Drug Contradictions

Question 1

Apirin

Answer 1

1) Hypersensitivity to aspirin or salicylates
2) Active bleeding peptic ulcer
3) Bleeding disorders
4) Suspected dissecting aneurism
5) Cheat Pain associates with psychostimulant OD if BP >160

Question 2

Dexamethasone

Answer 2

1) Hypersensitivity

Question 3

Adrenaline

Answer 3

1) hypovolaemic shock without fluid replacement

Question 4

Fentanyl

Answer 4

1) hypersensitive

2) late second stage labour

Question 5

Furosemide

Answer 5

Nil significant

Question 6

Glucagon

Answer 6

Nil significant

Question 7

GTN

Answer 7

1) hypersensitive
2) systolic BP <110 Tablet
3) systolic BO <90 Patch
4) Sildenadil Citrate (viagra) or Vardenafil (Levitra) in 24 hours or Tadalafil (Cialis) in previous 4 days.
5) HR > 150
6) Bradicardia, HR < 50 excluding autonomic dysreflexia
7) VT
8) Inferior STEMI with syst BP < 160
9) right vent MI

Question 8

Heparin

Answer 8

1) hypersensitive
2) active bleeding
3) oral anticoagulant
4) bleeding disorders
5) history of heparin induced thrombocytopenia
6) severe hepatic impairment/disease inc oesophageal varices
7) recent trauma

Question 9

Ipratropium bromide

Answer 9

1 hypersensitive to atropine or it’s derivatives

Question 10

Ketamine

Answer 10

1) suspected non traumatic brain injury with severe hypertension > 180

Question 11

Methoxyflurane

Answer 11

1) pre existing renal disease/impairment
2) Concurrent tetracycline use
3) exceeding 6mls in 24 hours
4) personal or family history of malignant hyperthermia
5) Muscular dystrophy

Question 12

Midazolam

Answer 12

1) hypersensitive to benzodiazepines

Question 13

Morphine

Answer 13

1) Hypersensitive
2) renal impairment/failure
3) late second stage labour

Question 14

Naloxone

Answer 14

Nil significant

Question 15

Olanzepine

Answer 15

Nil

Question 16

Ondansetron

Answer 16

1) hypersensitive
2) concurrent apomorphine use
3) known long qt syndrome
4) hypokalaemia or hypomagnesaemia

Question 17

Paracetamol

Answer 17

1) hypersensitive
2) children <1 mth
3) already administered past 4 hours
4) total intake 24 hours 4g or 60mg per kg kids
5) chest pain associated with ACS.

Question 18

Prochlorperazine

Answer 18

1) circulatory collapse
2) CNS depression
3) hypersensitivity
4) patients <21 years of age
5) pregnancy

Question 19

Slabultamol

Answer 19

1) nil significant

Question 20

Tenecteplase

Answer 20

1) Major surgery in previous 3 months
2) significant head injury in last 3 months
3) major trauma last 3 months
4) stroke/tia in past 3 months
5) ICH at any time
6) GI or genitourinary bleed last month
7) current bleeding disorder, active bleeding or bleeding tendencies
8) anticoagulants or glycoprotein IIb/IIIa inhibitors
9) allergy to tenecteplase or gentamicin

Question 21

Water for injection

Answer 21

Nil sig