Contraindications Flashcards
I 131 is c/i in
Medullary Carcinoma
Radioactive Iodines c/i in
Pregnancy
C/I of Alpha glucosidase inhibitors
Renal failure
(Absorbed and excreted by kidney)
Inhalation insulin
Asthma
COPD
Smokers
(Bronchospasm potential)
Inwhich condition you require decrease in insulin dosage
Renal insufficiency
NPH
Diabetic Ketoacidosis
Sulfonylureas
Hepatic/Renal insufficiency
Metformin
Heart
Alcohol
Organs
Procedures
Heart failure
CHF
MI
Severe Lung disease
due to renal dysfunction by lactic acidosis
Alcohol abuse
Renal and Hepatic failure
Temproray in IV radiographic contrast
Pioglitazones (thiazolidinedones)
CHF
SGLT2 Inhibitors
(2)
Renal Dysfunction
Dialysis
Hypersensitivity reaction
Alcohol Abuse
Growth Hormone
Physio:
Closed epiphyses: pediatric popn
Patho:
Prader Willi synd: Obese patients
Neoplasia
Diabetes Mellitus. Retinopathy. (neovascularization)
Bran (5)
Bran should not be used in patients with gut ulcerations, adhesions, stenosis and when faecal impaction is a possibility. Symptoms of irritable bowel syndrome (IBS) may be worsened by bran and other insoluble fibres.
Flatulence
Should be used cautiously in immobile patients because of potential for causing intestinal obstruction
Psyllium MOA
Plantago) and Ispaghula They contain natural colloidal mucilage which forms a bulky gelatinous mass by absorbing water.
It is largey fermented in colon: increases bacterial mass and
Softens the faeces.
Psyllium effects and uses
soluble fibres reduces rectosigmoid intra- luminal pressure and helps to relieve symptoms of IBS, including pain, constipation as well as diarrhoea. Symptoms of chronic diverticulosis may also be relieved.
STIMULANT PURGATIVES
They can reflexly stimulate
gravid uterus, therefore are contraindicated dur-
ing pregnancy. Subacute or chronic intestinal
obstruction is another contraindication.
Osmotic Purgatiives
Mag. salts are contraindicated in renal insufficiency, while Sod. salts should not be given to patients of CHF and other Sod. retaining states. Repeated use of saline purgatives can cause fluid and electrolyte imbalance.
Saline Purgative Agents
Saline purgatives are infrequently used for the treatment of constipation because they are inconvenient/unpleasant produce watery stools and after-constipation.
Laxatives in general
A patient of undiagnosed abdominal pain, colic or vomiting.
Organic (secondary) constipation due to stricture or obstruction in bowel, hypo- thyroidism, hypercalcaemia, malignancies and laxative abuse itself.
The primary cause should be treated in these cases.
All emetics are contraindicated in:
a) Corrosive (acid, alkali) poisoning: there is risk
of perforation and further injury to esophageal
mucosa.
(b) CNS stimulant drug poisoning: because
convulsions may be precipitated.
(c) Kerosine (petroleum) poisoning: there is
risk of aspiration of the liquid (due to low
viscosity) and chemical pneumonia.
(d) Unconscious patient: may aspirate the
vomitus, because laryngeal reflex is likely to
be impaired.
(e) Morphine or phenothiazine poisoning: because
emetics may fail to act.
These agents should not be administered
until the cause of vomiting has been diagnosed;
otherwise specific treatment of conditions like
intestinal obstruction, appendicitis, etc. may be
delayed due to symptom relief.
Neuroleptics
Anti emetics Inapproriate to use in:
Use of antiemetics in the following situations is inappropriate:
. Gastrointestinal obstruction-antiemetics may delay diagnosis.
Gastrointestinal toxicity/gastroenteritis-antiemetics may prevent the patient from eliminating the toxin.
Systemic hypotension-the phenothiazines and a-adrenergic antagonists, when used in high doses, can intensify hypotension.
Heparin
- Bleeding disorders, history of HIT.
- Severe hypertension (risk of cerebral hae-
morrhage), threatened abortion, piles, g.i. ulcers
(risk of aggravated bleeding). - Subacute bacterial endocarditis (risk of
embolism), large malignancies (risk of bleeding in the central necrosed area of the tumour),
tuberculosis (risk of haemoptysis). - Ocular and neurosurgery, lumbar puncture.
- Chronic alcoholics, cirrhosis, renal failure.
- Aspirin and other antiplatelet drugs should
be used very cautiously during heparin therapy.
