Contraindications

Question 1

Contraindication for antihistamines

Answer 1

Children < 4 years old

Question 2

Avoid these antihistamines in a patient with renal failure

Answer 2

Cetirizine
Levocetirizine
Acrivastine

Question 3

Monitor Na+ in patients with CHF

Answer 3

Sodium bicarbonate

Question 4

Antacid that an cause acid rebound

Answer 4

Calcium carbonate as calcium stimulates acid production

Question 5

Poorly absorbed, but accumulate if the patient has bad renal function

Answer 5

Magnesium or Aluminum hydroxide

Question 6

Don’t use it in men because it has anti-testosterone effects

Answer 6

Cimetidine

Question 7

Induces abortion in pregnancy

Answer 7

Misoprostol

Question 8

Contraindicated in pregnancy because it causes methemoglobinemia in infants

Answer 8

Metopramide

Question 9

Contraindications to laxatives

Answer 9

N/V, Abdominal cramps
Undiagnosed abdominal pain
Appendicitis
Overuse (chronic) 
Occasional use is safe
Dependence on laxative
Fluid/electrolyte imbalance
Spastic colitis
Ulcerative colitis

Question 10

3 most important contraindications to laxatives

Answer 10

****
Intestinal blockage
Perforation
Toxic megacolon
****

Question 11

Wouldn’t be effective in a patient with a cholecystectomy because it requires bile

Answer 11

Castor oil

Question 12

Stimulates uterus, contraindicated in pregnancy

Answer 12

Castor oil

Question 13

Probably don’t use this lubricant/softener because it leaks, causes lipoid pneumonia if it’s inhaled, and decreases absorption of fat soluble vitamins

Answer 13

Mineral oil

Question 14

Avoid in children and teens <18→ risk of dehydration

Answer 14

Linaclotide

Question 15

Contraindications to bismuth subsalicylate

Answer 15

Patients allergic to aspirin, Children (Reyes)

Caution in asthmatics

Question 16

Contraindications to opioids

Answer 16

Infections→ decrease expulsion of pathogens

Ulcerative colitis→ toxic megacolon

Question 17

Recovering drug addicts→ some abuse potential

Answer 17

diphenoxylate

Question 18

Contraindications to Sulfasalazine

Answer 18

Allergic reactions: salicylates

Avoid in children- Reye’s syndrome

Question 19

Contraindications to aspirin use

Answer 19

Hypoprothrombinemia
Vitamin K deficiency
Hemophilia
Severe hepatic damage 
Gastric ulcer
Hypersensitivity to aspirin or salicylates
Last 3 months of pregnancy

Question 20

Aspirin dose is decreased:

Answer 20

During long-term therapy with oral anticoagulants, hypoglycemic agents

Question 21

Stop aspirin

Answer 21

At least 1 week prior to surgery or delivery

Question 22

Generally don’t give NSAIDs in…

Answer 22

Renal or liver failure

Question 23

Contraindications of Celecoxib

Answer 23

GI disease
Asthma
Breast feeding
Pregnancy
Renal failure
Sulfonamide allergy

Question 24

Don’t give ____ to patients with a sulfonamide allergy

Answer 24

Celecoxib

Question 25

Don't use ____ for longer than 5 days due to GI effects

Answer 25

Ketorolac

Question 26

Don't give this NSAID during pregnancy because it crosses the placenta readily

Answer 26

Naproxen

Question 27

Don't give ____ to an alcoholic because of the risk of fatal hepatic necrosis

Answer 27

Acetaminophen

Question 28

Infliximab contraindications

Answer 28

Pregnancy Breast feeding Children Infections

Question 29

Leflunomide contraindications

Answer 29

Pregnancy Breast feeding Hepatic failure Renal failure

Question 30

Mycophenolate mofetil contraindications

Answer 30

``` Active GI disease (causes GI bleeding) Diarrhea Pregnancy Breast feeding Infections ```

Question 31

Anakira contraindications

Answer 31

Breast feeding Children Renal failure Hypersensitivity reactions

Question 32

Triptans contraindication

Answer 32

``` Breast-feeding Cardiac disease Cerebrovascular disease Coronary artery disease Diabetes mellitus Hypertension Intravenous administration Peripheral vascular disease Pregnancy Renal impairment Seizures Tobacco smoking ```

Question 33

Causes coronary artery vasospasm or cardiac arrhythmias, so can't given to anyone with cardiac disease

Answer 33

Triptans

Question 34

Contraindications to ergotamine use

Answer 34

``` Peripheral vascular disease Allergy Renal and hepatic diseases Malnutrition Peptic ulcers Pregnancy ```

Question 35

Examples of peripheral vascular disease, avoid using ergotamine

Answer 35

``` Thromboangiitis obliterans Thrombophlebitis Atherosclerosis Severe hypertension Ischemic heart disease Marked arteriosclerosis Raynaud's disease ```

Question 36

Analgesics contraindicated in gout

Answer 36

Decrease urate excretion: Aspirin Salicylates

Question 37

Don't give ____ until 2-3 weeks after an acute attack, because it can worsen acute attacks and/or trigger an attack

Answer 37

Probenecid

Question 38

High dose monotherapy causing renal failure (black box warning)

Answer 38

Lesinurad