Med. Ind/Contraindications Flashcards
Acetaminophen (Tylenol)
Indications
a. Pain and fever control
4. Contraindications
a. Known hypersensitivity
b. Severe active liver disease
AcetaZOLAMIDE (Diamox, Diamox Sequels)
Indications
a. AMS (treatment and prophylaxis)
b. Prevention of HACE
4. Contraindications
Hypersensitivity to acetaZOLAMIDE or sulfa
Known hypokalemia or hyponatremia
Renal or liver dysfunction
Should not be used for the treatment of HAPE
Acetic Acid (vinegar)
Indications
a. Otitis externa
b. Pain control for envenomation by jellyfish from outside the United States
4. Contraindications
a. Hypersensitivity
b. Perforated tympanic membranes
c. May increase nematocyst discharge for US jellyfish and should be used only outside the United States
Acetylcysteine (Mucomyst, Acetadote)
Indications
a. Acetaminophen overdose
Contraindications
a. Known hypersensitivity
b. Acute asthma
Activated Charcoal (Insta-Char, Actidose-Aqua, Liqui-Char)
Indications
a. Most oral poisonings and medication overdoses in the alert patient
b. Can be used after evacuation of poisons
Contraindications
a. Known hypersensitivity
b. Unprotected airway
c. Absence of a gag reflex
d. Ileus
e. Intestinal obstruction
f. Do not use after ingestion of petroleum distillates, hydrocarbons, heavy metals, acids or alkalis (corrosives), alcohols, iron, lithium, solvents.
g. Use caution in patients experiencing abdominal pain of unknown origin.
Adenosine (Adenocard)
Indications
a. First-line drug for most forms of stable, regular, narrow-complex SVT
b. Considered for marrow-complex reentry tachycardia while preparing for cardioversion
c. Can be used diagnostically for stable, regular, monomorphic wide-complex tachycardia
Contraindications
a. Known hypersensitivity
b. Second- or third-degree AV block or sick sinus syndrome or other sinus node disease
c. Poison- or drug-induced tachycardia
d. Use with caution in patients with a history of seizure disorder.
e. May induce bronchospasm in a patient with bronchoconstrictive or bronchospastic lung disease
Albuterol (Proventil, Ventolin, Proair, Accuneb)
Indications
a. Treatment and prevention of bronchospasm in patients with reversible obstructive airway disease
b. Treatment of inhaled airway/respiratory irritant agents
c. Hyperkalemia treatment
Contraindications
a. Known hypersensitivity
b. Dysrhythmias
c. Synergistic with other sympathomimetics
Amiodarone (Cordarone, Pacerone)
Indications
a. Cardiac arrest resulting from VF or pulseless VT after CPR, defibrillation, and epinephrine
b. Stable, regular narrow-complex tachycardia if the rhythm persists despite vagal maneuvers or adenosine or the tachycardia is recurrent
c. To control the ventricular rate in AF with a rapid ventricular response without preexcitation
d. Stable wide-complex tachycardia
e. Stable monomorphic VT
f. Polymorphic VT with a normal QT interval
Contraindications
a. Known hypersensitivity
b. Iodine hypersensitivity
c. Cardiogenic shock
d. Second- of third-degree AV block
e. Sick sinus syndrome
Aspirin (Acetylsalicylic Acid)
Indications
a. New-onset chest discomfort suggestive of ACS
Contraindications
a. Hypersensitivity to ASA or NSAIDs
b. Bleeding disorders
c. Hemolytic anemia
d. Lactating mothers
Atropine Sulfate
Indications
a. Hemodynamically unstable bradycardia
b. Acetylcholinesterase inhibitor poisoning
c. RSI in pediatrics
d. Beta blocker or calcium channel blocker overdose
Contraindications
a. Known hypersensitivity
b. Narrow-angle glaucoma
c. GI obstruction
d. Severe ulcerative colitis
e. Toxic megacolon
f. Bladder outlet obstruction
g. Myasthenia gravis
h. Hemorrhage with cardiovascular instability
i. Thyrotoxicosis
Benzocaine Spray (Hurricane)
Indications
a. Topical anesthetic
b. Suppresses the pharyngeal and tracheal gag reflex
Contraindications
a. Hypersensitivity
Bumetanide (Bumex)
Indications
a. Pulmonary edema, heart failure
Contraindications
a. Hypersensitivity to bumetanide, furosemide, or sulfonamides
b. Hypovolemia, anuria, acid-based imbalance, electrolyte imbalance, hepatic coma
c. Use with caution in patients with hepatic cirrhosis, ascites, or diabetes.
