Precautions

Question 1

Precautions for Adrenaline (4)

Answer 1

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

Question 2

Precautions for Aspirin (3)

Answer 2

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

Question 3

Precaution for Ceftriaxone (1)

Answer 3

Allergy to Penicillin antibiotics

Question 4

Precautions for Fentanyl (7)

Answer 4

1. R- respiratory depression, e.g. COPD
2. E-elderly/frail pts
3. A- asthma
4. R- rhinitis, rhinorrhoea or facial trauma (IN route)
5. H- hepatic function (impaired)
6. A- addiction to opioids (known)
7. M- monoamine oxidase inhibitors (pts on)

Question 5

Precautions for GTN (4)

Answer 5

1. No previous admin
2. Elderly pts
3. Recent MI
4. Concurrent use with tocolytics

Question 6

Precautions for Ipratropium Bromide (2)

Answer 6

1. Glaucoma

2. Avoid contact with eyes

Question 7

Precautions for Ketamine (2)

Answer 7

1. Any condition where significant elevation of BP would be hazardous e.g.:
   - Hypertension
   - CVA
   - Recent MI
   - CCF
2. If being administered for analgesia, slow push over 1 min to minimise risk of respiratory depression and hypertension

Question 8

Precautions for Methoxyflurane (3)

Answer 8

1. Penthrox inhaler must be hand held by pt so if becomes unconscious it will fall from pts face. Occasionally operator may need to assist but must monitor level of consciousness.
2. Pre-eclampsia
3. Concurrent use with Ocytocin may cause hypotension

Question 9

Precautions for Midazolam (4)

Answer 9

1. Reduced doses may be required for the elderly/frail, pts with chronic renal failure, CCF or shock
2. The CNS depressant effects of benzodiazepines are enhanced in the presence of narcotics and other tranquillisers including alcohol
3. Can cause severe respiratory depression in pts with COPD
4. Pts with myasthenia gravis (further depletes muscle tone)

Question 10

Precautions for Misoprostol (1)

Answer 10

1. History of asthma

Question 11

Precautions for Morphine (8)

Answer 11

1. H- hypotension
2. A- acute alcoholism
3. R- respiratory depression
4. A- asthma (current)
5. A- addiction to opioids (known)
6. M- monoamine oxidase inhibitors (pts on)
7. B- burns (respiratory tract)
8. E- elderly/frail pts

Question 12

Precautions for Naloxone (2)

Answer 12

1. If pt is known to be physically repent on opioids, be prepared for a combative pt after admin
2. Neonates

Question 13

Precautions for Ondansetron (5)

Answer 13

1. Pts with liver disease should not be administered more than 8mg per day
2. Care should be taken with pts on diuretics who may have underlying electrolyte imbalance
3. Ondanestron contains aspartame and should not be given top pts with phenylketonuria
4. Concurrent use with Tramadol
5. Pregnancy

Question 14

Precautions for Paracetamol (3)

Answer 14

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

Question 15

Precautions for Stemetil (3)

Answer 15

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

Question 16

Precaution for Salbutamol (1)

Answer 16

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