Medication Indications and Contraindication Flashcards
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)
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
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
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
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
Ceftriaxone - I & C/I
I:
1 Suspected Meningococcal Septicaemia
2 Severe Sepsis (with medical consult)
C/I:
1 Hypersensitivity to cephalosporin antibiotics
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
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
Diazepam - I & C/I
I:
1 Pts with a SAT score >= +1
C/I:
1 Hypersensitivity to diazepam or other benzodiazepines
2 Myasthenia Gravis
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
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
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)
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
ICP - Frusemide - I & C/I
I:
Acute Left ventricular failure with evidence of fluid overload
C/I:
Nil in the above setting
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
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
