Precautions Flashcards
Adrenaline (epinephrine)
Hypertension
Hypovolaemic shock
Concurrent MAOI therapy
Quetiapine toxicity
Amiodarone
For patients who are in cardiac arrest: Nil
For patients with sustained conscious VT (haemodynamically stable): Hypotension
Aspirin
Possible aortic aneurysm or any other condition that may require surgery
Pregnancy
History of GI bleeding or peptic ulcers
Box jellyfish antivenom
The antivenom is a foreign protein, which can cause sensitization, allergic reaction or anaphylaxis
Ceftriaxone
Any allergy or hypersensitivity to penicillin or carbapenem - isolated minor drug attributed to penicillin does not contraindicate the use of ceftriaxone
Clopidogrel
Severe renal impairment
Dexamethasone
Nil in this setting
Droperidol
Hypoperfused state
Concurrent use of CNS depressants
Enoxaparin
Renal/hepatic impairment
Low bodyweight (women <45 kg and men <57 kg)
Older people
Fentanyl
Hypotension
Respiratory tract burns
Respiratory depression and/or failure
Known addiction to narcotics
Current MAOI therapy
Glucagon
Nil
Glucose gel
Nil
Glucose 10%
Hyperglycaemia
Glyceryl trinitrate
Inferior AMI
Cerebral vascular disease
Risk of hypotension and/or syncope
Intoxication (GTN effects are enhanced)
Phosphodiesterase 5 inhibitor medication administration (e.g. tadalafil, sildenafil. vardenafil) in the previous 4 days
Heparin
Renal impairment
Hydrocortisone
Hypertension
Hydroxocobalamin
Hypertension (substantial increases in blood pressure may occur following hydroxocobalamin therapy)
Pregnancy (There are no adequate and well-controlled studies of hydroxocobalamin administration in pregnant women. Hydroxocobalamin should be used during pregnancy ONLY if the potential benefits justifies the potential risk to the fetus
Ibuprofen
Asthma
Hepatic dysfunction
History of GI bleeding or peptic ulcers
Influenza vaccine
Nil
Ipratropium bromide
Glaucoma
Loratadine
Severe hepatic impairment
Increased risk of sedation and anticholinergic effects in older people
Magnesium sulphate
Renal impairment
Methoxyflurane
ALOC
Intoxicated or drug affected patients
Cardiovascular instability
Respiratory depression
Midazolam
Reduced dosages must be considered in :
- Low body weight, older, cachectic or frail patients
- Patients with chronic renal failure, congestive cardiac failure or shock
Can cause severe respiratory depression in patients with COPD
Myasthenia gravis
Multiple sclerosis
Morphine
Hypotension
Respiratory tract burns
Respiratory depression and/or failure
Known addiction to narcotics
Concurrent MAOI therapy
Cardiac chest pain
Naloxone
Use with caution on patients with pre-existing cardiac disease
Ondansetron
Hepatic impairment
Elderly patients
Intestinal obstruction
Patients with risk factors for QT interval prolongation or cardiac arrhythmias
Oxygen
Patients with paraquat poisoning or bleomycin lung injury may be harmed by supplemental oxygen. Avoid oxygen unless the patient is hypoxaemic - target 88-92%
Prolonged administration to premature neonates
Newly born infants will have low Sp02 for the first 10 minutes following birth - refer to CPG: Resuscitation - Newly born.
Patients with cyanotic heart disease may have saturation targets between 75% to 85%. Clinicians should attempt to ascertain optimal target saturation levels for these patients from carers or health professional.
A BVM will not supply adequate oxygen unless IPPV is provided
The use of high flow oxygen in an attempt to protect against subsequent hypoxaemia in the event of deterioration has the potential to delay the recognition of such a deterioration. This may provide a false reassurance that the patient is stable.
Oxytocin
Myocardial ischaemia
May potentiate hypotension when administered with analgesia
Paracetamol
Hepatic dysfunction
Soluble tablets:
- Patients with sodium restriction (heart failure, chronic kidney disease)
- Phenylketonuria
Salbutamol
Acute pulmonary oedema
Ischaemic heart disease
Sodium chloride 0.9%
Patients with acute and/or history of heart failure
Pre-existing renal failure
Uncontrolled haemorrhage (unless associated with severe head injury)
Sucrose 24%
Nil
Tenecteplase
Nil
Ticagrelor
Concurrent medication known to induce bradycardia (e.g. beta blockers, calcium channel blockers, digoxin)
Symptomatic bradycardia (HR less than 60)
Tranexamic acid
Nil
Water for injection
Nil
