Contraindications

Question 1

Contraindication for Adrenaline (1)

Answer 1

Hypovolaemic shock without adequate fluid replacement

Question 2

Contraindications for Aspirin (5)

Answer 2

1. Known allergy or hypersensitivity
2. Actively bleeding peptic ulcers
3. Bleeding disorders
4. Suspected dissecting aortic aneurysm
5. Chest pain with associated psychostimulant OD if SBP >160

Question 3

Contraindications for Fentanyl (2)

Answer 3

1. History of hypersensitivty

2. Late second stage labour

Question 4

Contraindications for GTN (9)

Answer 4

1. Known hypersensitivity
2. SBP <110 mmHg for tablet
3. SBP <90 mmHg for patch
4. Sildenafil Citrate (Viagra) or Vardenafil (Levitra) in past 24 hours, or Tadalafil (Cialis) in past 4 days. -PDE5 inhibitors
5. HR >150 bpm
6. HR <50 bpm (excluding autonomic dysreflexia)
7. VT
8. Inferior STEMI with SBP < 160 mmHg
9. Right ventricular MI

Question 5

Contraindication for Ipratropium Bromide (1)

Answer 5

1. Known hypersensitivty to Atropine or its derivatives

Question 6

Contraindications for Ketamine (2)

Answer 6

1. Known hypersensitivity

2. Severe hypertension (SBP > 180 mmHg)

Question 7

Contraindications for Methoxyflurane (5)

Answer 7

1. Pre-existing renal disease/impairment
2. Concurrent use of tetracycline antibiotics
3. Exceeding total dose of 6ml in a 24 hour period
4. Personal or family history of malignant hyperthermia
5. Muscular dystrophy

Question 8

Contraindication for Midazolam (1)

Answer 8

1. Known hypersensitivity to benzodiazepines

Question 9

Contraindications for Misoprostal (2)

Answer 9

1. Allergy to prostaglandins

2. Exclude multiple pregnancies before drug administration

Question 10

Contraindications for Morphine (3)

Answer 10

1. History of hypersensitivity
2. Renal impairment/failure
3. Late second stage labour

Question 11

Contraindications for Ondansetron (4)

Answer 11

1. Known hypersensitivity
2. Concurrent Apomorphine use
3. Known Long Q-T syndrome
4. Hypokalaemia or hypomagnesaemia

Question 12

Contraindications for Paracetamol (5)

Answer 12

1. Hypersensitivity to paracetamol
2. Children <1 month of age
3. Paracetamol already administered with in past 4 hours
4. Total paracetamol intake in past 24 hours exceeding 4g (adults) or 60mg/kg (children)
5. Chest pain in suspected ACS

Question 13

Contraindications for Prochlorperazine (5)

Answer 13

1. Circulatory collapse (cool, pale, clammy skin, tachycardia, hypotension)
2. CNS depression
3. Previous hypersensitivity
4. Children
5. Pregnancy