Interactions-Table 1

Question 1

Question

Answer 1

Answer

Question 2

Diazepam (valium)

Answer 2

Effects are enhanced when used in conjunction with other CNS depressants and alcohol
Cimetidine may increase diazepam plasma levels

Question 3

Lorazepam

Answer 3

Effects of lorazepam will be increased when used in conjunction with other CNS depressants, alcohol, or cimetidine

Question 4

Midazolam (Versed)

Answer 4

Prolonged respiratory depression when given in conjunction with other CNS depressants such as alcohol, cimetidine (Tagamet) increases plasma levels of midazolam

Question 5

Succinylcholine (Anectine)

Answer 5

Effects potentiated by oxytocin, beta-blockers, and organop hospha tes
Diazepam may reduce duration of action

Question 6

Epinephrine (Adrenalin)

Answer 6

May increase hypotension caused by phenothiazines, alpha and beta blockers, can be deactivated in alkaline solutions or sodium bicarbonate

Question 7

Vasopressin

Answer 7

Epinephrine, heparin, alcohol, phenytoin, neostigmine, thiazide diuretics, carbamazepine

Question 8

Lidocaine

Answer 8

Use caution when administered with beta blockers or procainamide as drug toxicity may result

Question 9

Amiodarone

Answer 9

Increases digoxin levels and enhances pharmacological effects of procainamide, lidocaine, quinidine, and oral anticoagulants. Concurrent use of calcium channel blockers, beta blockers, fentanyl, or cimetidine may potentiate sinus bradycardia

Question 10

Atropine Sulfate

Answer 10

Antihistamines, tricyclic antidepressants, procainamide can lead to the anticholinergic effects of atropine

Question 11

Adenosine (Adenocard)

Answer 11

Patients taking caffeine or xanthines (aminophylline or theophylline) may require larger doses as these drugs antagonize

Question 12

Diltiazem (Cardizem)

Answer 12

adenosine

Question 13

Metoprolol (Lopressor, Toprol XL)

Answer 13

Patients on dipyridamole (Persantine) and carbamazepine (Tegretol) may need smaller doses of adenosine as these drugs potentiate adenosine’s effects

Question 14

Dopamine (Intropin)

Answer 14

Cardiogenic shock, hemodynamically significant hypotension (systolic BP of 70 - 100 mmHg not resulting from hypovolemia), symptomatic bradycardia

Question 15

Dobutrex (Dobutamine)

Answer 15

Absolute interaction with beta-blockers as they decrease dobutamine’s effectiveness. Use with extreme caution with tricyclic antidepressa nts

Question 16

Aspirin

Answer 16

Suspected AMI, chest pain, or ACS

Question 17

Nitroglycerin

Answer 17

May cause hypotension when used in conjunction with alcohol and antihypertensives (beta-blockers)

Question 18

Sodium Bicarbonate (NaHCO3)

Answer 18

Will deactivate most catecholamines and vasopressors
Sodium bicarbonate will precipitate when used in conjunction with calcium chloride

Question 19

Magnesium Sulfate

Answer 19

Can cause cardiac conduction abnormalities when used in conjunction with digitalis

Question 20

Oxytocin

Answer 20

Can cause hypertension when used in conjunction with vasoconstrictors

Question 21

Albuterol

Answer 21

Other sympathomimetic bronchodilators, beta-blockers. Use with extreme caution with patients on MAOIs and TCAs as potentiation may occur

Question 22

Atroven

Answer 22

None

Question 23

Methylprednisolone (Solu-medrol)

Answer 23

Use caution in patients on salicylates, phenytoin, rifampin, theophylline, furosemide, and thiazide diuretics

Question 24

50% Dextrose in water (D50W or D50)

Answer 24

None

Question 25

Glucagon (GlucaGen)

Answer 25

None Significant

Question 26

Diphenhydramine

Answer 26

Potentiated by the administration of other CNS depressants, antihistamines, narcotics, and alcohol. MAOIs may prolong or intensify the anticholinergic effects

Question 27

Haloperidol (Haldol)

Answer 27

Increased sedation with concomitant use of narcotic agonists, benzodiazepines, alcohol, TCAs, and antihistamines

Question 28

Naloxone (Narcan)

Answer 28

May cause narcotic withdrawal in the narcotic-dependent patient so administer only enough to reverse respiratory depression

Question 29

Furosemide (lasix)

Answer 29

Digitalis and lithium toxicity

Question 30

CyanoKit

Answer 30

Due to incompatibilities (particulate formation), the following medications need to be run through different tubing (separate from hydroxocobolamin):
diazepam dobutamine dopamine fentanyl nitroglycerin

Question 31

Calcium Chloride

Answer 31

Calcium chloride will precipitate when used in conjunction with sodium bicarbonate. Toxicity with digitalis. May antagonize the effects of calcium channel blockers

Question 32

Activated Charcoal

Answer 32

Do not administer at the same time as syrup of ipecac Ipecac will nullify the effects of activated charcoal

Question 33

Morphine Sulfate

Answer 33

Enhanced CNS depression when administered with antihistamines, sedatives, barbiturates, and alcohol. Tricyclic antidepressants and MAOIs may precipitate hypotensive crisis

Question 34

Fentanyl Citrate

Answer 34

Effects may be increased with other CNS depressants such as alcohol, narcotics, and sedative/hypnotics.
MAOI use may cause hypotension

Question 35

Ketorolac (toradol)

Answer 35

Potentiates medications that inhibit platelet aggregation

Question 36

Acetaminophen (tylenol, APAP)

Answer 36

Increased chance of hepatotoxicity when taken chronically or with alcohol, rifampin, carbamazepine, or barbiturates

Question 37

Ibuprofen (Advil, Motrin, Nuprin)

Answer 37

Reduces the effectiveness of loop diuretics and ACE-inhibitors Increases hemorrhage potential when given with aspirin

Question 38

Procainamide (Pronestyl)

Answer 38

Use caution when patient is on an antihypertensive agent