Medication Contraindications

Question 1

Adrenaline

Answer 1

1. Hypovolaemic shock without adequate fluid replacement

Question 2

Amiodarone

Answer 2

1. Tricyclic antidepressant toxicity
2. QTc >500 milliseconds
3. VT following ondansetron administration
4. Pregnancy (if not cardiac arrest)

Question 3

Aspirin

Answer 3

1. Hypersensitivity
2. Bleeding disorders
3. Suspect dissecting aortic aneurysm
4. Chest pain associated with psycho stimulant OD if SBP >160
5. Actively bleeding peptic ulcers

Question 4

Ceftriaxone

Answer 4

1. Allergies to cephalosporins
2. Preterm neonates (<41 weeks corrected gestational age)

Question 5

Dexamethasone

Answer 5

1. Hypersensitivity

Question 6

Dextrose 10%

Answer 6

None

Question 7

Droperidol

Answer 7

None

Question 8

Fentanyl

Answer 8

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

Question 9

Glucagon

Answer 9

1. Known pancreatic tumours
2. Known phaeochromocytoma

Question 10

Glyceryl Trinitrate (GTN)

Answer 10

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

Question 11

Hydrocortisone

Answer 11

1. Nil significant

Question 12

Ipatropium Bromide

Answer 12

1. Known hypersensitivity to atropine or its derivative’s

Question 13

Ketamine

Answer 13

Suspected NON-traumatic brain injury with severe hypertension (SBP > 180)

Question 14

Lignocaine

Answer 14

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

Question 15

Methoxyflurane

Answer 15

1. Pre-existing Renal disease
2. Malignant hyperthermia

Question 16

Midazolam

Answer 16

1. Known hypersensitivity to benzodiazepines

Question 17

Morphine

Answer 17

1. Late second stage labour
2. Renal impairment / failure
3. Hypersensitivity

Question 18

Naloxone

Answer 18

1. NIL significance to indication

Question 19

Olanzapine

Answer 19

NIL

Question 20

Ondansetron

Answer 20

1. Apomorphine (Parkinson’s medication)

Question 21

Oxytocin

Answer 21

1. None provide all babies have been delivered prior to administration

Question 22

Paracetamol

Answer 22

1. Babies under 1 month

Question 23

Prochloperazine (stemitil)

Answer 23

1. CNS depression (unconscious or intoxicated)
2. Patients under 21 years of age
   (Young adults and children are more susceptible to extrapyramidal reactions with prochlorperazine)