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Paramedic Drugs > Contraindications > Flashcards

Contraindications Flashcards

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1
Q

acetaminophen

A

Severe active liver disease

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2
Q

activated charcoal

A

● Unprotected airway
● Altered mental status
● Absence of a gag reflex
● Ileus
● Intestinal obstruction
● Ingestion of petroleum distillates, hydrocarbons, heavy metals, acids, alkalis,
corrosives, alcohols, iron, lithium, and solvents

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3
Q

adenosine

A

● Second- and third-degree AV blocks
● Sick sinus syndrome or other sinus node disease (unless a functioning artificial
pacemaker is present)
● Poison/drug-induced tachycardia
● Atrial fibrillation, atrial flutter, and ventricular tachycardia
● Polymorphic wide complex tachycardia
● Hemodynamically unstable tachycardia

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4
Q

albuterol

A

● Dysrhythmias (especially those caused by digitalis)
● Symptomatic tachycardias
● CHF

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5
Q

amiodorone

A

● Iodine hypersensitivity
● Cardiogenic shock
● Second- and third-degree AV blocks
● Sick sinus syndrome or other sinus node disease (unless a functioning artificial
pacemaker is present)

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6
Q

aspirin

A

●Hypersensitivity to NSAIDs
● ASA-intolerant asthma
● Bleeding disorders
● Hemolytic anemia
● Lactating mothers
● Hemorrhagic stroke
● Active bleeding (relative)

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7
Q

atropine

A

Note: all the following contraindications listed are relative
● Evolving MI
● Narrow-angle glaucoma
● GI obstruction
● Severe ulcerative colitis
● Toxic megacolon
● Bladder outlet obstruction
● Myasthenia gravis
● Hemorrhage with cardiovascular instability
Note: all the following contraindications listed are relative
● Evolving MI
● Narrow-angle glaucoma
● GI obstruction
● Severe ulcerative colitis
● Toxic megacolon
● Bladder outlet obstruction
● Myasthenia gravis
● Hemorrhage with cardiovascular instability
Note: all the following contraindications listed are relative
● Evolving MI
● Narrow-angle glaucoma
● GI obstruction
● Severe ulcerative colitis
● Toxic megacolon
● Bladder outlet obstruction
● Myasthenia gravis
● Hemorrhage with cardiovascular instability
● Thyrotoxicosis

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8
Q

calcium chloride

A

● Digoxin toxicity
● Hypercalcemia
● Suspected severe hypokalemia

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9
Q

calcium gluconate

A

●Digoxin toxicity
● Hypercalcemia
● Suspected severe hypokalemia

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10
Q

dexamethasone

A

●Systemic fungal infections
● Preterm infants
● Penetrating spinal cord injury

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11
Q

dextrose

A

●Hyperglycemia
● Severe dehydration
● Anuria
● Diabetic coma
● Intracranial or intraspinal hemorrhage
● Glucose-galactose malabsorption syndrome

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12
Q

diazepam

A

●Neurologic or respiratory depression
● Narrow-angle glaucoma
● Myasthenia gravis
● Head injury

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13
Q

diltiazem

A

●Hypotension
● Cardiogenic shock
● Wide-complex tachycardia
● Second- and third-degree AV blocks
● Sick sinus syndrome or sinus node disease (without functioning artificial
pacemaker)
● Poison/drug-induced tachycardia
● A-fib or a-flutter associated with an accessory bypass tract (i.e. WPW or LGL)
● Left ventricular systolic dysfunction
● Decompensated heart failure

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14
Q

diphenhydramine hydrochloride

A

●Newborns and premature infants
● Late stage pregnancy
● Breastfeeding mothers
● Asthma
● Narrow-angle glaucoma
● Benign prostatic hypertrophy
● Alcohol intoxication

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15
Q

dopamine hydrochloride

A

● Hypovolemia
● Pheochromocytoma
● Uncorrected tachydysrhythmias
● V-fib

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16
Q

epinephrine

A

●Coronary insufficiency
● Cardiac dilation
● Active labor
● Hyperthyroidism (relative)
● Uncontrolled hypertension (relative)
● Hypothermia (relative)
● Pulmonary edema (relative)
● Myocardial ischemia (relative)
● Hypovolemic shock (relative)

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17
Q

etomidate

A

● Labor and delivery
● Septic shock (particularly in children)

