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Drug Therapy Protocols - QAS ACP2 > Precautions > Flashcards

Precautions Flashcards

1
Q

Adrenaline (epinephrine)

A

Hypertension
Hypovolaemic shock
Concurrent MAOI therapy
Quetiapine toxicity

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2
Q

Amiodarone

A

For patients who are in cardiac arrest: Nil
For patients with sustained conscious VT (haemodynamically stable): Hypotension

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3
Q

Aspirin

A

Possible aortic aneurysm or any other condition that may require surgery
Pregnancy
History of GI bleeding or peptic ulcers

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4
Q

Box jellyfish antivenom

A

The antivenom is a foreign protein, which can cause sensitization, allergic reaction or anaphylaxis

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5
Q

Ceftriaxone

A

Any allergy or hypersensitivity to penicillin or carbapenem - isolated minor drug attributed to penicillin does not contraindicate the use of ceftriaxone

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6
Q

Clopidogrel

A

Severe renal impairment

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7
Q

Dexamethasone

A

Nil in this setting

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8
Q

Droperidol

A

Hypoperfused state
Concurrent use of CNS depressants

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9
Q

Enoxaparin

A

Renal/hepatic impairment
Low bodyweight (women <45 kg and men <57 kg)
Older people

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10
Q

Fentanyl

A

Hypotension
Respiratory tract burns
Respiratory depression and/or failure
Known addiction to narcotics
Current MAOI therapy

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11
Q

Glucagon

A

Nil

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12
Q

Glucose gel

A

Nil

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13
Q

Glucose 10%

A

Hyperglycaemia

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14
Q

Glyceryl trinitrate

A

Inferior AMI
Cerebral vascular disease
Risk of hypotension and/or syncope
Intoxication (GTN effects are enhanced)
Phosphodiesterase 5 inhibitor medication administration (e.g. tadalafil, sildenafil. vardenafil) in the previous 4 days

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15
Q

Heparin

A

Renal impairment

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16
Q

Hydrocortisone

A

Hypertension

17
Q

Hydroxocobalamin

A

Hypertension (substantial increases in blood pressure may occur following hydroxocobalamin therapy)
Pregnancy (There are no adequate and well-controlled studies of hydroxocobalamin administration in pregnant women. Hydroxocobalamin should be used during pregnancy ONLY if the potential benefits justifies the potential risk to the fetus

18
Q

Ibuprofen

A

Asthma
Hepatic dysfunction
History of GI bleeding or peptic ulcers

19
Q

Influenza vaccine

A

Nil

20
Q

Ipratropium bromide

A

Glaucoma

21
Q

Loratadine

A

Severe hepatic impairment
Increased risk of sedation and anticholinergic effects in older people

22
Q

Magnesium sulphate

A

Renal impairment

23
Q

Methoxyflurane

A

ALOC
Intoxicated or drug affected patients
Cardiovascular instability
Respiratory depression

24
Q

Midazolam

A

Reduced dosages must be considered in :
- Low body weight, older, cachectic or frail patients
- Patients with chronic renal failure, congestive cardiac failure or shock
Can cause severe respiratory depression in patients with COPD
Myasthenia gravis
Multiple sclerosis

25
Q

Morphine

A

Hypotension
Respiratory tract burns
Respiratory depression and/or failure
Known addiction to narcotics
Concurrent MAOI therapy
Cardiac chest pain

26
Q

Naloxone

A

Use with caution on patients with pre-existing cardiac disease

27
Q

Ondansetron

A

Hepatic impairment
Elderly patients
Intestinal obstruction
Patients with risk factors for QT interval prolongation or cardiac arrhythmias

28
Q

Oxygen

A

Patients with paraquat poisoning or bleomycin lung injury may be harmed by supplemental oxygen. Avoid oxygen unless the patient is hypoxaemic - target 88-92%
Prolonged administration to premature neonates
Newly born infants will have low Sp02 for the first 10 minutes following birth - refer to CPG: Resuscitation - Newly born.
Patients with cyanotic heart disease may have saturation targets between 75% to 85%. Clinicians should attempt to ascertain optimal target saturation levels for these patients from carers or health professional.
A BVM will not supply adequate oxygen unless IPPV is provided
The use of high flow oxygen in an attempt to protect against subsequent hypoxaemia in the event of deterioration has the potential to delay the recognition of such a deterioration. This may provide a false reassurance that the patient is stable.

29
Q

Oxytocin

A

Myocardial ischaemia
May potentiate hypotension when administered with analgesia

30
Q

Paracetamol

A

Hepatic dysfunction
Soluble tablets:
- Patients with sodium restriction (heart failure, chronic kidney disease)
- Phenylketonuria

31
Q

Salbutamol

A

Acute pulmonary oedema
Ischaemic heart disease

32
Q

Sodium chloride 0.9%

A

Patients with acute and/or history of heart failure
Pre-existing renal failure
Uncontrolled haemorrhage (unless associated with severe head injury)

33
Q

Sucrose 24%

A

Nil

34
Q

Tenecteplase

A

Nil

35
Q

Ticagrelor

A

Concurrent medication known to induce bradycardia (e.g. beta blockers, calcium channel blockers, digoxin)
Symptomatic bradycardia (HR less than 60)

36
Q

Tranexamic acid

A

Nil

37
Q

Water for injection

A

Nil

Drug Therapy Protocols - QAS ACP2 (9 decks)

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