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CCEMS Drugs > Drug Contraindications > Flashcards

Drug Contraindications Flashcards

1
Q

Acetaminophen (Tylenol)

A

None

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2
Q

Adenosine (Adenocard)

A
  • 2° or 3° A-V block (except in patients with a full functioning artificial pacemaker)
  • Sick Sinus Syndrome (except in patients with a full functioning artificial pacemaker)
  • Known Hypersensitivity
  • Should be used with caution in pregnant women
  • Should be used with caution in patients who are wheezing
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3
Q

Albuterol Sulfate (Proventil)

A

Albuterol should not be administered to patients with known hypersensitivity to any of its components. It should be used with caution in patients with:
• cardiovascular disorders, especially coronary insufficiency
• cardiac arrhythmias and hypertension
• convulsive disorders
• hyperthyroidism
• diabetes

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4
Q

Amiodarone HCl (Cordarone)

A
  • Known hypersensitivity
  • Hypotension
  • Bradycardia or high-degree AVB
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5
Q

Anti-Diuretic Hormone (ADH) (Vasopressin)

A

Known hypersensitivity

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6
Q

Aspirin

A

Known hypersensitivity

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7
Q

Atropine Sulfate

A

Atropine should not be used in patients presenting with atrial flutter or atrial fibrillation where there is rapid ventricular response. Patients with known history of glaucoma should not be given atropine.

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8
Q

Calcium Chloride

A

Calcium chloride should be given with extreme caution, and in reduced dosage to patients taking digitalis; given too rapidly, calcium can cause sudden death from VFIB

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9
Q

50% Dextrose

A

50% Dextrose should not be administered to any patient presenting with S/S of central nervous system pathology (i.e. Stroke or Closed Head Injury), unless they are hypoglycemic.

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10
Q

Diazepam (Valium)

A
  • alcohol or sedative ingestion
  • glaucoma
  • shock, coma, or acute alcoholic intoxication with ↓ V/S
  • caution in pregnancy, especially the 1st trimester (may use if eclampsia is refractory to Magnesium Sulfate)
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11
Q

Diltiazem (Cardizem)

A
  • Hypotension
  • Wide-complex tachycardia
  • Conduction system disturbances
  • Wolff-Parkinson-White Syndrome
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12
Q

Diphenhydramine (Benadryl)

A
  • pregnancy
  • asthma
  • glaucoma or prostate problems
  • known alcohol or depressant abuse
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13
Q

Dopamine HCL (Intropin)

A
  • Do not mix with sodium bicarbonate
  • Uncorrected tachyarrhythmias or VFIB
  • Serious acute hypertension may develop in patients with pheochromocytoma
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14
Q

Epinephrine HCL (Adrenaline)

A
  • There are no contraindications for the use of epinephrine in cardiac arrest or anaphylactic shock. The medication should be used with caution when the patient presents with:
    • Hypertension, angina, and/or hyperthyroidism.
    • Immediately following administration of sodium bicarbonate, which may inactivate epinephrine.
    • Patients receiving other medications that sensitize the myocardium to the actions of sympathomimetic drugs.
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15
Q

Etomidate (Amidate)

A

None when used as indicated

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16
Q

Fentanyl Citrate (Sublimaze)

A
  • Shock
  • Severe hemorrhage
  • Known hypersensitivity
  • Hypotension
  • Symptomatic Bradycardia
  • Closed Head Injury with signs/symptoms of CNS involvement
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17
Q

Fursoemide (Lasix)

A
  • Because of the potency of this medication, blood pressure must be monitored carefully during administration.
    • Should not be given to:
      • Pregnant patients
      • Patients with known or suspected Hypokalemia
      • Patients with Hypovolemia and/or dehydration
18
Q

Glucagon (Glucagen)

A

Known hypersensitivity

19
Q

Heparin

A
  • Hypersensitivity
  • Recent, or known active bleeding
  • Known bleeding disorders
  • Known thrombocytopenia (low platelet count)
20
Q

Hydromorphone (Dilaudid)

A
  • Known hypersensitivity
  • Must be used with extreme caution if possibility of CNS pathology exists.
  • Must be used with extreme caution in patients having an acute asthmatic attack, patients with COPD, and patients with pre-existing respiratory depression or hypoxia due to capacity to ↓ respiratory drive while simultaneously ↑ airway resistance to the point of apnea.
  • Should be used with caution and in reduced dosages in the presence of other CNS depressants including, but not limited to tricyclic antidepressants, tranquilizers, barbiturates, and alcohol.
  • Premature infants
  • Labor when delivery of a premature infant is anticipated
21
Q