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18
Q

fentanyl citrate

A

● MAOI use within the last 14 days
● Hypotension
● Hypoxia after oxygen therapy
● Hypoventilation
● Severe hemorrhage or shock
● Myasthenia gravis
● GCS <15 (relative)

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19
Q

flumazenil

A

●TCA overdose
● Known seizure history
● Altered level of consciousness of unknown etiology

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20
Q

furosemide

A

● Hypovolemia
● Anuria
● Hypotension (relative)
● Hepatic encephalopathy
● Suspected electrolyte imbalances

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21
Q

glucagon

A

●Pheochromocytoma
● Hyperglycemia
● Insulinoma

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22
Q

glucose, oral

A

● Decreased level of consciousness
● Nausea/vomiting

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23
Q

haloperidol

A

● Severe depression
● Neuroleptic malignant syndrome
● Poorly controlled seizure disorder
● Parkinson disease
● Agitation secondary to shock and hypoxia

24
Q

dilaudid

A

● MAOI use during the previous 14 days
● GI tract obstruction
● Hypotension (relative)
● Hypoxia (relative)
● Respiratory depression (relative)
● Head injury (relative)
● Older adults (relative)
● Altered level of consciousness (relative)

25
Q

hydroxycobalamin

A

None

26
Q

ibuprofen

A

● Known ASA hypersensitivity
● ASA-sensitive asthma
● Renal function impairment
● Pregnancy
● Known peptic ulcer disease
● Active intracranial hemorrhage
● Active GI bleed
● Thrombocytopenia
● Coagulation defects
● Necrotizing enterocolitis
● Perioperative pain from CABG

27
Q

ipratropium bromide

A

● Hypersensitivity to atropine, alkaloids, or peanuts
● Urinary retention (relative)
● Narrow-angle glaucoma (relative)
● Cardiovascular disease (relative)
● Hypertension (relative)

28
Q

ketamine

A

● Infants <3 months
● Pregnancy and breastfeeding mothers
● Chest pain
● Heart failure
● Symptomatic hyperthyroidism
● Significant mental health history (i.e PTSD, schizophrenia)
● Conditions where hypertension would be hazardous to patient care
● Intracranial lesions
● Patients with potential for increased ICP (relative)

29
Q

ketorolac tromethamine

A

● ASA-sensitive asthma
● ASA allergy
● Renal insufficiency/impairment/ transplant
● Pregnancy, breastfeeding, or active labor
● Known peptic ulcer disease
● Hypotension
● History of GI bleed
● Active bleeding including GI, intracranial, or traumatic injuries
● Current use of steroids or anticoagulants (may increase bleeding time)
● Coagulation defects
● Patients older than 65

30
Q

labetolol

A

● Asthma
● Heart failure
● Cardiogenic shock
● Second- and third-degree AV block
● Bradycardia

31
Q

lidocaine hydrochloride

A

● Hypersensitivity to amide-type local anesthetics or any of the “caines”
● Prophylactic use in AMI
● Second- and third- degree AV blocks (without functioning artificial pacemaker)
● Ventricular escape rhythm
● WPW
● SVT

32
Q

lorazepam

A

● Neurologic or respiratory depression
● Shock states
● Acute narrow-angle glaucoma
● Sleep apnea

33
Q

magnesium sulfate

A

● Heart blocks
● Myocardial damage
● Diabetic coma
● GI obstruction
● Hypermagnesemia
● Hypercalcemia
● Hypotension
● Known renal insufficiency (relative)

34
Q

mannitol

A

● Hypotension
● Pulmonary edema and severe pulmonary congestion
● Electrolyte abnormalities
● Severe dehydration
● Intracranial bleeding
● Heart failure
● Impaired renal function (relative - can result in fluid overload)

35
Q

methylprednisolone sodium succinate

A

● Premature infants
● Systemic fungal infections
● Cushing disease
● Hypertension
● Heart failure (relative)
● Penetrating spinal cord injury (relative)
● Active GI bleed (relative)

36
Q

midazolam hydrochloride

A

● Neurologic or respiratory depression
● Acute narrow-angle glaucoma
● Sleep apnea
● Overdose of, and concomitant use with, CNS depressants (including alcohol)
● Depressed vital signs, including shock states

