Contraindications Flashcards
(55 cards)
1
Q
ABIXIMAB
contraindications
A
- Active internal bleeding or recent history (within 6 weeks) of clinically significant gastrointestinal or genitourinary bleeding
- History of cerebrovascular accident (CVA) with current residual neurologic deficit or within the past 2 years
- Bleeding diathesis (bleeding disorder, condition or predisposition)
- Current use of warfarin (Coumadin) or use within the past 7 days unless prothrombin
time is <1.2 times control - Thrombocytopenia (<100,000 cells/mcl)
- Trauma or major surgery within the past 6 weeks
- Intracranial neoplasm
- Arteriovenous malformation or aneurysm
- Severe uncontrolled hypertension
(systolic BP >180mmHg, diastolic BP >110mmHg)
-Concomitant use of another GP IIb/IIIa inhibitor - History of vasculitis
- Acute pericarditis
- Use or intent to use IV Dextran
- Hypersensitivity to abciximab or murine proteins
2
Q
ACETYLSALICYLIC ACID, ASPIRIN, ASA
contraindications
A
- Bleeding ulcer, hemorrhagic states, hemophilia
- Known hypersensitivity to salicylates or other non-steroidal anti-inflammatories that has
led to hypotension and/or bronchospasm - Children and adolescents (prehospital personnel should not administer ASA to this age
group)
3
Q
ACETYLSALICYLIC ACID, ASPIRIN, ASA (EMT Administration)
contraindications
A
- Bleeding ulcer, hemorrhagic states, hemophilia
- Known hypersensitivity to salicylates or other non-steroidal anti-inflammatories that has
led to hypotension and/or bronchospasm - Children and adolescents (prehospital personnel should not administer ASA to this age
group)
4
Q
ADENOSINE
contraindications
A
- Sick sinus syndrome, 2nd or 3rd degree AV blocks; except in patients with a functioning ventricular pacemaker.
- Use cautiously in patients with known asthma (has precipitated acute bronchospasm).
- Patients on theophylline and related methylxanthines.
- Patients on dipyridamole (Persantine) or carbamazepine (Tegretol).
- Cardiac transplant patients are more sensitive to adenosine and require only a small dose
(relative). - Known atrial fibrillation or atrial flutter.
- Pregnancy (no controlled studies)
5
Q
ALBUMIN, normal serum 5% / 25%
contraindications
A
- Hypersensitivity
- CHF
- Severe anemia
- Renal insufficiency
6
Q
ALUTEROL SULFATE
contraindications
A
- Synergistic with other sympathomimetics
- Use caution in patients with diabetes, hyperthyroidism, and cerebrovascular disease
7
Q
AMIODARONE
contraindications
A
- Bradycardia
- Second or third degree heart block unless a functioning pacemaker is present
- Cardiogenic shock
- Hypotension
- Pulmonary congestion
8
Q
ATROPINE SULFATE
contraindications
* Pregnancy Risk Factors/Considerations?
A
- Hypersensitivity to atropine or any component of the formulation – Belladonna alkaloid allergy
- Glaucoma, acute narrow angle (relative contraindication for patient with symptomatic bradycardia), adhesions between the iris and lens
- Tachycardia
- Obstructive GI disease, paralytic ileus, intestinal atony of the elderly or debilitated
patient, severe ulcerative colitis, or toxic megacolon complicating ulcerative colitis - Hepatic disease
- Renal disease, obstructive uropathy
- Myasthenia gravis (unless used to treat side effects of acetylcholinesterase inhibitor
- Asthma
- Thyrotoxicosis
- Mobitz type II block
- 3rd degree heart block
- Risk category: C. Animal reproduction studies have not been conducted. Atropine has been found to cross the human placenta. Trace amounts of atropine can enter breast milk; use caution. Anticholinergic agents may suppress lactation.
9
Q
BUMETANIDE
contraindications
A
- Hypersensitivity
- Anuria
- Electrolyte deficiencies
- Hepatic coma
- Cautious use: hepatic cirrhosis, ascites, history of gout, hypersensitivity to furosemide
10
Q
CALCIUM CHLORIDE
contraindications
A
Hypercalcemia
Concurrent digoxin therapy (relative)
11
Q
CALCIUM GLUCONATE GEL, 2.5%
contraindications
A
For external use only.