Calcium Chloride
Indications
a. Hypocalcemia
b. Hyperkalemia
c. Beta blocker and calcium channel blocker toxicity
d. Antidote for magnesium sulfate overdose
Contraindications
a. Known hypersensitivity
b. Digoxin toxicity
c. Hypercalcemia
d. Suspected severe hypokalemia
Calcium Gluconate
Indications
a. Topical use in hydrofluoric acid burn management
b. Hypocalcemia
c. Hyperkalemia
d. Beta blocker and calcium channel blocker toxicity
Contraindications
a. Known hypersensitivity
b. Digoxin toxicity
c. Hypercalcemia
d. Suspected severe hypokalemia
Cimetidine (Tagamet)
Indications
a. Gastric or duodenal ulcers
b. GERD
c. Adjunct in treating hives and/or itching
Contraindications
a. Known hypersensitivity to cimetidine or other H2 blockers
Dexamethasone Sodium Phosphate (Decadron)
Indications
a. Anaphylaxis
b. Acute exacerbation of bronchial asthma
c. AMS
d. HACE
e. Spinal cord injury
f. Croup
g. Elevated ICP
h. Adjunct in treatment of shock
i. COVID-19
Contraindications
a. Documented hypersensitivity
b. Systemic fungal infection
c. Preterm infants
Dextrose
Indications
a. Hypoglycemia
b. Acutely altered mental status
c. Coma or seizure of unknown origin
d. Status epilepticus
Contraindications
a. Documented hypersensitivity
b. Hyperglycemia
c. Severe dehydration
d. Anuria
e. Diabetic coma
f. Intracranial or intraspinal hemorrhage
g. Glucose-galactose malabsorption syndrome
Diazepam (Valium, Diastat AcuDial)
Indications
a. Uncontrolled shivering
Contraindications
a. Documented hypersensitivity
b. Neurologic or respiratory depression
c. Narrow-angle glaucoma
d. Myasthenia gravis
e. Head injury
Diltiazem (Cardizem, Dilacor, Diltiaz)
Indications
a. Stable narrow-QRS tachycardia
i. Rhythm persists despite vagal maneuvers or administration of adenosine.
ii. Recurrent
b. To control the ventricular rate in patients with AF or atrial flutter without preexcitation
Contraindications
a. Known hypersensitivity
b. Hypotension
c. Cardiogenic shock
d. Wide-complex tachycardia
e. Second- or third-degree AV block
f. Sick sinus syndrome or other sinus node disease
g. Poison- or drug-induced tachycardia
h. AF or atrial flutter associated with an accessory bypass tract
i. Avoid use in patients with left ventricular systolic dysfunction or decompensated heart failure.
j. Use with extreme caution in patients taking oral beta blockers.
DiphenhydrAMINE (Benadryl)
Indications
a. Symptomatic allergic reactions
b. Symptomatic dystonia
c. Extrapyramidal signs or symptoms caused by phenothiazines
d. Antiemetic
e. Chemical restraint
Contraindications
a. Known hypersensitivity, newborns and premature infants, breastfeeding
b. Use with caution in patients with severe vomiting, asthma, narrow-angle glaucoma, benign prostatic hypertrophy, or alcohol intoxication.
c. Use is controversial in patients with lower respiratory tract disease.
