Drug contraindications

Question 1

Adrenaline

Answer 1

Hypovolaemic shock

Question 2

Aspirin

Answer 2

1. Active bleeding peptic ulcers
2. Bleeding disorders
3. Dissecting aortic aneurysm
4. Chest pain with psychostimulant OD
5. Hypersensitivity

Question 3

Ceftriaxone

Answer 3

Hypersensitivity to cephalosporin antibiotics

Question 4

Dexamethasone

Answer 4

Nil

Question 5

Dextrose 10%

Answer 5

Nil

Question 6

Fentanyl

Answer 6

Late second stage labour, hypersensitivity

Question 7

Glucagon

Answer 7

Nil

Question 8

GTN

Answer 8

1. Hypersensitivity
2. VT rhythm
3. Sex performance drugs (Viagra, Levitra, Cialis)
4. BP <90mmHg (for 50mg patch)
5. BP <110mmHg (for 300/600mcg tablet)
6. Inferior STEMI with BP >160mmHg
7. Right ventricular MI
8. Heart rate <50bpm
9. Heart rate >150bpm

Question 9

Ipratropium bromide

Answer 9

Hypersensitivity to atropine and it’s derivatives

Question 10

Ketamine

Answer 10

Brain injury with severe hypertension >180mmHg

Question 11

Midazolam

Answer 11

Known hypersensitivity to benzos

Question 12

Morphine

Answer 12

Hypersensitivity, late second stage labour, renal impairment/failure

Question 13

Naloxone

Answer 13

Nil

Question 14

Normal saline

Answer 14

Nil

Question 15

Ondanstron

Answer 15

1. Hypersensitivity
2. Co-current apomorphine use
3. Long Q-T syndrome
4. High magnesium
5. High potassium

Question 16

Olanzapine

Answer 16

Nil

Question 17

Paracetamol

Answer 17

1. Hypersensitivity
2. <1 month old
3. Already administered in last 4 hours
4. Max dose in last 24 hours (4g)
5. Chest pain in ACS

Question 18

Prochlorperazine

Answer 18

1. <21 years old
2. Hypersensitivity
3. CNS depression
4. Circulatory collapse (indicated by poor perfusion)
5. Pregnancy

Question 19

Salbutamol

Answer 19

Nil