Dangerous contraindications to top 100 drugs

Question 1

2 Xi to use of loop diuretics

Answer 1

dehydration

hypovolaemia

Question 2

3 Xi to use of adenosine

Answer 2

coronary ischaemia
hypotension
decompensated HF

Question 3

dangerous area to inject adrenaline

Answer 3

Area supplied by end artery

Question 4

3 Xi to use of spironolactone (aldosterone antagonist)

Answer 4

severe renal impairment
hyperkalemia
addisons disease

Question 5

3 Xi situations to use of allopurinol (gout)

Answer 5

acute attack of gout
sign of skin rash on previous use
sign of hypersensitivity on prev use

Question 6

1 Xi to use of aminosalycilates (Ulcerative C and Rheumatoid A) e.g. mesalazine

Answer 6

patients allergic to aspirin

Question 7

2 Xi to ACEis and ARBs

Answer 7

renal artery stenosis

AKI

Question 8

Reason why you cant use SSRI/ TCA plus an MAOi

Answer 8

all increase synaptic serotonin –> serotonin syndrome

TCAs and MAOis increase NA –> hypertension and hyperthermia

Question 9

1 Xi to use of D2 blocker antiemetics (metoclopramide/domperidone)

Answer 9

gastric perforation

Question 10

reason why you cant use metoclopramide (D2 antiemetic) with parkinsons drugs

Answer 10

antagonism

Question 11

1 Xi to use of phenothiazine antiemetics (prochlorperazine)

Answer 11

severe liver disease

Question 12

1 Xi to antifungal drugs

Answer 12

pregnancy (risk of foetal malformation)

Question 13

1 Xi to use of antimuscarinics for overactive bladder

Answer 13

UTI

Question 14

2 Xi to use of atypical antipsychotics (olanzapine)

Answer 14

severe HF

neutropenia

Question 15

3 Xi to aspirin

Answer 15

under 16 years (risk of rekes syndrome)
3rd trimester
aspirin allergy

Question 16

2 XI to beta blockers

Answer 16

asthma

heart block

Question 17

3 Xi to bisphosphonates

Answer 17

severe renal impairment
hypocalcaemia
upper GI disorders

Question 18

1 Xi to calcium/ vitamin D

Answer 18

Hypercalcaemia

Question 19

2 Xi to calcium channel blockers (amlodipine)

Answer 19

unstable angina

severe aortic stenosis

Question 20

1 Xi to carbemazepine and phenytoin (antiepileptics)

Answer 20

antiepileptic hypersensitivity syndrome

Question 21

Xi to penicillins, cephalosporins and carbapenem antibiotics (amoxicillin, cefotaxime, ertapenem)

Answer 21

previous anaphylaxis

Question 22

3 Xi to digoxin

Answer 22

2nd degree heart block
intermittent complete heart block
ventricular arrhythmias

Question 23

2 Xi to potassium sparing diuretics (amiloride)

Answer 23

severe renal impairment

hyperkalemia

Question 24

1 Xi to thiazide and thiazide like diuretics

Answer 24

hypokalemia

Question 25

2 Xi to fibrinolytic drugs

Answer 25

any bleeding or recent bleeding (esp intracranial haemorrhage) previous streptokinase treatment is a contraindication for prescribing streptokinase again due to Ig formation

Question 26

1 Xi to all laxatives

Answer 26

intestinal obstruction

Question 27

1 Xi to use of macrolide antibiotics (clarithromycin)

Answer 27

macrolide hypersensitivity

Question 28

3 Xi to metformin

Answer 28

severe renal impairment AKI severe tissue hypoxia

Question 29

2 Xi to methotrexate

Answer 29

pregnancy | severe renal impairment

Question 30

1 Xi to metronidazole (antibiotic for anaerobic bacteria)

Answer 30

alcohol (produces disulfiram like reaction)

Question 31

1 Xi to nicorandil (stable angina)

Answer 31

phosphodiesterase inhibitor use (sildenafil)

Question 32

4 Xi to nitrates

Answer 32

severe aortic stenosis hypotension haemodynamic instability sildenafil

Question 33

3 Xi to nitrofurantion (UTI)

Answer 33

later stages of pregnancy babies under 3 months renal impairment

Question 34

4 Xis to NSAIDS

Answer 34

severe renal impairment heart failure liver failure NSAID hypersensitivity

Question 35

1 Xi to oestrogens and proeostrogens

Answer 35

breast cancer

Question 36

1 Xi to weak opioids (tramadol)

Answer 36

uncontrolled epilepsy

Question 37

2 Xi to broad spectrum penicillins

Answer 37

penicillin allergy | severe renal impairment

Question 38

2 Xi to penicillinase resistant penicillins (flucloxacillin)

Answer 38

penicllin allergy | prior penicllin related hepatotoxicity

Question 39

1 Xi to oral K+

Answer 39

severe renal impairment

Question 40

3 Xi to tetracyclines

Answer 40

pregnancy breastfeeding children under 12

Question 41

2 Xi to thiazolidinediones (pioglitazone, insulin sensitiser for T2DM)

Answer 41

HF | bladder cancer

Question 42

1 Xi to trimethoprim (UTIs)

Answer 42

first trimester of pregnancy

Question 43

2 Xi to vaccines

Answer 43

previous anaphylaxis to a past vaccine with any of same constituents significant immunosuppression

Question 44

2 Xi to valproate (epilepsy and BD)

Answer 44

any childbearing potential/risk of conception | first trimester of pregnancy

Question 45

2 Xi to warfarin

Answer 45

pregnancy | immediate bleeding risk

Question 46

2 Xi to Zdrugs for insomnia (zopi-)

Answer 46

obstructive sleep apnoea | respiratory muscle weakness or respiratory depression

Question 47

1 irrelevant Xi to 5-a reductase inhibitors (finasteride, 2nd line for benign prostatic hyperplasia)

Answer 47

any exposure during pregnancy with a male foetus (touching tablets or via semen with male taking 5-a reductase inhibitors)