37
Q

morphine sulfate

A

● MAOI use in the previous 14 days
● Paralytic ileus
● Toxin-mediated diarrhea
● Heart failure due to chronic lung disease
● Head injury
● Hypoventilation
● Hypotension
● Bradycardia
● Brain tumor
● Delirium tremens
● Seizure disorders
● Active labor of premature infant
● Acute or severe asthma
● Upper airway obstruction
● GCS <15 (relative)
● Older patients (relative)
● Breastfeeding mothers and pregnancy (relative)
● Hypoxia after supplemental oxygen (relative)

38
Q

naloxone hydrochloride

A

● Neonates of opioid-addicted mothers (relative)
● Opioid dependency (relative)

39
Q

nitroglycerin

A

● Hypotension (SBP <90 OR at least 30mmHg below baseline)
● Hypovolemia
● Intracranial bleeding
● Head injury
● Cardiac tamponade
● Severe brady/tachycardia
● Right ventricular infarct
● Sildenafil (Vaigra) or vardenafil (Levitra) within 24 hours
● Tadalafil (Cialis) within 48 hours
● Hepatic disease (relative)
● Anemia (relative)
● Diabetes (relative)
● Breastfeeding mothers and pregnancy (relative)

40
Q

norepinephrine bitartrate

A

● Hypotension secondary to hypovolemia
● Current MAOI use
● Pregnancy (relative)

41
Q

ondansetron hydrochloride

A

● Long QT syndrome
● Patients taking apomorphine (can cause significant hypotension and syncope)

42
Q

oxygen

A

Paraquat and diquat poisoning

43
Q

oxytocin

A

Active labor

44
Q

pheylephrine

A

Geriatric patients with preexisting cardiovascular disease (relative)

45
Q

pralidoxime

A

None

46
Q

procainamide hydrochloride

A

● Torsades de Pointes
● Second- and third-degree AV block (without functioning artificial pacemaker)
● Systemic lupus erythematosus
● Preexisting QT prolongation
● Digitalis toxicity
● TCA overdose
● Asthma (relative)
● Digitalis-induced dysrhythmias (relative)
● Myasthenia gravis (relative)

47
Q

promethazine hydrochloride

A

● Known hypersensitivity to any phenothiazines
● Concurrent use of large amounts of CNS depressants
● Reye syndrome
● Lower respiratory symptoms
● Children <2 years
● Sleep apnea
● Respiratory impairment
● Seizure disorders
● Breastfeeding mothers
● Concurrent administration of Haldol or droperidol

48
Q

rocuronium bromide

A

● Hypersensitivity to bromides
● Inability to control the airway or support ventilation
● Neuromuscular disease
● Heart and liver disease (relative)

49
Q

sodium bicarbonate

A

● Known metabolic or respiratory alkalosis
● Hypokalemia
● Hypernatremia
● Hypocalcemia
● Heart failure (relative)
● Renal disease (relative)

50
Q

succinylcholine chloride

A

● Inability to control the airway or support ventilation
● Renal failure
● Neuromuscular diseases
● Para/quadriplegia
● Penetrating eye injury
● Prolonged immobilization
● Stroke with residual motor dysfunction
● History of malignant hyperthermia
● Multisystem trauma
● Burns
● Known or suspected hyperkalemia, including injury-induced hyperkalemia

51
Q

terbutaline sulfate

A

● Tachydysrhythmias
● Prevention of preterm labor

52
Q

thiamine hydrochloride

A

None

53
Q

tranexiamic acid

A

● Mechanism of injury more than 3 hours prior to EMS care
● Subarachnoid hemorrhage
● Isolated head injury
● History of PE, DVT or other thromboembolic disorder

54
Q

vecuronium bromide

A

● Hypersensitivity to bromides
● Inability to control the airway or support ventilation
● Neuromuscular disease
● Acute narrow-angle glaucoma
● Penetrating eye injury
● Newborns
● Hepatic or renal failure

55
Q

verapamil hydrochloride

A

● WPW and LGL
● Second- and third-degree AV block, sick sinus syndrome, or other sinus node
disease*
● Hypotension
● Cardiogenic shock
● Severe left ventricular dysfunction
● Wide complex tachycardias
● Children <12 months
*Unless a functioning artificial pacemaker is present

56
Q
A

Paramedic Drugs (11 decks)

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