Contraindications

Question 1

I 131 is c/i in

Answer 1

Medullary Carcinoma

Question 2

Radioactive Iodines c/i in

Answer 2

Pregnancy

Question 3

C/I of Alpha glucosidase inhibitors

Answer 3

Renal failure
(Absorbed and excreted by kidney)

Question 4

Inhalation insulin

Answer 4

Asthma
COPD
Smokers

(Bronchospasm potential)

Question 5

Inwhich condition you require decrease in insulin dosage

Answer 5

Renal insufficiency

Question 6

NPH

Answer 6

Diabetic Ketoacidosis

Question 7

Sulfonylureas

Answer 7

Hepatic/Renal insufficiency

Question 8

Metformin
Heart
Alcohol
Organs
Procedures

Answer 8

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

Question 9

Pioglitazones (thiazolidinedones)

Answer 9

CHF

Question 10

SGLT2 Inhibitors
(2)

Answer 10

Renal Dysfunction
Dialysis
Hypersensitivity reaction
Alcohol Abuse

Question 11

Growth Hormone

Answer 11

Physio:
Closed epiphyses: pediatric popn

Patho:
Prader Willi synd: Obese patients
Neoplasia
Diabetes Mellitus. Retinopathy. (neovascularization)

Question 12

Bran (5)

Answer 12

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

Question 13

Psyllium MOA

Answer 13

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.

Question 14

Psyllium effects and uses

Answer 14

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.

Question 15

STIMULANT PURGATIVES

Answer 15

They can reflexly stimulate
gravid uterus, therefore are contraindicated dur-
ing pregnancy. Subacute or chronic intestinal
obstruction is another contraindication.

Question 16

Osmotic Purgatiives

Answer 16

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.

Question 17

Saline Purgative Agents

Answer 17

Saline purgatives are infrequently used for the treatment of constipation because they are inconvenient/unpleasant produce watery stools and after-constipation.

Question 18

Laxatives in general

Answer 18

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.

Question 19

All emetics are contraindicated in:

Answer 19

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.

Question 20

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.

Answer 20

Neuroleptics

Question 21

Anti emetics Inapproriate to use in:

Answer 21

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.

Question 22

Heparin

Answer 22

1. Bleeding disorders, history of HIT.
2. Severe hypertension (risk of cerebral hae-
   morrhage), threatened abortion, piles, g.i. ulcers
   (risk of aggravated bleeding).
3. Subacute bacterial endocarditis (risk of
   embolism), large malignancies (risk of bleeding in the central necrosed area of the tumour),
   tuberculosis (risk of haemoptysis).
4. Ocular and neurosurgery, lumbar puncture.
5. Chronic alcoholics, cirrhosis, renal failure.
6. Aspirin and other antiplatelet drugs should
   be used very cautiously during heparin therapy.