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San Diego EMS Protocols 2019 > Medications (quick contraindication/side effect) > Flashcards

Medications (quick contraindication/side effect) Flashcards

1
Q

Acetaminophen

A

Contraindications:

  • <2 years of age
  • Severe hepatic impairment
  • Severe active liver disease
  • If known or suspected total dose exceeding 4000mg in a 24-hour period

Side Effects:

  • Nausea, vomiting
  • Headache, sleep problems
  • Constipation
  • Itching, agitation
  • Partial or total lung collapse in pediatric patients
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2
Q

Adenosine

A

Contraindications:

  • 2nd and 3rd degree AV heart blocks
  • Sick sinus syndrome (without pacemaker)

Side Effects:

  • SOB/Dyspnea; may cause bronchospasm in COPD patients (BHO)
  • Chest pressure/palpitations
  • Facial flushing/headache
  • Dizzy/lightheadedness
  • Nausea
  • Transient arrhythmias (PVC’s, PAC’s, sinus bradycardia, AV block, sinus tach, or asystole) These are generally not treated and are quickly self-limiting.
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3
Q

Albuterol

A

Contraindications:

  • None in adults
  • Peds: croup/stridor (nebulized saline/epinephrine is indicated)

Side Effects:

  • Tachycardia/palpitations
  • Dizziness, headache
  • Tremors, nervousness
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4
Q

Amiodorone Hydrochloride

A

Contraindications:

  • Hypotension
  • 2nd & 3rd degree heart blocks
  • Idioventricular rhythms
Side Effects:
-Hypotension
-Exacerbation of presenting arrhythmia
AFTER DAYS OF USE
-Liver injury
-Pulmonary injury: pulmonary infiltrates, bronchospasm, SOB cough, hemoptysis, hypoxia
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5
Q

Aspirin

A

Contraindications:
-None

Side Effects:

  • GI upset (indigestion, nausea/vomiting, epigastric pain, heartburn)
  • Occult or prolonged bleeding
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6
Q

Atropine Sulfate

A

Contraindications:
-Asystole

Side Effects:

  • Tachycardia/palpitations
  • Dry mouth/nausea/vomiting
  • Pupil dilation/blurred vision
  • Flushed/hot/dry skin
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7
Q

Atrovent

A

Contraindications:
-None

Side Effects:

  • Nervous/dizziness
  • Headache
  • Cough
  • Paradoxical bronchospasm
  • Palpitations
  • Blurred vision/eye irritation (with direct contact of mist)
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8
Q

Calcium Chloride

A

Contraindications:
-None

Side Effects:

  • Decreased heart rate (may cause asystole)
  • Hypotension
  • Syncope
  • Nausea/vomiting
  • Metallic taste
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9
Q

Charcoal

A

Contraindications:

  • Isolated alcohol
  • Heavy metal
  • Caustic agent
  • Hydrocarbons
  • Iron ingestion

Side Effects:

  • Nausea/vomiting
  • Consipation/diarrhea
  • Abdominal cramping
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10
Q

Dextrose (D50/D10)

A

Contraindications:
-None

Side Effects:

  • Local venous irritation/infection
  • Hyperglycemia
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11
Q

Diphenhydramine

A

Contraindications:
-None

Side Effects:

  • Drowsiness/sedation (excitement in children)
  • Dry mouth/thickened bronchial secretions
  • Hypotension
  • Palpitations/tachycardia
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12
Q

Dopamine Hydrochloride

A

Contraindications:
-None

Side Effects:

  • At high infusion rates, hypertension and extreme vasoconstriction may occur
  • At low infusion rates, hypotension may occur
  • Tachyarrhythmias/palpitations
  • Increased myocardial O2 demand
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13
Q

Epinephrine

A

Contraindications:
-None

Side Effects:

  • Anxiety/restlessness
  • Palpitations/tachyarrhythmias
  • Ventricular irritability
  • Increased myocardial O2 demands
  • Hypertension
  • Angina
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14
Q

Fentanyl Citrate (+BHPO criteria)

A

Contraindications:
-None

BHPO only:

  • Isolated head injuries
  • Acute onset severe headache
  • Drug/ETOH intoxication
  • Multiple trauma with GCS <15
  • Suspected active labor

Side Effects:

  • Respiratory depression/apnea
  • Decreased LOC
  • Transient hypotension
  • Nausea/vomiting/dizziness
  • Muscular rigidity
  • Bradycardia
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15
Q

Glucagon

A

Contraindications:
-None

Side Effects:

  • Nausea/vomiting
  • Tachycardia/HTN
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16
Q

Ketamine

A

Contraindications:

  • Pediatrics
  • Pregnancy
  • Severe hypertension
  • Alcohol intoxicated

Side Effects:
-Increased heart rate
-Increased blood pressure
-Increased respiratory rate
-Nausea
>With higher doses and rapid infusion (“disassociative effects”)
-Euphoria (pleasant: dream-like states, vivid imagery)
-Dysphoria (unpleasant: anxiety, disorientation, hallucinations)

17
Q

Lidocaine

A

Contraindications:

  • 2nd & 3rd degree heart block
  • Idioventricular rhythms

Side Effects: (Toxicity)
>Early >Late
-Anxiety -Seizure
-Euphoria -Decreased BP
-Combative -Coma
-Nausea -Widening QRS
-Twitching -Prolonged PRI
-Numbness -V-Fib

18
Q

Midazolam

A

Contraindications:
-None

Side Effects:
-Respiratory depression/apnea

19
Q

Morphine Sulfate (+BHPO criteria)

A

Contraindications:
-None

BHPO only:

  • Isolated head injuries
  • Acute onset severe headache
  • Drug/ETOH intoxication
  • Multiple trauma with GCS <15
  • Suspected active labor

Side Effects:

  • Respiratory depression/apnea
  • Decreased LOC
  • Transient hypotension
  • Nausea/vomiting
  • Pinpoint pupils
20
Q

Naloxone

A

Contraindications:
-None

Side Effects:

  • Acute withdrawal symptoms
  • Nausea/vomiting
  • Tachycardia/hypertension
21
Q

Nitroglycerin

A

Contraindications:

  • Patient who has taken a sexual enhancement medication such as Viagra, Cialis, Levitra within 48 hours
  • Patients taking medication for pulmonary hypertension, usually Sildenafil (trade names: Revatio, Flolan, and Veletri)

Side Effects:

  • Orthostatic hypotension
  • Dizziness/syncope
  • Temporary pulsating headache
  • Facial flushing
22
Q

Normal Saline

A

Contraindications:
-Rales (exception for sepsis S-143)

Side Effects:
-None

23
Q

Ondansetron

A

Contraindications:
-None

Side Effects:

  • GI symptoms, especially diarrhea
  • Headache
24
Q

Sodium Bicarbonate

A

Contraindications:
-None

Side Effects:
-Electrolyte/pH imbalances

San Diego EMS Protocols 2019 (7 decks)

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