Medication Indications and Contraindication Flashcards by Wilko Wilkinson

ICP - Adenosine - I & C/I

I:
1 Regular Supra-ventricular Tachycardia (SVT) (narrow complex)
2 Regular supra-ventricular Tachycardia with ventricular aberrancy of conduction (SVT-A)

C/I:
1 History of second or third degree heart block or sick sinus syndrome (except for patients with a functioning artificial pacemaker)
2 Sinus node disease, such as sick sinus syndrome
3 Chronic obstructive lung disease eg. Asthma
4 Known hypersensitivity to Adenosine. (Very rare)

How well did you know this?

Not at all

Perfectly

Adrenaline - I & C/I

I:
1-3 Cardiac Arrest rhythms (Persistent VF or unconscious pulseless VT, Asystole, PEA)
4-5 Inadequate Perfusion (cardiogenic, non-cardiogenic)
6 Anaphylaxis reactions
7 Severe Asthma
8 Unconscious asthma with no blood pressure
9 Croup or suspected croup/epiglottitis
10 Bradycardia with poor perfusion

C/I:
Hypovolaemic shock without adequate fluid replacement

How well did you know this?

Not at all

Perfectly

Amiodarone - I & C/I

I:
1 VF or pulseless VT refractory to cardioversion
2 Sustained or recurrent VT

C/I:
1 Ventricular Tachycardia
-Inadequate perfusion and deteriorating rapidly
-pregnancy
2 Known hypersensitivity to amiodarone or Iodine
3 Tricyclic antidepressant medication overdose

How well did you know this?

Not at all

Perfectly

Aspirin - I & C/I

I:
To minimise platelet aggregation and thrombus formation in order to retard the progression of coronary artery thrombosis in ACS.

C/I:
1 Hypersensitivity
2 Active bleeding peptic ulcers
3 Bleeding disorders
4 Suspected dissecting aortic aneurysm
5 Chest pain with psychostimulant overdose with BP >160

How well did you know this?

Not at all

Perfectly

ICP - Atropine - I & C/I

I:
1 Bradycardia with less than adequate perfusion
2 Organophosphate poisoning with excessive cholinergic effects
3 Nerve agent poisoning

C/I:
Nil in the above indication

How well did you know this?

Not at all

Perfectly

Ceftriaxone - I & C/I

I:
1 Suspected Meningococcal Septicaemia
2 Severe Sepsis (with medical consult)

C/I:
1 Hypersensitivity to cephalosporin antibiotics

How well did you know this?

Not at all

Perfectly

ICP - Clopidogrel - I & C/I

I:
1 Pts with STEMI who have been approved for thrombolysis

C/I:
1 Allergy to clopidogrel
2 Pts who are contraindicated as per the AT Reprofusion Checklist

How well did you know this?

Not at all

Perfectly

Dexamethasone - I & C/I

I:
1 Bronchospasm associated with acute respiratory distress not responsive to nebulised Salbutamol
2 Acute exacerbation of COPD
3 Suspected Croup
4 Severe COVID19

C/I:
Known hypersensitivity to dexamethasone or other corticosteroids

How well did you know this?

Not at all

Perfectly

Diazepam - I & C/I

I:
1 Pts with a SAT score >= +1

C/I:
1 Hypersensitivity to diazepam or other benzodiazepines
2 Myasthenia Gravis

How well did you know this?

Not at all

Perfectly

Droperidol - I & C/I

I:
1 Pts with a SAT score >= +2

C/I:
1 Known allergy or adverse reaction
2 Parkinson's Disease
3 Previous Hx dystonic reactions
4 Paeds <8

How well did you know this?

Not at all

Perfectly

ICP - Enoxaparin - I & C/I

I:
1 Pts with STEMI who have been approved for thrombolysis by AT Retrieval Consultant

C/I:
1 Allergy to Enoxaparin
2 Pts who are contraindicated as per the AT Reprofusion Checklist

How well did you know this?