12
Q
CHARCOAL, ACTIVATED (without sorbitol)
contraindications
A
- Ingestion of caustics
- Ingestion of hydrocarbons (relative)
- Oral administration to comatose patient
- Simultaneous administration of other oral drugs
13
Q
CIMETIDINE
contraindications
A
Hypersensitivity to drug
14
Q
DEXAMETHASONE SODIUM PHOSPHATE
contraindications
A
Systemic fungal infections
Hypersensitivity to any component of dexamethasone, including sulfites Preterm infants
15
Q
DEXTROSE 50%
contraindications
A
- Known thiamine deficiency (relative, if suspected give thiamine close to same time).
- Delirium tremens; use with caution in patients with acute alcoholism. Administer in
conjunction with thiamine - Head injury (unless documented hypoglycemia).
- Intra cranial hemorrhage (relative).
- Severe pain (paradoxical excitement may occur).
16
Q
DIAZEPAM
contraindications
A
Hypersensitivity (allergy)
Glaucoma, acute narrow angle (relative)
17
Q
DILTIAZEM
contraindications
A
- Hypotension (less than 90 mmHg systolic)
- Acute Myocardial infarction
- Cardiogenic shock
- Ventricular tachycardia or wide-complex VT of unknown origin
- Second or third-degree AV block
- Wolff-Parkinson-White (WPW) syndrome
- Sick Sinus syndrome
- Beta Blocker Use
18
Q
DIPHENHYDRAMINE HCL
contraindications
A
- Known hypersensitivity to diphenhydramine or drugs of similar chemical structure.
- Newborn or premature infants; nursing mothers.
- Considerable caution in patients with glaucoma, acute narrow angle; stenosing or
obstructive diseases of the GI tract; bronchial asthma; hyperthyroidism; cardiovascular disease or hypertension; age greater than 60 years (all relative benefit vs risk).
19
Q
DOPAMINE
contraindications
A
Hypovolemic shock (relative)
Pheochromocytoma
MAO inhibitors, such as Marplan, Nardil, or Parnate
20
Q
EPINEPHRINE AUTO-INJECTOR
contraindications
A
There are no absolute contraindications in a life-threatening situation.
21
Q
EPINEPHRINE HCL
contraindications
A
None known for cardiac arrest Hypothermia, relative contraindication
22
Q
EPTIFIBATIDE
contraindications
A
- Active internal bleeding or recent history (within 30 days) of clinically significant gastrointestinal or genitourinary bleeding
- History of cerebrovascular accident (CVA) with current residual neurologic deficit or within the past 2 years
- Bleeding diathesis (bleeding disorder, condition or predisposition)
- Current use of warfarin (Coumadin) or use within the past 7 days unless prothrombin
time is <1.2 times control - Thrombocytopenia (<100,000 cells/mcl)
- Trauma or major surgery within the past 6 weeks
- Intracranial neoplasm
- Arteriovenous malformation, aneurysm or evidence of aortic dissection
- Severe uncontrolled hypertension
(systolic BP >200mmHg, diastolic BP >110mmHg) - History of vasculitis
- Concomitant use of another GP IIb/IIIa inhibitor
- Acute pericarditis
- Hypersensitivity to eptifibatide
23
Q
ETOMIDATE
contraindications
A
Hypersensitivity
24
Q
FAMOTIDINE
contraindications
A
Hypersensitivity to drug
25
FENTANYL CITRATE
| contraindications
- Known allergy or intolerance to drug (assess for medic alert bracelet)
- Respiratory depression if airway and breathing can’t be supported
- Known elevated intracranial pressure e.g. mass lesion
- Head injury with ALOC (relative)
- Asthma (relative)
- Abdominal pain (relative)
26
FUROSEMIDE
| contraindications
- Anuria (relative)
- Hypovolemia
- Hypotension
27
GLUCAGON
| contraindications
- Known hypersensitivity
- Pheochromocytoma
- Insulinoma
- Should not be routinely used to replace dextrose when IV access has been obtained
28
HEMOSTATIC AGENTS
| contraindications
- Application to injuries related to eyes or airway
- Kaolin powder should not be applied directly to the wound
29
HYDROXOCOBALAMIN
| contraindications
None
30
INSULIN
| contraindications
Hypersensitivity to drug or its components Hypoglycemia
31
IPRATROPIUM BROMIDE
| contraindications
Ipratropium bromide is contraindicated in known or suspected cases of hypersensitivity to ipratropium bromide or to atropine and its derivatives. Precaution: should be used with caution in patients with narrow angle glaucoma.
32
KETAMINE HYDROCHLORIC INJECTION
| contraindications
- Angina
- CHF
- Symptomatic Hyperthyroidism
- Pregnancy-Relative (Category B)
33
LIDOCAINE HCL
| contraindications
- Known hypersensitivity/allergy.
