Dangerous contraindications to top 100 drugs Flashcards
2 Xi to use of loop diuretics
dehydration
hypovolaemia
3 Xi to use of adenosine
coronary ischaemia
hypotension
decompensated HF
dangerous area to inject adrenaline
Area supplied by end artery
3 Xi to use of spironolactone (aldosterone antagonist)
severe renal impairment
hyperkalemia
addisons disease
3 Xi situations to use of allopurinol (gout)
acute attack of gout
sign of skin rash on previous use
sign of hypersensitivity on prev use
1 Xi to use of aminosalycilates (Ulcerative C and Rheumatoid A) e.g. mesalazine
patients allergic to aspirin
2 Xi to ACEis and ARBs
renal artery stenosis
AKI
Reason why you cant use SSRI/ TCA plus an MAOi
all increase synaptic serotonin –> serotonin syndrome
TCAs and MAOis increase NA –> hypertension and hyperthermia
1 Xi to use of D2 blocker antiemetics (metoclopramide/domperidone)
gastric perforation
reason why you cant use metoclopramide (D2 antiemetic) with parkinsons drugs
antagonism
1 Xi to use of phenothiazine antiemetics (prochlorperazine)
severe liver disease
1 Xi to antifungal drugs
pregnancy (risk of foetal malformation)
1 Xi to use of antimuscarinics for overactive bladder
UTI
2 Xi to use of atypical antipsychotics (olanzapine)
severe HF
neutropenia
3 Xi to aspirin
under 16 years (risk of rekes syndrome)
3rd trimester
aspirin allergy
2 XI to beta blockers
asthma
heart block
3 Xi to bisphosphonates
severe renal impairment
hypocalcaemia
upper GI disorders
1 Xi to calcium/ vitamin D
Hypercalcaemia
2 Xi to calcium channel blockers (amlodipine)
unstable angina
severe aortic stenosis
1 Xi to carbemazepine and phenytoin (antiepileptics)
antiepileptic hypersensitivity syndrome
Xi to penicillins, cephalosporins and carbapenem antibiotics (amoxicillin, cefotaxime, ertapenem)
previous anaphylaxis
3 Xi to digoxin
2nd degree heart block
intermittent complete heart block
ventricular arrhythmias
2 Xi to potassium sparing diuretics (amiloride)
severe renal impairment
hyperkalemia
1 Xi to thiazide and thiazide like diuretics
hypokalemia
2 Xi to fibrinolytic drugs
any bleeding or recent bleeding (esp intracranial haemorrhage)
previous streptokinase treatment is a contraindication for prescribing streptokinase again due to Ig formation
1 Xi to all laxatives
intestinal obstruction
1 Xi to use of macrolide antibiotics (clarithromycin)
macrolide hypersensitivity
3 Xi to metformin
severe renal impairment
AKI
severe tissue hypoxia
2 Xi to methotrexate
pregnancy
severe renal impairment
1 Xi to metronidazole (antibiotic for anaerobic bacteria)
alcohol (produces disulfiram like reaction)
1 Xi to nicorandil (stable angina)
phosphodiesterase inhibitor use (sildenafil)
4 Xi to nitrates
severe aortic stenosis
hypotension
haemodynamic instability
sildenafil
3 Xi to nitrofurantion (UTI)
later stages of pregnancy
babies under 3 months
renal impairment
4 Xis to NSAIDS
severe renal impairment
heart failure
liver failure
NSAID hypersensitivity
1 Xi to oestrogens and proeostrogens
breast cancer
1 Xi to weak opioids (tramadol)
uncontrolled epilepsy
2 Xi to broad spectrum penicillins
penicillin allergy
severe renal impairment
2 Xi to penicillinase resistant penicillins (flucloxacillin)
penicllin allergy
prior penicllin related hepatotoxicity
1 Xi to oral K+
severe renal impairment
3 Xi to tetracyclines
pregnancy
breastfeeding
children under 12
2 Xi to thiazolidinediones (pioglitazone, insulin sensitiser for T2DM)
HF
bladder cancer
1 Xi to trimethoprim (UTIs)
first trimester of pregnancy
2 Xi to vaccines
previous anaphylaxis to a past vaccine with any of same constituents
significant immunosuppression
2 Xi to valproate (epilepsy and BD)
any childbearing potential/risk of conception
first trimester of pregnancy
2 Xi to warfarin
pregnancy
immediate bleeding risk
2 Xi to Zdrugs for insomnia (zopi-)
obstructive sleep apnoea
respiratory muscle weakness or respiratory depression
1 irrelevant Xi to 5-a reductase inhibitors (finasteride, 2nd line for benign prostatic hyperplasia)
any exposure during pregnancy with a male foetus (touching tablets or via semen with male taking 5-a reductase inhibitors)