Not at all

Perfectly

ICP - Ergometrine - I & C/I

I:
PPH or post-abortal haemorrhage greater than 600ml, and certain all foetuses have been delivered

C/I:
1 Known allergy
2 Past Hx of pre-eclampsia
3 Hypertension (BP >160)

How well did you know this?

Not at all

Perfectly

Fentanyl - I & C/I

I:
1 Pain Relief
2 Sedation to maintain intubation

C/I:
1 Hypersensitivity
2 Active Labour
3 Paeds <1 years
4 For IN use - Epistaxis or occluded nasal passages

How well did you know this?

Not at all

Perfectly

ICP - Frusemide - I & C/I

I:
Acute Left ventricular failure with evidence of fluid overload

C/I:
Nil in the above setting

How well did you know this?

Not at all

Perfectly

Glucagon - I & C/I

I:
Diabetic Hypoglycaemia (BGL <4mmol/L) in Pts unable to self administer oral glucose paste

C/I:
Nil in the above indication

How well did you know this?

Not at all

Perfectly

GTN - I & C/I

I:
1 Chest pain associated with ACS
2 Hypertension associated with ACS (SBP >160, DBP >100)
3 Left Ventricular Failure (pulmonary oedema)
4 Autonomic Dysreflexia

C/I:
1 Ventricular Tachycardia
2 Right Ventricular Infarct
3 HR >150 or <50 (excluding for Autonomic Dysreflexia)
4 BP less than 100mmHg
5 Use of Viagra in past 24hrs, or Cialis in the past 4/7
6 Hypersensitivity

ICP - Heparin - I & C/I

I:
1 Pts with STEMI who have been approved for thrombolysis by AT Retrieval Consultant

C/I:
1 Allergy to Heparin
2 Pts who are contraindicated as per the AT Reprofusion Checklist

Ibuprofen - I & C/I

I:
Mild to moderate pain due to acute inflammation and tissue injury.

C/I:
1 Heart failure / Cardiovascular disease (due to medications used to treat)
2 Pregnancy – third trimester
3 Patients taking anticoagulants (blood thinners)
4 Previous renal disease
5 Current bleed, GI bleeding or peptic ulcer
6 Severe renal impairment
7 Children < 3months

Ipratropium Bromide - I & C/I

Atrovent

I:
Severe respiratory distress with associated bronchospasm

C/I:
Known hypersensitivity to Atropine or its derivatives

ICP - Ketamine - I & C/I

I:
Enhanced pain relief in patients with borderline or inadequate perfusion associated with:
Uncontrolled MSK pain
Severe burns

C/I:
1 Known hypersensitivity
2 Paeds <1yr
3 Traumatic Head Injury
4 Hypertension (BP >180mmHg SYS, >100mmHg DIA)
5 Suspected ACS
6 Suspected heart failure
7 Known hydrocephalus or raised intraoccular pressure

Lignocaine Hydrochloride - I & C/I

I:
Diluent for Ceftriaxone for IM administration for suspected meningococcal disease

C/I:
1 Known hypersensitivity
2 Bradycardia with inadequate perfusion
3 Evidence of 2nd or 3rd degree heart block

ICP - Magnesium Sulphate - I & C/I

I:
1 Pts with severe asthma not responding to nebulised salbutamol
2 Torsardes de Pointes
3 Eclampsia
4 Pre-eclampsia (with medical consult)

C/I:
1 Known hypersensitivity
2 Heart Blocks
3 Impaired renal or hepatic function
4 Addison's Disease

Methoxyflurane - I & C/I

I:
Pain relief where narcotics are contraindicated or not appropriate

C/I:
1 Pre-existing renal disease or impairment
2 Family Hx of anaesthetic induced malignant hyperthermia
3 Concurrent Tetracycline antibiotics use
4 Exceeding dose more than 6mls in 24 hours OR 15mls in any 7 day period