- Use extreme caution in patients with conduction disturbance (second or third degree
block).
- Do not treat ectopic beats if heart rate is < 60. They are probably compensating for the
bradycardia; instead, treat the bradycardia.
34
LORAZEPAM
| contraindications
- Known sensitivity to the benzodiazepines
- Acute narrow angle glaucoma or myasthenia gravis
- Known hypersensitivity to polyethylene glycol, propylene glycol, or benzyl alcohol
- Pregnancy (relative)
35
MAGNESIUM SULFATE
| contraindications
- Hypermagnesemia
- Use cautiously in patients with impaired renal function and pre-existing heart blocks
(relative).
- Precautions: Caution when used with barbituates, narcotics, or other hypnotics (or
system anesthetics) in conjunction with Magnesium Sulfate due to the additive central depressive effects of magnesium.
36
METHYLPREDNISOLONE SODIUM SUCCINATE
| contraindications
Preterm infants
37
MIDAZOLAM HYDROCHLORIDE
| contraindications
- Hypersensitivity to midazolam
- Relative contraindication in: Myasthenia gravis or other neuromuscular disorders; acute
alcohol intoxication; severe, chronic obstructive pulmonary disease; and acute pulmonary
insufficiency
- Pregnancy (relative)
38
MORPHINE SULFATE
| contraindications
- Respiratory depression
- Head injuries
- Elevated Intra cranial pressure
- Asthma, relative
- Abdominal pain, relative
39
NALMEFENE HCL
| contraindications
Hypersensitivity
40
NALOXONE HCL
| contraindications
Hypersensitivity
41
NITROGLYCERIN
| contraindications
- Hypovolemia
- Increased Intra cranial pressure
- Hypotension (relative)
42
NOREPINEPHRINE
| contraindications
- Hypersensitivity to drug
- Hypotension caused by blood volume deficit (except in emergencies until blood volume
replacement is completed), profound hypoxia or hypercarbia
- Mesenteric or peripheral vascular thrombosis
43
ONDANSETRON
| contraindications
- Hypersensitivity
- Use with caution in patients with hepatic impairment
- Avoid use in patients with long QT syndrome
44
OXYTOCIN
| contraindications
Hypersensitivity
45
PHENYLEPHRINE NASAL SPRAY 0.5%
| contraindications
Known allergy to medication
46
PROPARACAINE HYDROCHLORIDE OPTHALMIC
| contraindications
Known hypersensitivity to Proparacaine.
47
PROPOFOL
| contraindications
Allergies to eggs, egg products, soybeans, or soy products
48
RACEMIC EPINEPHRINE
| contraindications
- Allergy to any of the ingredients (may contain sulfites)
- Coronary Artery Disease/Insufficiency
- Arrhythmias
- Epiglottitis
- Hypertension
49
RANITIDINE
| contraindications
Hypersensitivity to drug and patient with acute porphyria
50
SODIUM BICARBONATE 8.4%
| contraindications
Alkalosis
51
SUCCINYLCHOLINE
| contraindications
- Muscle disorders
- Personal or family history of malignant hyperthermia
- History of hyperkalemia
- Burn injured patients*
- Ocular injuries
- Patients in whom successful endotracheal intubation is doubtful
52
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THIAMINE HCL (VITAMIN B1)
contraindications
```
Do not give intra-arterial
53
TIROFIBAN
| contraindications
- Active internal bleeding or recent history (within 30 days) of clinically significant gastrointestinal or genitourinary bleeding
- History of cerebrovascular accident (CVA) with current residual neurologic deficit or within the past 2 years
- Bleeding diathesis (bleeding disorder, condition or predisposition)
- Current use of warfarin (Coumadin) or use within the past 7 days unless prothrombin
time is <1.2 times control
- Thrombocytopenia (<100,000 cells/mcl)
- Trauma or major surgery within the past 6 weeks
- Intracranial neoplasm
- Arteriovenous malformation, aneurysm or evidence of aortic dissection
- Severe uncontrolled hypertension
(systolic BP >180mmHg, diastolic BP >110mmHg)
- History of vasculitis
Concomitant use of another GP IIb/IIIa inhibitor
Acute pericarditis
Hypersensitivity to tirofiban
54
VASOPRESSIN
| contraindications
- Responsive patient with coronary artery disease
- Hypertension
55
VERAPAMIL HCL
| contraindications
AV block
Sick sinus syndrome
Any wide QRS complex tachycardia WPW
Shock
Severe CHF
IV beta blocker
Hypotension