DOBUTamine Hydrochloride (Dobutrex)
Increases renal blood flow secondary to increased cardiac output
3. Indications
a. Heart failure with a SBP of 70 to 100 mm Hg and no signs of shock
Contraindications
a. Known hypersensitivity
b. Suspected or known poison/drug-induced shock
c. SBP less than 10 mm Hg and signs of shock
d. Idiopathic hypertrophic subaortic stenosis
DOPamine Hydrochloride (Intropin)
Indications
a. Refractory cardiogenic or distributive shock
b. Hypotension with low cardiac output states
c. Second-line drug from symptomatic bradycardia
Contraindications
a. Known hypersensitivity
b. Hypovolemia
c. Pheochromocytoma
d. Uncorrected tachydysrhythmias
e. VF
Droperidol (Inapsine)
Indications
a. Chemical restraint
b. Acute delirium or psychosis
Contraindications
a. Known hypersensitivity
b. Known or suspected prolonged QT interval
c. Use with extreme caution in patients with bradycardia, cardiac disease, concurrent MAOI therapy, or use of Class I and Class III antidysrhythmics or other drugs.
Epinephrine (Adrenalin, EpiPen, AsthmaNefrin)
Indications
a. Cardiac arrest
b. Bradycardia
c. Shock
d. Anaphylaxis
e. Sever refractory wheezing (IM)
f. Coup/bronchiolitis (nebulized)
Contraindications
a. Known hypersensitivity, coronary insufficiency, cardiac dilation
b. Uncontrolled hypertension
c. Hypothermia
d. Pulmonary edema
e. Myocardial ischemia
f. Hypovolemic shock
Etomidate (Amidate)
Indications
a. Premedication for medication-facilitated intubation or procedural sedation
Contraindications
a. Known hypersensitivity
b. Labor/delivery
c. Septic shock (particularly in children)
Famotidine (Pepcid)
Indications
a. GI ulcer
b. Suspected upper GI bleeding
c. GERD
d. As an adjunct in the treatment of urticaria and/or pruritus
Contraindications
a. Known hypersensitivity to famotidine or other H2 blockers
Fentanyl Citrate (Sublimaze)
Indications
a. Pain management
b. Anesthesia adjunct
c. Severe respiratory distress (palliative care)
4. Contraindications
a. Known hypersensitivity
b. Patients who have taken an MAOI in the previous 14 days
c. Administer with caution to patients with a Glasgow Coma Scale (GCS) score less than 15.
d. Hypotension
e. Hypoxia after maximal supplemental oxygen therapy
f. Signs of hypoventilation
Glucagon (GlucaGen)
Indications
a. Altered mental status when hypoglycemia is suspected
b. Antidote for symptomatic bradycardia caused by beta blocker or calcium channel blocker overdoses
Contraindications
a. Known hypersensitivity, pheochromocytoma, hyperglycemia, insulinoma
5. Adverse reactions/side effects
a. Dizziness/headache
b. Hypotension
c. Tachycardia
d. Nausea/vomiting
e. Rebound hypoglycemia
Haloperidol (Haldol)
Indications
a. Acute psychotic episodes or agitated/violent behavior
b. Anxiety
Contraindications
a. Documented hypersensitivity
b. Severe CNS depression
c. Neuroleptic malignant syndrome
d. Poorly controlled seizure disorder
e. Parkinson disease
f. Agitation secondary to shock and hypoxia
Helium Gas Mixture (Heliox)
Indications
a. Persistent or severe bronchospasm
Contraindications
a. None
HydrALAZINE (Apresoline)
Indications
a. Pregnancy-induced hypertension lasting more than 15 minutes with associated preeclampsia symptoms
Contraindications
a. Known hypersensitivity, CAB, mitral valve rheumatic heart disease
b. Use with caution in patients with stroke, known renal disease, or hypotension.
Hydrocortisone Sodium Succinate (Solu-Cortef)
Indications
a. Shock with history of adrenal insufficiency or long-term steroid dependence
i. Anaphylaxis, asthma, and COPD
Contraindications
a. Known hypersensitivity
b. Systemic fungal infections
c. Premature infants
HYDROmorphone (Dilaudid)
Indications
a. Management of acute moderate to severe pain
Contraindications
a. Known hypersensitivity
b. MAOI use during the previous 14 days
c. GI obstruction
d. Administer with caution in:
i. Older adults
ii. Patients with a GCS score less than 15
iii. Patients with hypotension, hypoxia, signs of hypoventilation, head injury, or concomitant use of CNS depressants