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Unit 3 Pharm III > Contraindications > Flashcards

Contraindications Flashcards

1
Q

Abrupt withdrawal can precipitate hypertensive crisis

A

Centrally Acting Sympatholytics /“Central Alpha Agonists”

Clonidine (Catapres)
Methyldopa

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2
Q

Aldosterone Antagonists and K+ sparing diuretics contraindications

A

Hyperkalemi
Anuria
severe, progressive kidney disease/dysfunction

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3
Q

Can’t be given during pregnancy or if the patient has angioedema

A

ACEs and ARBs

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4
Q

TMP-SMX is contraindicated if (renal)

A

CrCl <15 ml/min

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5
Q

Drugs that contain sulfa

A 
Furosemide (Lasix)
Torsemide (Demadex)
Bumetanide (Bumex)
HCTZ (Microzide)
Chlorothiazide (Diuril)
TMP+SMX

Caution:
Metolazone (thiazide related)

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6
Q

Antibiotics + Pregnancy

A

Quinolones, tetracyclines, metronidazole and aminoglycosides unless severe or life threatening infection
Trimethoprim in first trimester (folate)
Sulfas at term (interferes with bile conjugation)
Nitrofurantoin at term (risk of neonatal hemolysis)

Generally, avoid any antibiotics in first trimester if possible and use shortest effective duration

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7
Q

Don’t use ____ with digoxin due to risk of bradycardia or AV block

A

Carvedilol

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8
Q

Contraindications to laxative use

A 
Acute abdomen
Intestinal obstruction
Perforation
Toxic megacolon
Unexplained abdominal pain
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9
Q

Absolute contraindications for opioid use

A

Hepatic disease

Increased intracranial pressure

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10
Q

Avoid this central alpha agonist during pregnancy

A

Clonidine

methyldopa okay

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11
Q

Avoid _____ in fibromyalgia

A

Opioids

too often prescribed but not recommended

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12
Q

Pyridium is contraindicated if..

A

CrCl < 50

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13
Q

Beers Criteria

A

use Bactrim with caution→ can elevate risk of hyperkalemia in patients with decreased kidney function who are receiving ACE-I or ARBs

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14
Q

Caution
Rebound effect: acid hypersecretion with
abrupt discontinuation→ Consider taper therapy

A

PPIs

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15
Q

Avoid codeine and tramadol if….

A

<12 years old

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16
Q

High potency steroids

A

Can’t be used on face

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17
Q

Avoid ____ for pain control if a patient has a history of falls or fractures

A

SNRIs

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18
Q

Lactic acidosis concerns mean you shouldn’t give _____ if kidney impairment

A

metformin

Stop in cases of N/V, dehydration

19
Q

Avoid these medications in ESRD

A

morphine
demerol
hydrocodone
codeine

20
Q

If social history includes _______ opioids might not be the best choice

A

History of addictive behavior
Caring for small children at home
Teenagers in home

21
Q

Digoxin

A

Don’t give if reduced renal clearance or hypokalemia

22
Q

Firefighters don’t get

A

Muscle relaxants

23
Q

Contains Salicylate → contraindicated with ASA allergy

Avoid use in children/teenagers who have or are recovering from viral illness→ Risk of Reye Syndrome (from ASA)

A

Pepto Bismol

24
Q

BPH: avoid

A

Meds that trigger urinary retention:

Antihistamines

25
Q

Avoided in patients with seizure disorder or anorexia

A

Bupropion (Wellbutrin)

26
Q

Beta blockers

A 
Asthma
Severe bradycardia
2nd/3rd-degree AV block
Uncompensated HF
SBP <100,
Cardiogenic shock
  • *Avoid abrupt withdrawal!!**
  • Can precipitate acute coronary events and severe increases in BP
27
Q

Glaucoma: avoid

A

Meds that trigger increased IOP:

Antihistamines

28
Q

Anti-diarrheal Cautions/Contraindications

A 
Bloody or suspected infectious diarrhea
High fever/toxicity
Pseudomembranous colitis
Acute ulcerative colitis
Use caution in patients with a history of drug abuse
29
Q

Caution in elderly patients with IBS

A

Dicyclomine (Bentyl)

30
Q

CCBs contraindications

A

SA or AV node
Abnormalities, B-blockers, HF

HF→ not given due to edema side effects

31
Q

NOT indicated for acute “rescue” treatment of bronchospasm

A

Inhaled anticholinergics (SAMAs/LAMAs)

32
Q

Don’t give _____ to RA

A

long term short acting opioids! Switch to long acting with short acting PRN for breakthrough pain.

(this applies to any chronic pain situation)

33
Q

Is NOT for use with opioids

A

Buprenorphine patch

34
Q

Extreme caution with these medications in ESRD

A

hydromorphone

oxycodone

35
Q

Don’t use loops (furosemide) with _____ because hypokalemia will increase its toxicity

A

Digoxin

36
Q

Don’t use opioids in combination with

A

Benzos or gabapentinoids

Due to Overdose, respiratory depression and death

(dunno if this only applies to elderly?)

37
Q

Metoclopramide CI

A

obstruction
perforation
GI hemorrhage

38
Q

Don’t give ___ if the patient has anuria

A

Diuretics (loops, but I think it applies to all)

39
Q

3 drugs not to combine bc all lower BP, together could cause hypotension

A

Furosemide
carvedilol
lisinopril

40
Q

SNRI contraindicated if liver disease

A

Duloxetine (Cymbalta)

41
Q

Too sedating for transportation drivers

A

Cetirizine (Zyrtec)

Levocetirizine (Xyzal)

Azelastine (Asteline)
Nasal Spray

Diphenhydramine (Benadryl)

42
Q

Nitrates CI

A

Within 24 hours of
Sildenafil (Viagra

HCM

RV infarction

43
Q

Abortifacient→ Contraindicated in pregnancy or those who may become pregnant while taking the drug

A

Misoprostol

Unit 3 Pharm III (10 decks)

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