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Arizona Drug Profile (revised 3/27/2015) > Contraindications > Flashcards

Contraindications Flashcards

1
Q

ABIXIMAB

contraindications

A
  • Active internal bleeding or recent history (within 6 weeks) of clinically significant gastrointestinal or genitourinary bleeding
  • History of cerebrovascular accident (CVA) with current residual neurologic deficit or within the past 2 years
  • Bleeding diathesis (bleeding disorder, condition or predisposition)
  • Current use of warfarin (Coumadin) or use within the past 7 days unless prothrombin
    time is <1.2 times control
  • Thrombocytopenia (<100,000 cells/mcl)
  • Trauma or major surgery within the past 6 weeks
  • Intracranial neoplasm
  • Arteriovenous malformation or aneurysm
  • Severe uncontrolled hypertension
    (systolic BP >180mmHg, diastolic BP >110mmHg)
    -Concomitant use of another GP IIb/IIIa inhibitor
  • History of vasculitis
  • Acute pericarditis
  • Use or intent to use IV Dextran
  • Hypersensitivity to abciximab or murine proteins
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2
Q

ACETYLSALICYLIC ACID, ASPIRIN, ASA

contraindications

A
  • Bleeding ulcer, hemorrhagic states, hemophilia
  • Known hypersensitivity to salicylates or other non-steroidal anti-inflammatories that has
    led to hypotension and/or bronchospasm
  • Children and adolescents (prehospital personnel should not administer ASA to this age
    group)
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3
Q

ACETYLSALICYLIC ACID, ASPIRIN, ASA (EMT Administration)

contraindications

A
  • Bleeding ulcer, hemorrhagic states, hemophilia
  • Known hypersensitivity to salicylates or other non-steroidal anti-inflammatories that has
    led to hypotension and/or bronchospasm
  • Children and adolescents (prehospital personnel should not administer ASA to this age
    group)
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4
Q

ADENOSINE

contraindications

A
  • Sick sinus syndrome, 2nd or 3rd degree AV blocks; except in patients with a functioning ventricular pacemaker.
  • Use cautiously in patients with known asthma (has precipitated acute bronchospasm).
  • Patients on theophylline and related methylxanthines.
  • Patients on dipyridamole (Persantine) or carbamazepine (Tegretol).
  • Cardiac transplant patients are more sensitive to adenosine and require only a small dose
    (relative).
  • Known atrial fibrillation or atrial flutter.
  • Pregnancy (no controlled studies)
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5
Q

ALBUMIN, normal serum 5% / 25%

contraindications

A
  • Hypersensitivity
  • CHF
  • Severe anemia
  • Renal insufficiency
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6
Q

ALUTEROL SULFATE

contraindications

A
  • Synergistic with other sympathomimetics
  • Use caution in patients with diabetes, hyperthyroidism, and cerebrovascular disease
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7
Q

AMIODARONE

contraindications

A
  • Bradycardia
  • Second or third degree heart block unless a functioning pacemaker is present
  • Cardiogenic shock
  • Hypotension
  • Pulmonary congestion
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8
Q

ATROPINE SULFATE
contraindications
* Pregnancy Risk Factors/Considerations?

A
  • Hypersensitivity to atropine or any component of the formulation – Belladonna alkaloid allergy
  • Glaucoma, acute narrow angle (relative contraindication for patient with symptomatic bradycardia), adhesions between the iris and lens
  • Tachycardia
  • Obstructive GI disease, paralytic ileus, intestinal atony of the elderly or debilitated
    patient, severe ulcerative colitis, or toxic megacolon complicating ulcerative colitis
  • Hepatic disease
  • Renal disease, obstructive uropathy
  • Myasthenia gravis (unless used to treat side effects of acetylcholinesterase inhibitor
  • Asthma
  • Thyrotoxicosis
  • Mobitz type II block
  • 3rd degree heart block
  • Risk category: C. Animal reproduction studies have not been conducted. Atropine has been found to cross the human placenta. Trace amounts of atropine can enter breast milk; use caution. Anticholinergic agents may suppress lactation.
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9
Q

BUMETANIDE

contraindications

A
  • Hypersensitivity
  • Anuria
  • Electrolyte deficiencies
  • Hepatic coma
  • Cautious use: hepatic cirrhosis, ascites, history of gout, hypersensitivity to furosemide
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10
Q

CALCIUM CHLORIDE

contraindications

A

Hypercalcemia
Concurrent digoxin therapy (relative)

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11
Q

CALCIUM GLUCONATE GEL, 2.5%

contraindications

A

For external use only.

