Precautions

Question 1

Glyceryl Trinitrate

Answer 1

1. No previous administration
2. Elderly
3. Recent MI
4. Concurrent use with other tocolytics

Question 2

Methoxyflurane

Answer 2

1. Must be able to be hand held by patient (affects levels of consciousness)
2. pre-eclampsia
3. Concurrent use with oxytocin (may cause hypotension)

Question 3

Aspirin

Answer 3

1. Peptic ulcer
2. Asthma
3. Patients on anticoagulants

Question 4

Adrenaline

Answer 4

Reduced doses

1. Elderly/frail patients
2. Patients with cardiovascular disease
3. Patients on monoamine oxidase inhibitors
4. Higher doses may be required for patients on beta blockers

Question 5

Dexamethasone

Answer 5

1. Unclear or contaminated solutions should be discarded

Question 6

Fentanyl

Answer 6

1. Elderly/frail
2. Impaired hepatic function
3. Respiratory depression (COPD)
4. Current asthma
5. Patients on monoamine oxidase inhibitors
6. Known addiction to opioids
7. Rhinitis, rhinorrhea or facial trauma (IN route)

Question 7

Ipratropium Bromide

Answer 7

1. Glaucoma

2. Avoid contact with eyes

Question 8

Ketamine

Answer 8

1. May exacerbate cardiovascular conditions (uncontrolled hypertension, stroke, recent MI, cardiac failure) due to effects on HR and BP

Question 9

Midazolam

Answer 9

1. Reduced doses required for elderly/frail, chronic renal failure, CCF or shock
2. The CNS depressant effects of benzos are enhanced in the presence of narcotics and other tranquillisers including alcohol
3. Can cause severe respiratory depression in patients with COPD
4. Patients with myasthenia gravis

Question 10

Morphine

Answer 10

1. Elderly/frail
2. Hypotension
3. Respiratory depression
4. Current asthma
5. Respiratory tract burns
6. Known addiction to opioids
7. Acute alcoholism
8. Patients on monoamine oxidase inhibitors

Question 11

Naloxone

Answer 11

1. If pt is known to be physically dependent on opioids, be prepared for combativeness after administration
2. Neonates

Question 12

Olanzipine

Answer 12

1. May be less effective if patient agitation is due to drug intoxication (esp. stimulants) or alcohol withdrawal. Benzos are considered first line-agents in these patients
2. Elderly/frail patents and children are more susceptible to adverse affects.

Question 13

Ondansetron

Answer 13

1. Patients with liver disease should not receive more than 8mg of Ondansetron per day
2. Care should be taken with patients on diuretics who may have an underlying electrolyte imbalance
3. Ondansetron contains aspartame and should not be given to patients with phenylketonuria
4. Concurrent use of tramadol
5. Pregnancy

Question 14

Paracetamol

Answer 14

1. Impaired hepatic function or liver disease
2. Elderly/frail
3. Malnourished

Question 15

Prochlorperazine

Answer 15

1. Hypotension
2. Epilepsy
3. Pts affected by alcohol or on anti-depressants

Question 16

Salbutamol

Answer 16

1. Large doses of Salbutamol have been reported to cause intracellular metabolic acidosis

Question 17

Ceftriaxone

Answer 17

1. Allergy to penicillin anitbiotics

Question 18

Dextrose 10%, Glucagon

Answer 18

NIL

Question 19

Lidocaine

Answer 19

1. IM and local infiltration- inadvertent intravascular administration may result in systemic toxicity
2. IO- impaired CV function (hypotension, bradycardia, poor perfusion, heart block, heart failure)

Question 20

Oxytocin

Answer 20

1. If given IV may cause transient hypotension

2. Concurrent use with methoxy may cause hypotension