Contraindications Flashcards
ABIXIMAB
contraindications
- 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
ACETYLSALICYLIC ACID, ASPIRIN, ASA
contraindications
- 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)
ACETYLSALICYLIC ACID, ASPIRIN, ASA (EMT Administration)
contraindications
- 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)
ADENOSINE
contraindications
- 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)
ALBUMIN, normal serum 5% / 25%
contraindications
- Hypersensitivity
- CHF
- Severe anemia
- Renal insufficiency
ALUTEROL SULFATE
contraindications
- Synergistic with other sympathomimetics
- Use caution in patients with diabetes, hyperthyroidism, and cerebrovascular disease
AMIODARONE
contraindications
- Bradycardia
- Second or third degree heart block unless a functioning pacemaker is present
- Cardiogenic shock
- Hypotension
- Pulmonary congestion
ATROPINE SULFATE
contraindications
* Pregnancy Risk Factors/Considerations?
- 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.
BUMETANIDE
contraindications
- Hypersensitivity
- Anuria
- Electrolyte deficiencies
- Hepatic coma
- Cautious use: hepatic cirrhosis, ascites, history of gout, hypersensitivity to furosemide
CALCIUM CHLORIDE
contraindications
Hypercalcemia
Concurrent digoxin therapy (relative)
CALCIUM GLUCONATE GEL, 2.5%
contraindications
For external use only.
CHARCOAL, ACTIVATED (without sorbitol)
contraindications
- Ingestion of caustics
- Ingestion of hydrocarbons (relative)
- Oral administration to comatose patient
- Simultaneous administration of other oral drugs
CIMETIDINE
contraindications
Hypersensitivity to drug
DEXAMETHASONE SODIUM PHOSPHATE
contraindications
Systemic fungal infections
Hypersensitivity to any component of dexamethasone, including sulfites Preterm infants
DEXTROSE 50%
contraindications
- 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).
DIAZEPAM
contraindications
Hypersensitivity (allergy)
Glaucoma, acute narrow angle (relative)
DILTIAZEM
contraindications
- 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
DIPHENHYDRAMINE HCL
contraindications
- 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).
DOPAMINE
contraindications
Hypovolemic shock (relative)
Pheochromocytoma
MAO inhibitors, such as Marplan, Nardil, or Parnate
EPINEPHRINE AUTO-INJECTOR
contraindications
There are no absolute contraindications in a life-threatening situation.
EPINEPHRINE HCL
contraindications
None known for cardiac arrest Hypothermia, relative contraindication
EPTIFIBATIDE
contraindications
- 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
ETOMIDATE
contraindications
Hypersensitivity
FAMOTIDINE
contraindications
Hypersensitivity to drug
FENTANYL CITRATE
contraindications
- 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)
FUROSEMIDE
contraindications
- Anuria (relative)
- Hypovolemia
- Hypotension
GLUCAGON
contraindications
- Known hypersensitivity
- Pheochromocytoma
- Insulinoma
- Should not be routinely used to replace dextrose when IV access has been obtained
HEMOSTATIC AGENTS
contraindications
- Application to injuries related to eyes or airway
- Kaolin powder should not be applied directly to the wound
HYDROXOCOBALAMIN
contraindications
None
INSULIN
contraindications
Hypersensitivity to drug or its components Hypoglycemia
IPRATROPIUM BROMIDE
contraindications
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.
KETAMINE HYDROCHLORIC INJECTION
contraindications
- Angina
- CHF
- Symptomatic Hyperthyroidism
- Pregnancy-Relative (Category B)
LIDOCAINE HCL
contraindications
- 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.
LORAZEPAM
contraindications
- Known sensitivity to the benzodiazepines
- Acute narrow angle glaucoma or myasthenia gravis
- Known hypersensitivity to polyethylene glycol, propylene glycol, or benzyl alcohol
- Pregnancy (relative)
MAGNESIUM SULFATE
contraindications
- 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.
METHYLPREDNISOLONE SODIUM SUCCINATE
contraindications
Preterm infants
MIDAZOLAM HYDROCHLORIDE
contraindications
- 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)
MORPHINE SULFATE
contraindications
- Respiratory depression
- Head injuries
- Elevated Intra cranial pressure
- Asthma, relative
- Abdominal pain, relative
NALMEFENE HCL
contraindications
Hypersensitivity
NALOXONE HCL
contraindications
Hypersensitivity
NITROGLYCERIN
contraindications
- Hypovolemia
- Increased Intra cranial pressure
- Hypotension (relative)
NOREPINEPHRINE
contraindications
- 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
ONDANSETRON
contraindications
- Hypersensitivity
- Use with caution in patients with hepatic impairment
- Avoid use in patients with long QT syndrome
OXYTOCIN
contraindications
Hypersensitivity
PHENYLEPHRINE NASAL SPRAY 0.5%
contraindications
Known allergy to medication
PROPARACAINE HYDROCHLORIDE OPTHALMIC
contraindications
Known hypersensitivity to Proparacaine.
PROPOFOL
contraindications
Allergies to eggs, egg products, soybeans, or soy products
RACEMIC EPINEPHRINE
contraindications
- Allergy to any of the ingredients (may contain sulfites)
- Coronary Artery Disease/Insufficiency
- Arrhythmias
- Epiglottitis
- Hypertension
RANITIDINE
contraindications
Hypersensitivity to drug and patient with acute porphyria
SODIUM BICARBONATE 8.4%
contraindications
Alkalosis
SUCCINYLCHOLINE
contraindications
- 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
THIAMINE HCL (VITAMIN B1) contraindications
Do not give intra-arterial
TIROFIBAN
contraindications
- 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
VASOPRESSIN
contraindications
- Responsive patient with coronary artery disease
- Hypertension
VERAPAMIL HCL
contraindications
AV block
Sick sinus syndrome
Any wide QRS complex tachycardia WPW
Shock
Severe CHF
IV beta blocker
Hypotension