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12
Q

CHARCOAL, ACTIVATED (without sorbitol)

contraindications

A
  • Ingestion of caustics
  • Ingestion of hydrocarbons (relative)
  • Oral administration to comatose patient
  • Simultaneous administration of other oral drugs
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13
Q

CIMETIDINE

contraindications

A

Hypersensitivity to drug

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14
Q

DEXAMETHASONE SODIUM PHOSPHATE

contraindications

A

Systemic fungal infections
Hypersensitivity to any component of dexamethasone, including sulfites Preterm infants

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15
Q

DEXTROSE 50%

contraindications

A
  • Known thiamine deficiency (relative, if suspected give thiamine close to same time).
  • Delirium tremens; use with caution in patients with acute alcoholism. Administer in
    conjunction with thiamine
  • Head injury (unless documented hypoglycemia).
  • Intra cranial hemorrhage (relative).
  • Severe pain (paradoxical excitement may occur).
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16
Q

DIAZEPAM

contraindications

A

Hypersensitivity (allergy)
Glaucoma, acute narrow angle (relative)

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17
Q

DILTIAZEM

contraindications

A
  • Hypotension (less than 90 mmHg systolic)
  • Acute Myocardial infarction
  • Cardiogenic shock
  • Ventricular tachycardia or wide-complex VT of unknown origin
  • Second or third-degree AV block
  • Wolff-Parkinson-White (WPW) syndrome
  • Sick Sinus syndrome
  • Beta Blocker Use
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18
Q

DIPHENHYDRAMINE HCL

contraindications

A
  • Known hypersensitivity to diphenhydramine or drugs of similar chemical structure.
  • Newborn or premature infants; nursing mothers.
  • Considerable caution in patients with glaucoma, acute narrow angle; stenosing or
    obstructive diseases of the GI tract; bronchial asthma; hyperthyroidism; cardiovascular disease or hypertension; age greater than 60 years (all relative benefit vs risk).
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19
Q

DOPAMINE

contraindications

A

Hypovolemic shock (relative)
Pheochromocytoma
MAO inhibitors, such as Marplan, Nardil, or Parnate

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20
Q

EPINEPHRINE AUTO-INJECTOR

contraindications

A

There are no absolute contraindications in a life-threatening situation.

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21
Q

EPINEPHRINE HCL

contraindications

A

None known for cardiac arrest Hypothermia, relative contraindication

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22
Q

EPTIFIBATIDE

contraindications

A
  • Active internal bleeding or recent history (within 30 days) of clinically significant gastrointestinal or genitourinary bleeding
  • History of cerebrovascular accident (CVA) with current residual neurologic deficit or within the past 2 years
  • Bleeding diathesis (bleeding disorder, condition or predisposition)
  • Current use of warfarin (Coumadin) or use within the past 7 days unless prothrombin
    time is <1.2 times control
  • Thrombocytopenia (<100,000 cells/mcl)
  • Trauma or major surgery within the past 6 weeks
  • Intracranial neoplasm
  • Arteriovenous malformation, aneurysm or evidence of aortic dissection
  • Severe uncontrolled hypertension
    (systolic BP >200mmHg, diastolic BP >110mmHg)
  • History of vasculitis
  • Concomitant use of another GP IIb/IIIa inhibitor
  • Acute pericarditis
  • Hypersensitivity to eptifibatide
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23
Q

ETOMIDATE

contraindications

A

Hypersensitivity

24
Q

FAMOTIDINE

contraindications

A

Hypersensitivity to drug

25
Q

FENTANYL CITRATE

contraindications

A
  • Known allergy or intolerance to drug (assess for medic alert bracelet)
  • Respiratory depression if airway and breathing can’t be supported
  • Known elevated intracranial pressure e.g. mass lesion
  • Head injury with ALOC (relative)
  • Asthma (relative)
  • Abdominal pain (relative)
26
Q

FUROSEMIDE

contraindications

A
  • Anuria (relative)
  • Hypovolemia
  • Hypotension
27
Q

GLUCAGON

contraindications

A
  • Known hypersensitivity
  • Pheochromocytoma
  • Insulinoma
  • Should not be routinely used to replace dextrose when IV access has been obtained
28
Q

HEMOSTATIC AGENTS

contraindications

A
  • Application to injuries related to eyes or airway
  • Kaolin powder should not be applied directly to the wound
29
Q

HYDROXOCOBALAMIN

contraindications

A

None

30
Q

INSULIN

contraindications

A

Hypersensitivity to drug or its components Hypoglycemia

31
Q

IPRATROPIUM BROMIDE

contraindications

A

Ipratropium bromide is contraindicated in known or suspected cases of hypersensitivity to ipratropium bromide or to atropine and its derivatives. Precaution: should be used with caution in patients with narrow angle glaucoma.

