Contraindications

Question 1

What are the contraindications of isosorbide dinitrate?

Answer 1

• severe hypotension, shock, or acute MI with low left ventricular filling pressure
• increased intracranial pressure, angle-closure glaucoma, anginal pain associated with hypertrophic obstructive cardiomyopathy, severe anemia
• co-administration with phosphodiesterase type V inhibitors

Question 2

What are the contraindications of isosorbide 5-mononitrate?

Answer 2

• severe hypotension, shock, or acute MI with low left ventricular filling pressure
• increased intracranial pressure, angle-closure glaucoma, anginal pain associated with hypertrophic obstructive cardiomyopathy, severe anemia
• co-administration with phosphodiesterase type V inhibitors

Question 3

What are the contraindications of nitroglycerin

Answer 3

• same as isosorbide dinitrate
• transdermal form is contraindicated in patients with allergy to skin tape
• IV form is contraindicated in patients with cardiac tamponade, restrictive cardiomyopathy, or constrictive pericarditis

Question 4

What are the contraindications of sodium nitroprusside?

Answer 4

• preexisting hypotension, obstructive valvular disease, heart failure associated with reduced peripheral vascular resistance
• hepatic or renal failure
• optic atrophy
• surgery pts with inadequate cerebral circulation
• tobacco amblyopia

Question 5

What are the contraindications of inhaled nitric oxide gas?

Answer 5

-neonates with dependance on right-to-left shunting

Question 6

What are the contraindications of PDE5 inhibitors?

Answer 6

-concommitant use of organic nitrate vasodilators

Question 7

What are the contraindications of calcium channel blockers?

Answer 7

-preexisting hypotension

Question 8

What are the contraindications of benzothiazepine/diltiazem?

Answer 8

• sick sinus syndrome or second or third degree AV block
• supraventricular tachycardia associated with a bypass tract
• left ventricular failure
• hypotension (systolic less than 90)
• acute MI with x-ray documented pulmonary congestion

Question 9

What are the contraindications of phenylalkylamine/verapamil?

Answer 9

• same as diltiazem
• additionally, IV verapamil is contraindicated in patients with ventricular tachycardia and patients receiving IV beta-blockers

Question 10

What are the contraindications of potassium channel openers?

Answer 10

-pheonochromocytoma

Question 11

What are the contraindications of endothelia receptor antagonists?

Answer 11

• pregnancy

- concomitant use of cyclosporine A or glyburide

Question 12

What are the contraindications of hydralazine?

Answer 12

• dissecting aortic aneurysm
• coronary artery dieases
• mitral valvular rheumatic heat disease