Contraindications

Question 1

Adrenaline

Answer 1

Hypovolaemic shock without adequate fluid replacement

Question 2

Aspirin

Answer 2

Hypersensitivity to aspirin/salicylates
Actively bleeding peptic ulcer
Bleeding disorders
Suspected dissecting aortic aneurysm
Chest pain associated with psychostimulant OD if SBP >160mmHg

Question 3

Ceftriaxone

Answer 3

Allergy to Cephalosporin antibiotics

Question 4

Dexamethasone

Answer 4

Known hypersensitivity

Question 5

Dextrose 10%

Answer 5

Nil of significance in above indication

Question 6

Droperidol

Answer 6

Nil

Question 7

Fentanyl

Answer 7

• History of hypersensitivity
• Late second stage of labour
• Serotonin syndrome
• Monoamine oxidase inhibitors (MAOIs) within previous 14 days

Question 8

Glucagon

Answer 8

Nil of significance in the above indication

Question 9

Glyceryl Trinitrate

Answer 9

BP <100mmHg
HR > 150
HR <50 (except in autonomic dysreflexia)
Ventricular tachycardia
PDE5 inhibitors (current/recent use) (sildenafil (Viagra), tadalafil (Cialis), vardenafil (Staxyn, Levitra), avanafil (Stendra)
Riociguat (current use) (rioteph, adempas)
Bleeding in pregnancy

Question 10

Heparin

Answer 10

Known allergy or hypersensitivity
Active bleeding
Oral anticoagulants
Bleeding disorders
History of Heparin-Induced Thrombocytopaenia (HIT)
Severe hepatic impairment/ disease, including oesophageal varies
Recent trauma or surgery (< 3 weeks)

Question 11

Hydrocortisone

Answer 11

Nil significant

Question 12

Ipratropium Bromide

Answer 12

Known hypersensitivity to Atropine or its derivatives

Question 13

Ketamine

Answer 13

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

Question 14

Lidocaine

Answer 14

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

Question 15

Methoxyflurane

Answer 15

Pre-existing renal disease
Known (or genetic susceptibility) to malignant hyperthermia

Question 16

Midazolam

Answer 16

Known hypersensitivity to benzodiazepines

Question 17

Morphine

Answer 17

History of hypersensitivity
Renal impairment/failure
Late second stage of labour

Question 18

Naloxone

Answer 18

Nil of significance in above indication

Question 19

Normal Saline

Answer 19

Nil of significance in above indication

Question 20

Olanzapine

Answer 20

Nil

Question 21

Ondansetron

Answer 21

Apomorphine- Reports of profound hypotension and loss of consciousness with both

Question 22

Oxytocin

Answer 22

None, provided all babies have been delivered prior to administration

Question 23

Paracetamol

Answer 23

Children < 1 month of age

Question 24

Prochlorperazine

Answer 24

CNS Depression (i.e unconscious or severely intoxicated)
Patients < 21 years of age (children and young adults are more susceptible to extrapyramidal reactions)

Question 25

Salbutamol

Answer 25

Nil of significance in the above indication

Question 26

Tenecteplase

Answer 26

Major surgery in the past 3 months
Significant head injury in the past 3 months
Major trauma in the past 3 months
Stroke/TIA in the past 3 months
ICH at any time
GI or genitourinary bleed in the past month
Current bleeding disorder, active bleeding (excluding menses) or bleeding tendencies
Anticoagulant or glycoprotein IIb/IIIa inhibitors
Allergy to tenecteplase or gentamicin

Question 27

Water for Injection

Answer 27

Nil in the above indication

Question 28

Tranexamic acid

Answer 28

Injury occurred >2 hours prior to administration