Cautions and contradictions

Question 1

What is a caution?

Answer 1

A situation in which additional care is required because the risk:benefit
balance is altered

Question 2

What is Contraindication?

Answer 2

A situation in which a medicinal product should not be
used because the risk outweighs potential benefits.

• Increased expectation of ADR
• Decreased benefit of therapy

Question 3

Why might contraindications occur?

Answer 3

• Drug exacerbates disease (“drug-disease interaction”)

• Adverse events are more likely due to an existing condition
or demographic factor – Drug creates a safety issue because of the condition eg. Pregnancy,

• Subgroups of patients have a predisposition to ADR
such as immunological factors (e.g. allergy, hypersensitivity) and metabolic factors

• Drug-drug interaction should also be considered

Question 4

Give some reasons for specific paediatric contraindications and
precautions?

Answer 4

– Effects on growth and development
– Toxic excipients
– Aspiration/choking risk when administering
tablets to young children

Question 5

Name some drugs that are contraindicated to pregnancy?

Answer 5

Thalidomide

SSRI

Often drugs are contraindicated without human testing

Question 6

What drugs are contraindicated to lactation?

Answer 6

Hormone agonists and antagonists affecting the reproductive
system may be contraindicated during lactation

Fulvestrant

Co-cyprindiol

Question 7

What drugs are contraindicated to age?

Answer 7

Aspirin causes Reyes syndrome in children - children under 16 years of age unless advised by a doctor

Question 8

When can children under 16 take Aspirin?

Answer 8

When for Kawasaki syndrome and prevention of thrombus formation after cardiac surgery

Question 9

Why might ‘contraindicated’ be described as drug interactions in some medical literature?

Answer 9

To emphasize that there is often a logical
explanation for drug interactions, cautions
and contraindications.