Metoclopramide - I & C/I

Maxolon

I:
Nausea and vomiting associated with
1 Narcotics pain relief
2 Past Hx of migraines

C/I:
1 Known hypersensitivity
2 GIT haemorrhage, perforation or obstruction
3 Paeds <16yrs

Midazolam - I & C/I

I: 1 Continuous or recurrent Seizures ``` ICP 2 Severe Trauma or Severe Burns 3 Sedation to maintain intubation 4 Sedation to enable synchronized cardiversion 5 Sedation for agitated patients 6 Sedation for psychostimulant overdose ``` C/I: 1 Known hypersensitivity to benzodiazapines

Morphine - I & C/I

I: Pain relief Sedation to maintain intubation C/I: 1 Known hypersensitivity 2 Active Labour

Naloxone - I & C/I

I: Severe respiratory depression and altered conscious state secondary to narcotics or related drug use C/I: Nil in the in the above setting

Ondansatron - I & C/I

``` I: Nausea and vomiting associated with 1 Cardiac Chest Pain 2 Secondary to cytotoxic drugs or radiotherapy 3 Severe gastroenteritis 4 Previous Dx migraine Prophylaxis use in 1 Eye injuries 2 Suspected Spinal Injuries 3 Planned AMR transport 4 Motion sickness ``` C/I: 1 Known hypersensitivity 2 Paeds <2yrs

Oxygen - I & C/I

I: 1 Treatment of hypoxaemia/hypoxia 2 To assist with organ perfusion in patients with poor perfusion C/I: 1 Known paraquat posioning (herbicide) 2 Lung disease secondary to bleomycin therapy (cancer treatment)

Oxygen - Special Circumstances

All patients with suspected carbon monoxide poisoning, diving emergency or pneumothorax should be given high dose oxygen until arrival at hospital.

Paracetamol - I & C/I

I: Mild Pain ``` C/I: 1 Known hypersensitivity 2 Suspected cardiac chest pain (ACS) 3 Paeds <1 months age 4 Any previous dose in the past 4 hours OR more than 4g (60mg/kg paeds) in the past 24hrs ```

Prochlorperazine - I & C/I | Stemetil

I: Treatment or prophylaxis of N&V for 1 Motion sickness 2 Eye injuries 3 Planned AMR transport 4 Vertigo or N&V associated with migraine, labyrinthitis or Meniere's Synrome 5 Known allergy or contraindiction to Metoclopramide ``` C/I: 1 Circulatory collapse 2 CNS Depression 3 Previous hypersensitivity 4 Paeds <2years ```

Salbutamol - I & C/I

``` I: Respiratory distress with suspected brochospasm 1 Asthma 2 Allergic Reaction 3 COPD 4 smoke inhalation ``` C/I: Ni in the above indication

ICP - Sodium Bicarbonate - I & C/I

I: 1 Sympomatic TCA overdose or hyperkalaemia (peaked T waves) 2 Crush syndrome with evidence of hyperkalaemia 3 Cardiac arrest with suspected hyperkalaemia or TCA overdose C/I: Nil in the above indications

ICP - Tenecteplase - I & C/I

I: 1 Pts with STEMI who have been approved for thrombolysis by AT Retrieval Consultant C/I: 1 Allergy to Tenectaplase 2 Pts who are contraindicated as per the AT Reprofusion Checklist

ICP - Oxytocin - I & C/I

I: 1 Active management of third stage labour 2 Primary or Secondary Post-partum Haemorrhage C/I: 1 Known Allergy or hypersensitivity 2 Severe Toxaemia (pre-eclampsia) 3 Hypertonic uterine contractions 4 Cord Prolapse 5 Undelivered foetus

ICP - TXA - I & C/I

I: 1 Post partum haemorrhage blood loss unresponsive to other treatments C/I: 1 Active thromboembolic disease