AV - All Medication CONTRAINDICATIONS

Question 1

Adrenaline

Answer 1

Hypovolaemic shock without adequate fluid replacement.

Question 2

Aspirin

Answer 2

1. C-hest pain assoc. w/ psychostimulant OD if SBP > 160
   (e. g. methamphetamines, cocaine)
2. H-ypersensitivity to aspirin / salicyclates (naturally occuring in some foods)
3. A-ctively bleeding peptic ulcers
   (sore on lining of oesophagus, stomach, or small intestine)
4. B-leeding disorders
   (e. g. haemophilia, Von Willebrand Disease)
5. S-uspected dissecting aortic aneurysm
   (sudden, severe “ripping/tearing” pain in chest / upper back pain rad. to neck / down back and w/ SOB)

Question 3

Ceftriaxone

Answer 3

Allergy to Cephalosporin ABs

Question 4

Dexamethasone

Answer 4

Known hypersensitivity

Question 5

Dextrose 10%

Answer 5

NIL

Question 6

Fentanyl

Answer 6

1. Hx of hypersensitivity

2. Late 2nd stage labour

Question 7

Glucagon

Answer 7

NIL

Question 8

Glyceryl Trinitrate

Answer 8

1. Known hypersensitivity
2. SBP < 110 (tablet)
3. SBP < 90 (patch)
4. Sildenafil Citrate (Viagra) or Vardenafil (Levitra) in previous 24 hrs; Tadalafil (Cialis) in previous 4 days (PDE5 inhibitors)
5. HR > 150
6. HR < 50 (excl. AD)
7. VT
8. Inferior STEMI w/ SBP < 160
9. Right ventricular MI

Question 9

Heparin

Answer 9

1. known allergy / hypersensitivity
2. active bleeding (excl. menses)
3. oral anticoagulants
4. bleeding disorders
5. hx of heparin-induced thrombocytopaenia (HIT)
6. severe hepatic impairment / disease
7. recent trauma / surgery (< 3 wks)

Question 10

Ipratropium Bromide

Answer 10

Known hypersensitivity to Atropine / its derivatives

Question 11

Ketamine

Answer 11

Susp. non-TBI w/ severe hypertension (SBP > 180)

Question 12

Lidocaine (Lignocaine)

Answer 12

Known hypersensitivity to lidocaine / related local anaesthetics

Question 13

Methoxyflurane

Answer 13

1. Pre-existing renal disease / impairment
2. Exceeding total daily dose 6 mL in 24 hrs
3. Concurrent use of tetracycline ABs
4. Pers / fam hx of malignant hyperthermia
5. Muscular dystrophy

Question 14

Midazolam

Answer 14

Known hypersensitivity to benzodiazepines

Question 15

Morphine

Answer 15

1. Hx of hypersensitivity
2. Renal impairment / failure
3. Late 2nd stage labour

Question 16

Naloxone

Answer 16

NIL

Question 17

Normal Saline

Answer 17

NIL

Question 18

Olanzapine

Answer 18

NIL

Question 19

Ondansetron

Answer 19

1. Known hypersensitivity
2. Concurrent Apomorphine use
3. Known long Q-T syndrome
4. Hypokalaemia or Hypomagnesaemia

Question 20

Oxytocin

Answer 20

1. Previous hypersensitivity
2. Severe toxaemia (pre-eclampsia)
3. Exclude multiple pregnancy before drug administration
4. Cord prolapse

Question 21

Paracetamol

Answer 21

1. Hypersensitivity to paracetamol
2. < 1/12
3. Paracetamol in prev. 4/24
4. Paracetamol daily max: adult 4g, paeds 60mg/kg
5. Chest pain in susp. acute coronary syndrome

Question 22

Procholorperazine

Answer 22

1. Pts < 21 yrs
2. Pregnancy
3. Prev. hypersensitivity
4. Circulatory collapse (cool, pale, clammy, tachycardic, hypotension)
5. CNS depression

Question 23

Salbutamol

Answer 23

NIL

Question 24

Tenecteplase

Answer 24

1. major surgery in past 3/12
2. significant head injury in past 3/12
3. major trauma in past 3/12
4. stroke / TIA in past 3/12
5. ICH at any time
6. GI or GU bleed in past 1/12
7. current bleeding disorder, active bleeding (excl. menses), or bleeding tendencies
8. anticoagulants or glycoprotein IIb / IIIa inhibitors
9. allergy to tenecteplase or gentamicin

Question 25

Water for injection

Answer 25

NIL

Question 26

NO Contras (7)

Answer 26

sugar-sugar-na-Na… “Sal-Lanza” & water

Dextrose 10%; Glucagon; naloxone; NaCl; Salbutamol; Olanzapine, and Water for inj.

Question 27

Multiple CI’s (11)

Answer 27

“GAMPaPrOnOxMF-TH”

G-TN: 9; 
A-spirin: 5; 
M-ethoxyflurane: 5; 
P-aracetamol: 5; P-rochlorperazine: 5
O-ndansetron: 4; O-xytocin: 4; 
M-orphine: 3; 
F-entanyl: 2

Question 28

Single CI’s only (7)

Answer 28

“MAL-DICK”

M-idazolam; A-drenaline; L-ignocaine; 
D-examethasone; 
I-pratropium bromide; 
C-eftriaxone; 
K-etamine