Drug Contraindications

Question 1

What are the contra’s for Adrenaline?

Answer 1

• Hypovolaemic shock without adequate fluid replacement

Question 2

What are the contra’s for Amiodarone?

Answer 2

• Tricyclic Antidepressant toxicity
• QTC > 500 milliseconds
• VT following ondansetron administration
• Pregnancy (if not cardiac arrest)

Question 3

What are the contra’s for Aspirin?

Answer 3

1. Hypersensitivity to aspirin/salicylates
2. Actively bleeding peptic ulcers
3. Bleeding disorders
4. Suspected dissecting aortic aneurysm
5. Chest pain associated with psychostimulant OD if SBP >160mmHg

Question 4

What are the contra’s for Ceftriaxone?

Answer 4

1. Cephalosporin allergy
2. Preterm neonates (<41 weeks corrected gestational age)

Question 5

What are the contra’s for Dexamethasone?

Answer 5

1. Known hypersensitivity

Question 6

What are the contra’s for Dexamethasone?

Answer 6

1. None

Question 7

What are the contra’s for Droperidol?

Answer 7

1. Nil

Question 8

What are the contra’s for Fentanyl?

Answer 8

1. Serotonin syndrome
2. Monoamine oxidase inhibitors (MAOIs) within the previous 14 days
3. Late second stage of labour

Question 9

What are the contra’s for Glucagon?

Answer 9

1. Known pancreatic tumours
2. Known phaeochromocytoma (tumour of adrenal gland)

Question 10

What are the contra’s for Glyceryl Trinitrate (GTN)?

Answer 10

1. BP <100mmHg
2. HR >150 bpm
3. HR <50 bpm (except in autonomic dysreflexia)
4. VT
5. PDE5 inhibitors (current/recent use)
6. Riociguat (current use)
7. Bleeding in pregnancy

Question 11

What are the contra’s for Hartmann’s?

Answer 11

1. Nil

Question 12

What are the contra’s for Heparin?

Answer 12

1. Known allergy or hypersensitivity
2. Active bleeding (excluding menses)
3. Oral anticoagulation
4. Bleeding disorders
5. History of Heparin-Induced Thrombocytopaenia (HIT)
6. Severe hepatic impairment/disease, including oesophageal varices
7. Recent trauma or surgery (< 3 weeks)

Question 13

What are the contra’s for Hydrocortisone?

Answer 13

1. None

Question 14

What are the contra’s for Ipratropium Bromide?

Answer 14

1. Known hypersisitivity to Atropine or its derivatives

Question 15

What are the contra’s for Ketamine?

Answer 15

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

Question 16

What are the contra’s for Lignocaine?

Answer 16

1. Known hypersensitivity to lidocaine or related local anaesthetics
   (bupivicaine, levobupivacaine, prilocaine, ropivacaine)

Question 17

What are the contra’s for Methoxyflurane?

Answer 17

1. Pre-existing renal disease
   (including previously diagnosed renal impairment or failure. Kidney stones or renal colic are not included)
2. Known (or genetic susceptibility) to malignant hyperthermia

Question 18

What are the contra’s for Midazolam?

Answer 18

1. Known hypersensitivity to benzodiazepines

Question 19

What are the contra’s for Morphine?

Answer 19

1. History of hypersensitivity
2. Renal impairment/failure
3. Late second stage of labour

Question 20

What are the contra’s for Naloxone?

Answer 20

1. Nil of significance for the above indication

Question 21

What are the contra’s for Normal Saline?

Answer 21

1. Nil of significance in the above indication

Question 22

What are the contra’s for Olanzapine?

Answer 22

1. Nil

Question 23

What are the contra’s for Ondansetron?

Answer 23

1. Apomorphine

Question 24

What are the contra’s for Oxytocin?

Answer 24

1. None, provided all babies have been delivered prior to administration

Question 25

What are the contra's for Paracetamol?

Answer 25

1. Children < 1 month of age

Question 26

What are the contra's for Plasma-Lyte?

Answer 26

1. Nil

Question 28

What are the contra's for Prochlorperazine?

Answer 28

1. CNS depression 2. Patients < 21 years of age *Children and young adults are more susceptible to extrapyramidial reactions with prochlorperazine*

Question 29

What are the contra's for Salbutamol?

Answer 29

1. Nil of significance in the above indications

Question 30

What are the contra's for Tenectaplase? ## Footnote Not necessary as only given in rural Have to use thrombolysis checklist

Answer 30

1. Major surgery in past 3 months 2. Significant head injury in past 3 months 3. Major trauma in the past 3 months 4. Stroke/TIA in the past 3 months 5. ICH at any time 6. GI or genitourinary bleed in the past month 7. Current bleeding disorder, actibe bleeding (exclusing menses) or bleeding tendencies 8. Anticoagulants or glycoprotein IIb/IIa inhibitors 9. Allergy to tenecteplase or gentamicin

Question 31

What are the contra's for Tranexamic Acid?

Answer 31

1. Injury occurred > 2 hours prior to administration

Question 32

What are the contra's for Water for Injection?

Answer 32

1. Nil in the above indication