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Drugs > Precautions > Flashcards

Precautions Flashcards

1
Q

Ceftriaxone
precautions

A

allergy to penicillin antibiotics

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2
Q

Midazolam
precautions

A
  • Reduced doses may be required for the elderly/frail, patients with chronic renal failure, CCF (congestive cardiac failure), or shock
  • The CNS depressant effects of benzodiazepines are enhanced in the presence of narcotics and other tranquillisers including alcohol
  • Can cause severe respiratory depression in patients with COPD
  • Patients with myasthenia gravis
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3
Q

Salbutamol
precautions

A

large doses of salbutamol have been reported to cause intracellular metabolic acidosis

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4
Q

Prochlorperazine
precautions

A
  • Elderly patients (more susceptible to adverse effects)
  • Parkinson’s disease (can worsen symptoms of Parkinson’s disease, avoid if possible)
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5
Q

Paracetamol
precautions

A
  • Hepatotoxicity can occur with overdose (do not administer if already had within the past 4 hours, or if total [aracetamol intake within the past 24 hours exceeds 4g (adults) or 60mg/kg (children)

The risk of hepatoxicity (implies chemical-driven liver damage)
- impaired hepatic (liver) function or liver disease
- elderly/frail patients
- malnourishment

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6
Q

Ondansetron
precautions

A
  • pregnancy 1st trimester - consult with receiving hospital
  • congenital (a disease or physical abnormality present from birth) long QT syndrome - causes QT prolongation and increases the risk of Torsades de pointes in patients with a prolonged ST interval
  • Severe hepatic disease (liver disease) - limit total daily dose to a maximum of 8mg
  • Ondansetron ODT may contain aspartame which should be avoided in patients with phenylketonuria (PKU)
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7
Q

normal saline
precautions

A

none

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8
Q

Naloxone
precautions

A
  • If the patient is known to be physically dependent on opioids, be prepared for a combative patient after administration
  • neonates (a newborn child)
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9
Q

Morphine
precautions

A
  • elderly/frail patients
  • hypotension
  • respiratory depression
  • current asthma
  • respiratory tract burns
  • known addiction to opioids
  • acute alcoholism
  • patients on monoamine oxidase inhibitors
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10
Q

Methoxyflurane
precautions

A
  • patients should not be administered > 6mL of Methoxyflurane in 24 hours, due to increased nephrotoxicity
  • to limit occupational exposure, Methoxyflurane should not be administered in a confined space. Ensure adequate ventilation in an ambulance. Place used penthrox inhalers in a closed plastic bag when not in use.
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11
Q

Ketamine
precautions

A

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

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12
Q

Ipratropium Bromide
precautions

A
  • glaucoma
  • avoid contact with eyes
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13
Q

Glyceryl Trinitrate
Precautions

A
  • use lower doses (e.g. 300 mcg) in patients who are elderly (age > 60), have no previous exposure to GTN, or with recent MI, as they may be more susceptible to adverse effects
  • right ventricular MI or inferior STEMI with systolic BP < 160 mmHg - use cautiously due to the risk of severe hypotension from preload reduction
  • preterm labour - concurrent use with other tocolytics
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14
Q

Dextrose 10%
Precautions

A

none

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15
Q

Dexamethasone
Precautions

A

Solutions that are not clear or are contaminated should be discarded

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16
Q

Fentanyl
Precautions

A
  • Elderly/frail patients
  • Impaired hepatic function
  • Respiratory depression, e.g. COPD
  • Current asthma
  • Patients on monoamine oxidase inhibitors
  • Known addiction to opioids
  • Rhinitis, rhinorrhea, or facial trauma (IN rout)
17
Q

Aspirin
Precautions

A
  • Peptic ulcer
  • Asthma
  • Patients on anticoagulants
18
Q

Adrenaline
Precautions

A
  • Elderly/frail patients
  • Patients with cardiovascular disease
  • Patients on monoamine oxidase inhibitors
  • High doses may be required for patients on beta blockers
19
Q

Olanzapine
Precautions

A
  • maybe less effective if patient agitation is due to drug intoxication (especially stimulants) or alcohol withdrawal. Benzodiazepines are considered first-line agents in these patients
  • elderly/frail patients and children are more susceptible to adverse effects
20
Q

Lidocaine
Precautions

A
  • IM and local infiltration - inadvertent intravascular administration may result in systemic toxicity (see below)
  • IO - impaired CV function )e.g. hypotension, bradycardia, poor perfusion, heart block, heart failure)
21
Q

Heparin
Precautions

A

Renal impairment

22
Q

Oxytocin
precautions

A

none

23
Q

Tenecteplase
Precautions

A
  • Age ≥ 75 years
  • non-compressible vascular puncture
  • history of liver disease
  • SBP >160 mmHg or DBP >110 mmHg
  • Low body weight
  • Active peptic ulcer
  • Anaemia
  • Acute pericarditis or subacute bacterial endocarditis
  • Traumatic or prolonged (>10 mins) CPR
  • Pregnant or within 1 week post-partum
  • HR >120 bpm
24
Q

Droperidol
Precautions

A
  • Elderly/frail patients are more susceptible to adverse effects
  • Parkinson’s disease (may experience worsening of symptoms
  • Lewy body dementia (may experience increased agitation)
  • QT prolongation has been reported rarely (possibly providing ECG monitoring after sedation has been achieved)

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