Final - Contraindications

Question 1

methylergonovine

Answer 1

Severe HTN = preeclampsia is not a candidate

Question 2

Antacids
Antifungals
Alcohol
Seizure  meds
food

Answer 2

isoniazide

Question 3

History of hearing loss

When administered with metformin, may increase risk of lactic acidosis

Answer 3

vancomycin

Question 4

Pregnancy
CNS disorders
Renal impairment
Increase anticoagulant effects with warfarin
Milk
Slow metabolism xanthines (caffeinated = hyperactive reaction

Answer 4

ciprofloxacin

Question 5

warfarin + fluconazole =

Answer 5

increase bleeding

Question 6

Hepatic impairment
Hypokalemia
Pregnancy = fetal malformations
Warfarin = increases bleeding
Oral hypoglycemic
Erythromycin – increase risk of cardiotoxicity & death

Answer 6

fluconazole

Question 7

Suppressive immune system (anemic)
Hepatic impairment (increase ALT, AST, chronic alcoholic)
Warfarin
Disulfiram
Lithium

Answer 7

metronidazole

Question 8

Cardiac Disease = can prolong PR interval = 3rd degree heart block = fatal
Hepatic impairment
Statins = increase risk for myopathy
Antidysrhythmic durgs = life-threatening dysrhythmias

Answer 8

lopinavir with ritonavir

Question 9

Warfarin
Pregnancy/lactation
Oral contraceptives
Black cohosh (herbal supp.)

Answer 9

tomoxifen

Question 10

STATINS = myopathy, muscle breakdown, rhabdomyelosis
Hepatotoxic drugs
SUN
Pregnancy
**Grapefruit juice
alcohol

Answer 10

cyclosporine

Question 11

Hypersensitivity

Lactation = caution with pregnancy & decrease bone marrow reserve

Answer 11

methimazole

Question 12

2nd, 3rd Degree AV block
Lupus
Myasthenia gravis
Bone marrow depression

Answer 12

procainamide

Question 13

Severe bradycardia
Cardiogenic shock
Sick sinus syndrome: SA node not functioning properly
Severe sinus node dysfunction
3rd degree AV block
COPD
Multiple drug reactions! =

Answer 13

amniodarone

Question 14

Cardiogenic Shock
2nd, 3rd Heart block
Interact with some other meds

Answer 14

propranolol

Question 15

• bradycardia

- AB block

Answer 15

esmolol

Question 16

AV block
Sick sinus syndrome
Sever hypotension
Bleeding aneurysm
Intracranial surgery

Answer 16

verapamil

Question 17

Internal bleeding
Intracranial bleeding
Severe HTN (bc of burst blood vessel)
Bacterial endocarditis (inflammation around heart)
Meds & herbal supplements

Answer 17

heparin

Question 18

• IV Dextran

- oral anticoagulants

Answer 18

abciximab

Question 19

Antagonizes thrombolytics
Estrogens & oral contraceptics: hypercoagulation
Recent thromboembolic disease (DIC)
Renal impairment
Urinary tract bleeding: promotes formation of clots in renal pelvis or ureters) =

Answer 19

aminocaproic acid

Question 20

Intracranial hemorrhage

WARFARIN c INR >1.7 or PT >15

Answer 20

alteplase

Question 21

lithium + furosemid =

Answer 21

toxicity

Question 22

can you have anuria with diuretics

Answer 22

no

Question 23

Phsphodiesterase-5 inhibitors (Viagra)
Anything that causes hypotension
Worsened by increase vasodilation (bleeding, ICP)
Pericardial tamponade & constrictive pericarditis
Liver & renal disease
Treat before: dehydration or hypovolemia

Answer 23

nitroglycerine

Question 24

High intracranial pressure (brings fluid with it and increase pressure)
Renal failure
Sympathomimetics will block action of it

Answer 24

nitroprusidde sodium

Question 25

Seizure disorder Pregnancy (it has causes of birth defects) Cardiac disease/MI Other CNS depressants = increased sedation Hyperthyroifism/Thyroid hormone = dysrhythmias MAOIs SSRIs = imipramine toxicity St. John’s Wort = risk of serotonin syndrome Herbal supplements Increased ICP Hepatic disase

Answer 25

tricyclics

Question 26

Grapefruit juice Bipolar disorder (stimulates their manic phase) Newborn may have withdrawal symptoms Diabetes Phenothiazine Other CNS depressants = increased sedation St. John’s Wort = risk of serotonin syndrome Antidysrhythmics & benzos Warfarin, asa, NSAIDS (may increase bleeding risk)

Answer 26

SSRIs

Question 27

``` Mania Seizure HTN Hepatic disease Elderly, children, lactating women ```

Answer 27

duloxetine

Question 28

NSAIDS & thiazides + lithium =

Answer 28

increased lithium reabsorption = potential toxicity

Question 29

haloperidol + lithium =

Answer 29

increase neurotoxicity

Question 30

CNS depression, seizures, dysrhythmias, hypotension, suicidal ideation DKA lactation SSRIs: increase levels of risperidone CNS depressants: CNS depression Antihypertensive: may potentiate hypotension

Answer 30

risperidone

Question 31

``` Lactation Seizure disorders Drugs metabolized by liver SSRIs Antipsychotics & lithium increase risk of EPS Grapefruit ```

Answer 31

aripiprazole

Question 32

paralytic ileus

Answer 32

hydromorphone

Question 33

DO NOT USE WITHIN 14 DAYS OF MAOI (hypersensitivity) | not recommended for use longer than 48 hrs, chronic pain, or PCA

Answer 33

meperidine

Question 34

Grapefruit juice Kava Pregnancy & lactation Narrow-angle glaucoma

Answer 34

benzodiazepines

Question 35

Soybean & egg products OB pt’s Increased ICP (due to increased CO2)

Answer 35

propofol