Ibuprofen (Motrin)

A
  • Severe aspirin allergy
  • Severe reactive airway disease
  • Known hypersensitivity
22
Q

Ipratropium (Atrovent)

A

Known Hypersensitivity to Atropine/Atrovent

23
Q

Ketamine (Ketalar)

A
  • Patients with a predisposition for laryngospasm
  • Hx of glaucoma, or acute globe injury
  • Severe cardiovascular disease (angina, heart failure, uncontrolled hypertension)
24
Q

Ketorolac (Toradol)

A
  • Hypersensitivity to the drug or aspirin
  • Active bleeding
  • History of peptic ulcer disease
  • Fractures where the potential for excessive bleeding exists
  • Renal Insufficiency or failure
25
Q

Lidocaine HCL (Xylocaine, Lidocaine Jelly)

A
  • Known hypersensitivity
  • 2° or 3° AVB
  • Sinus bradycardia or sinus arrest
  • Idioventricular rhythm
26
Q

Magnesium Sulfate

A

None when used as indicated

27
Q

Methylprednisolone (Solu-Medrol)

A
  • Known hypersensitivity

* Closed head injury or cerebrovascular accident

28
Q

Metoprolol (Lopressor)

A
  • Heart rate less than 70
  • Systolic blood pressure less than 100 mm Hg
  • Presence of AV heart block
  • Pulmonary edema as evidenced by crackles
29
Q

Midazolam (Versed)

A
  • Known hypersensitivity

* Hypotension (SBP < 100 mmHg)

30
Q

Morphine Sulfate

A
  • Known hypersensitivity
  • Premature infants
  • Labor when delivery of a premature infant is anticipated
  • The respiratory depressant effects and its ability to ↑ CSF pressure may be markedly exaggerated in the presence of head injury, other intracranial lesions, or a pre-existing ↑ in intracranial pressure. Must be used with extreme caution and only if its use is absolutely necessary if possibility of CNS pathology exists.
  • Must be used with extreme caution in patients having an acute asthmatic attack, patients with COPD, and patients with pre-existing respiratory depression or hypoxia due to capacity to ↓ respiratory drive while simultaneously ↑ airway resistance to the point of apnea.
  • Should be used with caution and in reduced dosages in the presence of other CNS depressants including, but not limited to tricyclic antidepressants, tranquilizers, barbiturates, and alcohol.
31
Q

Naloxone (Narcan)

A

None

32
Q

Nitroglycerin (Nitostat, Nitrolingual Spray)

A
  • Patients taking Viagra (or other erectile dysfunction medication)
  • Should be used with extreme caution (or not at all) in patients presenting with:
    • Increased ICP
    • Glaucoma
    • Hypotension
    • Severe anemia
    • Stroke / intracerebral hemorrhage
33
Q

Ondansetron HCL (Zofran)

A
  • Known Hypersensitivity

* Children less than 4 years of age

34
Q

Oxytocin (Pitocin)

A
  • Obstetrical emergencies where the benefit-to-risk ratio for either the fetus or the mother favors surgical intervention.
  • Fetal distress where delivery is not imminent.
  • Where the uterus is already hyperactive or hypertonic.
  • Patients who are hypersensitive to the medication.
    • Situations where vaginal delivery is contraindicated.
    • cord presentation or prolapse
    • placenta previa
35
Q

Promethazime (Phenergan)

A

Known Hypersensitivity

36
Q

Rocuronium (Zemuron)

A

Patient who is not intubated

37
Q

Sodium Bicarbonate

A
  • Hypokalemia

* Patients who cannot tolerate a salt load (e.g. CHF)

38
Q

Succinylcholine Chloride (Anectine)

A
  • Patients in whom a surgical airway would be difficult or impossible (i.e. massive swelling or significant neck injury).
  • Patients that would be difficult, or impossible to intubate or ventilate after paralysis (i.e. unresolved upper airway obstruction or acute epiglottitis).
39
Q

Tetracaine Ophthalmic Solution

A

Known hypersensitivity

40
Q

Thiamine

A

Known hypersensitivity

41
Q

Vecuronium (Norcuron)

A

Patient who is not intubated

CCEMS Drugs (3 decks)

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