32
Q

KETAMINE HYDROCHLORIC INJECTION

contraindications

A
  • Angina
  • CHF
  • Symptomatic Hyperthyroidism
  • Pregnancy-Relative (Category B)
33
Q

LIDOCAINE HCL

contraindications

A
  • Known hypersensitivity/allergy.
  • Use extreme caution in patients with conduction disturbance (second or third degree
    block).
  • Do not treat ectopic beats if heart rate is < 60. They are probably compensating for the
    bradycardia; instead, treat the bradycardia.
34
Q

LORAZEPAM

contraindications

A
  • Known sensitivity to the benzodiazepines
  • Acute narrow angle glaucoma or myasthenia gravis
  • Known hypersensitivity to polyethylene glycol, propylene glycol, or benzyl alcohol
  • Pregnancy (relative)
35
Q

MAGNESIUM SULFATE

contraindications

A
  • Hypermagnesemia
  • Use cautiously in patients with impaired renal function and pre-existing heart blocks
    (relative).
  • Precautions: Caution when used with barbituates, narcotics, or other hypnotics (or
    system anesthetics) in conjunction with Magnesium Sulfate due to the additive central depressive effects of magnesium.
36
Q

METHYLPREDNISOLONE SODIUM SUCCINATE

contraindications

A

Preterm infants

37
Q

MIDAZOLAM HYDROCHLORIDE

contraindications

A
  • Hypersensitivity to midazolam
  • Relative contraindication in: Myasthenia gravis or other neuromuscular disorders; acute
    alcohol intoxication; severe, chronic obstructive pulmonary disease; and acute pulmonary
    insufficiency
  • Pregnancy (relative)
38
Q

MORPHINE SULFATE

contraindications

A
  • Respiratory depression
  • Head injuries
  • Elevated Intra cranial pressure
  • Asthma, relative
  • Abdominal pain, relative
39
Q

NALMEFENE HCL

contraindications

A

Hypersensitivity

40
Q

NALOXONE HCL

contraindications

A

Hypersensitivity

41
Q

NITROGLYCERIN

contraindications

A
  • Hypovolemia
  • Increased Intra cranial pressure
  • Hypotension (relative)
42
Q

NOREPINEPHRINE

contraindications

A
  • Hypersensitivity to drug
  • Hypotension caused by blood volume deficit (except in emergencies until blood volume
    replacement is completed), profound hypoxia or hypercarbia
  • Mesenteric or peripheral vascular thrombosis
43
Q

ONDANSETRON

contraindications

A
  • Hypersensitivity
  • Use with caution in patients with hepatic impairment
  • Avoid use in patients with long QT syndrome
44
Q

OXYTOCIN

contraindications

A

Hypersensitivity

45
Q

PHENYLEPHRINE NASAL SPRAY 0.5%

contraindications

A

Known allergy to medication

46
Q

PROPARACAINE HYDROCHLORIDE OPTHALMIC

contraindications

A

Known hypersensitivity to Proparacaine.

47
Q

PROPOFOL

contraindications

A

Allergies to eggs, egg products, soybeans, or soy products

48
Q

RACEMIC EPINEPHRINE

contraindications

A
  • Allergy to any of the ingredients (may contain sulfites)
  • Coronary Artery Disease/Insufficiency
  • Arrhythmias
  • Epiglottitis
  • Hypertension
49
Q

RANITIDINE

contraindications

A

Hypersensitivity to drug and patient with acute porphyria

50
Q

SODIUM BICARBONATE 8.4%

contraindications

A

Alkalosis

51
Q

SUCCINYLCHOLINE

contraindications

A
  • Muscle disorders
  • Personal or family history of malignant hyperthermia
  • History of hyperkalemia
  • Burn injured patients*
  • Ocular injuries
  • Patients in whom successful endotracheal intubation is doubtful
52
Q 
THIAMINE HCL (VITAMIN B1)
contraindications
A

Do not give intra-arterial

53
Q

TIROFIBAN

contraindications

A
  • Active internal bleeding or recent history (within 30 days) of clinically significant gastrointestinal or genitourinary bleeding
  • History of cerebrovascular accident (CVA) with current residual neurologic deficit or within the past 2 years
  • Bleeding diathesis (bleeding disorder, condition or predisposition)
  • Current use of warfarin (Coumadin) or use within the past 7 days unless prothrombin
    time is <1.2 times control
  • Thrombocytopenia (<100,000 cells/mcl)
  • Trauma or major surgery within the past 6 weeks
  • Intracranial neoplasm
  • Arteriovenous malformation, aneurysm or evidence of aortic dissection
  • Severe uncontrolled hypertension
    (systolic BP >180mmHg, diastolic BP >110mmHg)
  • History of vasculitis
     Concomitant use of another GP IIb/IIIa inhibitor
     Acute pericarditis
     Hypersensitivity to tirofiban
54
Q

VASOPRESSIN

contraindications

A
  • Responsive patient with coronary artery disease
  • Hypertension
55
Q

VERAPAMIL HCL

contraindications

A

AV block
Sick sinus syndrome
Any wide QRS complex tachycardia WPW
Shock
Severe CHF
IV beta blocker
Hypotension

Arizona Drug Profile (revised 3/27/2015) (8 decks)

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