prostatic hypertrophy
● Alcohol intoxication

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15
Q

dopamine hydrochloride

A

● Hypovolemia
● Pheochromocytoma
● Uncorrected tachydysrhythmias
● V-fib

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16
Q

epinephrine

A

●Coronary insufficiency
● Cardiac dilation
● Active labor
● Hyperthyroidism (relative)
● Uncontrolled hypertension (relative)
● Hypothermia (relative)
● Pulmonary edema (relative)
● Myocardial ischemia (relative)
● Hypovolemic shock (relative)

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17
Q

etomidate

A

● Labor and delivery
● Septic shock (particularly in children)

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18
Q

fentanyl citrate

A

● MAOI use within the last 14 days
● Hypotension
● Hypoxia after oxygen therapy
● Hypoventilation
● Severe hemorrhage or shock
● Myasthenia gravis
● GCS <15 (relative)

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19
Q

flumazenil

A

●TCA overdose
● Known seizure history
● Altered level of consciousness of unknown etiology

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20
Q

furosemide

A

● Hypovolemia
● Anuria
● Hypotension (relative)
● Hepatic encephalopathy
● Suspected electrolyte imbalances

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21
Q

glucagon

A

●Pheochromocytoma
● Hyperglycemia
● Insulinoma

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22
Q

glucose, oral

A

● Decreased level of consciousness
● Nausea/vomiting

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23
Q

haloperidol

Study These Flashcards
A

● Severe depression
● Neuroleptic malignant syndrome
● Poorly controlled seizure disorder
● Parkinson disease
● Agitation secondary to shock and hypoxia

24
Q

dilaudid

Study These Flashcards
A

● MAOI use during the previous 14 days
● GI tract obstruction
● Hypotension (relative)
● Hypoxia (relative)
● Respiratory depression (relative)
● Head injury (relative)
● Older adults (relative)
● Altered level of consciousness (relative)

