Medication Precautions

Question 1

Adrenaline

Answer 1

1. Elderly/frail patients
2. patients with cardiovascular disease
3. patients on monoamine oxidase inhibitors
4. higher doses may be required for patients on beta blockers

Question 2

Aspirin

Answer 2

1.Peptic ulcer
2.asthma
3.patients on antocoagulants

Question 3

Ceftriaxone

Answer 3

Allergy to penicillin

Question 4

Dexamethasone

Answer 4

1. Solutions which are not clear or are contaminated should be discarded

Question 5

Dextrose 10%

Answer 5

Nil significant

Question 6

Droperidol

Answer 6

1.Elderly/frail patients are more susceptible to adverse effects
2.Parkinsons disease
3.Lewy body dementia, may experience agitation
4.QT prolongnation has been reported rarely. Where possible provide ECG monitoring after sedation has been achieved.

Question 7

Fentanyl

Answer 7

1.Elderly/frail patients
2.impaired hepatic function
3.COPD
4.Current asthma
5.patients on monoamine oxidase inhibitors
6.known addiction to opioids
7.Rhinitis, rhinorrhea or facial trauma

Question 8

Glucagon

Answer 8

Nil

Question 9

GTN

Answer 9

1.Use lower doses in patients who have no previous exposure and recent MI
2.Right ventricular MI or Inferior stemi with SBP of <160
3.preterm labour

Question 10

Heparin

Answer 10

Renal Impairment

Question 11

Hydrocortisone

Answer 11

Nil

Question 12

Ipatropium bromide

Answer 12

1. Glucoma
2. Avoid contact with the eyes

Question 13

Ketamine

Answer 13

1.May exacerbate cardiovascular conditions

Question 14

Lignocaine

Answer 14

1. IM and local infiltraion, may result in systemic toxicity
2. IO-Impaired CV function

Question 15

Methoxyflurane

Answer 15

1.Patients should not be administered >6ml of methoxyflurane in a 24hr periord due to nephrotoxicity

2.Should not be administered in a confined space

Question 16

Midazolam

Answer 16

1. Reduced does may required for elderly
2. The CNS depressant effects of benzodiazipines are enhanced by the presents of narcotics and alcohol
3. can cause severe resp depression in patients with COPD
4. Patients with myasthenia gravis

Question 17

Morphine

Answer 17

1. Elderly/frail
2. hypotension
3. current asthma
4. respiratory tract burns
5. known addiction to opioids
6. acute alcoholism
7. Patients on monoamine oxidase Inhibitors

Question 18

Naloxone

Answer 18

1. If patients depend on opioids be prepared for the combative patient
2. neonates

Question 19

NS

Answer 19

Nil

Question 20

Olanzapine

Answer 20

1. May be less effective if patient agitation is due to drug intoxication
2. elderly frail and children may be more susceptible to side effects

Question 21

Ondansetron

Answer 21

1. pregnancy in first trimester
2. Congenital Long QT syndrome
3. severe hepatic disease
4. Ondans ODT may contain aspartame which should be avoided in patients with phenylketonuria

Question 22

Oxytocin

Answer 22

Nil

Question 23

Paracetamol

Answer 23

1. Hepatotoxicity can occur with overdose
2. Risk of hepatotoxicity is increased with impaired hepatic function, elderly/frail, malnourishment

Question 24

Prochlorperazine

Answer 24

1. Elderly patients (Increase adverse effects)
2. parkinsons disease (can worsen symptoms)

Question 25

Salbutamol

Answer 25

Large doses have been reported to cause intracellular metabolic acidosis

Question 26

Tenecteplase

Answer 26

1. Age >75y 2. Non-compressible vascular puncture 3. History of liver disease 4. SBP >160 or DBP >110 5. low body weight 6. active peptic ulcer 7. anaemia 8. Acute pericarditis or bacterial endocarditis 9. Traumatic or prolonged CPR 10. Pregnant or within 1 week post partum 11. HR>120

Question 27

Tranexamic ACID

Answer 27

Rapid administration increase risk of adverse effects.