Contraindications

Question 1

Albuterol sulfate

Answer 1

Severe tachycardia is a relative contraindication

Question 2

Amiodarone

Answer 2

Precautions:

. Wide complex irregular tachycardia
. Sympathomimetic toxidromes, I.e. cocaine or amphetamine overdose
. NOT to be used to treat ventricular escape beats or accelerated idioventricular rhythms

Contraindications:

. 2nd° or 3rd° AV block
. Cardiogenic shock

Question 3

Aspirin

Answer 3

Active gastrointestinal bleeding

Aspirin allergy

Question 4

Atropine sulfate

Answer 4

Precautions:

. Should not be used without base contact direction for stable bradycardia

. Closed angle glaucoma

Question 5

Calcium gluconate

Answer 5

Known hypercalemia.

Suspected digoxin toxicity (I.e. Digoxin overdose)

Question 6

Cyanokit

Answer 6

Hypersensitivity to vitamin B-12

Question 7

Dextrose

Answer 7

None

Special considerations include extravasation may cause to Tissue necrosis; use a large vein and aspirate occasionally to ensure route patency.

Question 8

diphenhydramine

Answer 8

Precautions:

asthma or COPD, thickens Bronchial secretions

Narrow–angle glaucoma

Question 9

Fentanyl

Answer 9

Hypotension, hemodynamic instability or shock.

Respiratory depression

Question 10

Glucagon

Answer 10

None

Question 11

Haloperidol

Answer 11

Precautions:

. Haldol May cause hypotension, tachycardia, and prolongation of the QT interval. Use with caution in severe cardiovascular disease
. Some patients may experience unpleasant sensations manifested as restlessness, hyperactivity, or anxiety following administration
. Rare instances of neuroleptic malignant syndrome I have been known to occur after the use of Haldol

Contraindications:

.Suspected myocardial infarction.
.Hypotension. 
.Respiratory or CNS depression. 
.Pregnancy. 
.Children

Question 12

Ipratropium bromide (atrovent)

Answer 12

Do not administered to children

Question 13

Ketamine

Answer 13

Relatively contraindicated in penetrating eye trauma

Relative contraindication in patients with known cardiovascular disease. (Ketamine causes tachycardia)

Question 14

Magnesium sulfate

Answer 14

Precautions:

. heart block
. Decrease in respiratory or cardiac function
. Use caution with patients on digitalis

Question 15

Methylprednisolone (solu-medrol)

Answer 15

Evidence of active G.I. bleed

Question 16

Midazolam (versed)

Answer 16

Hypotension

Question 17

Morphine Sulfate

Answer 17

Hypovolemia

Hypotension (relative)

Question 18

Naloxone (narcan)

Answer 18

None

Question 19

NitroGlycerin

Answer 19

Suspected right ventricular infarct

Hypotension SBP

Question 20

Ondansetron (zofran)

Answer 20

None

Question 21

Oxygen

Answer 21

Precautions:

. if the patient is not breathing adequately, the treatment of choice is assisted ventilation, not just oxygen

. When pulse oximetry is available, titrate SpO2 to >90%. This may take some time

. Do not withhold oxygen from COPD patient out of concerns for loss of hypoxic respiratory drive. This is never a concern in the prehospital setting with short transport times

Question 22

Phenylephrine (neosephine)

Answer 22

Precautions:

. avoid administration into the eyes, which will dilate pupil

Question 23

Racemic epinephrine

Answer 23

None

Question 24

Sodium bicarbonate

Answer 24

Metabolic and respiratory alkalosis

Hypocalcemia

Hypokalemia

Question 25

Topical Ophthalmic Anesthetics

Answer 25

Precautions:
. transient burning/stinging when initially applied

Contraindications:
. Known allergy to local anesthetics
. Globe lacerations or rupture

Question 26

Adenosine

Answer 26

Any regular tachycardia. Specifically never administer to an irregular wide-complex tachycardia or, which may be lethal