25
hydroxycobalamin
None
26
ibuprofen
● Known ASA hypersensitivity ● ASA-sensitive asthma ● Renal function impairment ● Pregnancy ● Known peptic ulcer disease ● Active intracranial hemorrhage ● Active GI bleed ● Thrombocytopenia ● Coagulation defects ● Necrotizing enterocolitis ● Perioperative pain from CABG
27
ipratropium bromide
● Hypersensitivity to atropine, alkaloids, or peanuts ● Urinary retention (relative) ● Narrow-angle glaucoma (relative) ● Cardiovascular disease (relative) ● Hypertension (relative)
28
ketamine
● Infants <3 months ● Pregnancy and breastfeeding mothers ● Chest pain ● Heart failure ● Symptomatic hyperthyroidism ● Significant mental health history (i.e PTSD, schizophrenia) ● Conditions where hypertension would be hazardous to patient care ● Intracranial lesions ● Patients with potential for increased ICP (relative)
29
ketorolac tromethamine
● ASA-sensitive asthma ● ASA allergy ● Renal insufficiency/impairment/ transplant ● Pregnancy, breastfeeding, or active labor ● Known peptic ulcer disease ● Hypotension ● History of GI bleed ● Active bleeding including GI, intracranial, or traumatic injuries ● Current use of steroids or anticoagulants (may increase bleeding time) ● Coagulation defects ● Patients older than 65
30
labetolol
● Asthma ● Heart failure ● Cardiogenic shock ● Second- and third-degree AV block ● Bradycardia
31
lidocaine hydrochloride
● Hypersensitivity to amide-type local anesthetics or any of the “caines” ● Prophylactic use in AMI ● Second- and third- degree AV blocks (without functioning artificial pacemaker) ● Ventricular escape rhythm ● WPW ● SVT
32
lorazepam
● Neurologic or respiratory depression ● Shock states ● Acute narrow-angle glaucoma ● Sleep apnea
33
magnesium sulfate
● Heart blocks ● Myocardial damage ● Diabetic coma ● GI obstruction ● Hypermagnesemia ● Hypercalcemia ● Hypotension ● Known renal insufficiency (relative)
34
mannitol
● Hypotension ● Pulmonary edema and severe pulmonary congestion ● Electrolyte abnormalities ● Severe dehydration ● Intracranial bleeding ● Heart failure ● Impaired renal function (relative - can result in fluid overload)
35
methylprednisolone sodium succinate
● Premature infants ● Systemic fungal infections ● Cushing disease ● Hypertension ● Heart failure (relative) ● Penetrating spinal cord injury (relative) ● Active GI bleed (relative)
36
midazolam hydrochloride
● Neurologic or respiratory depression ● Acute narrow-angle glaucoma ● Sleep apnea ● Overdose of, and concomitant use with, CNS depressants (including alcohol) ● Depressed vital signs, including shock states
37
morphine sulfate
● MAOI use in the previous 14 days ● Paralytic ileus ● Toxin-mediated diarrhea ● Heart failure due to chronic lung disease ● Head injury ● Hypoventilation ● Hypotension ● Bradycardia ● Brain tumor ● Delirium tremens ● Seizure disorders ● Active labor of premature infant ● Acute or severe asthma ● Upper airway obstruction ● GCS <15 (relative) ● Older patients (relative) ● Breastfeeding mothers and pregnancy (relative) ● Hypoxia after supplemental oxygen (relative)
38
naloxone hydrochloride
● Neonates of opioid-addicted mothers (relative) ● Opioid dependency (relative)
39
nitroglycerin
● Hypotension (SBP <90 OR at least 30mmHg below baseline) ● Hypovolemia ● Intracranial bleeding ● Head injury ● Cardiac tamponade ● Severe brady/tachycardia ● Right ventricular infarct ● Sildenafil (Vaigra) or vardenafil (Levitra) within 24 hours ● Tadalafil (Cialis) within 48 hours ● Hepatic disease (relative) ● Anemia (relative) ● Diabetes (relative) ● Breastfeeding mothers and pregnancy (relative)
40
norepinephrine bitartrate
● Hypotension secondary to hypovolemia ● Current MAOI use ● Pregnancy (relative)
41
ondansetron hydrochloride
● Long QT syndrome ● Patients taking apomorphine (can cause significant hypotension and syncope)
42
oxygen
Paraquat and diquat poisoning
43
oxytocin
Active labor
44
pheylephrine
Geriatric patients with preexisting cardiovascular disease (relative)
45
pralidoxime
None
46
procainamide hydrochloride
● Torsades de Pointes ● Second- and third-degree AV block (without functioning artificial pacemaker) ● Systemic lupus erythematosus ● Preexisting QT prolongation ● Digitalis toxicity ● TCA overdose ● Asthma (relative) ● Digitalis-induced dysrhythmias (relative) ● Myasthenia gravis (relative)
47
promethazine hydrochloride
● Known hypersensitivity to any phenothiazines ● Concurrent use of large amounts of CNS depressants ● Reye syndrome ● Lower respiratory symptoms ● Children <2 years ● Sleep apnea ● Respiratory impairment ● Seizure disorders ● Breastfeeding mothers ● Concurrent administration of Haldol or droperidol
48
rocuronium bromide
● Hypersensitivity to bromides ● Inability to control the airway or support ventilation ● Neuromuscular disease ● Heart and liver disease (relative)
49
sodium bicarbonate
● Known metabolic or respiratory alkalosis ● Hypokalemia ● Hypernatremia ● Hypocalcemia ● Heart failure (relative) ● Renal disease (relative)
50
succinylcholine chloride
● Inability to control the airway or support ventilation ● Renal failure ● Neuromuscular diseases ● Para/quadriplegia ● Penetrating eye injury ● Prolonged immobilization ● Stroke with residual motor dysfunction ● History of malignant hyperthermia ● Multisystem trauma ● Burns ● Known or suspected hyperkalemia, including injury-induced hyperkalemia
51
terbutaline sulfate
● Tachydysrhythmias ● Prevention of preterm labor
52
thiamine hydrochloride
None
53
tranexiamic acid
● Mechanism of injury more than 3 hours prior to EMS care ● Subarachnoid hemorrhage ● Isolated head injury ● History of PE, DVT or other thromboembolic disorder
54
vecuronium bromide
● Hypersensitivity to bromides ● Inability to control the airway or support ventilation ● Neuromuscular disease ● Acute narrow-angle glaucoma ● Penetrating eye injury ● Newborns ● Hepatic or renal failure
55
verapamil hydrochloride
● WPW and LGL ● Second- and third-degree AV block, sick sinus syndrome, or other sinus node disease* ● Hypotension ● Cardiogenic shock ● Severe left ventricular dysfunction ● Wide complex tachycardias ● Children <12 months *Unless a functioning artificial pacemaker is present
56

Paramedic Drugs (11 decks)

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