Precautions

Question 1

Adrenaline

Answer 1

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 2

Aspirin

Answer 2

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

Question 3

Dexamethasone

Answer 3

1. Solutions which are not clear or are contaminated should be discarded

Question 4

Fentanyl

Answer 4

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

Question 5

Glucagon

Answer 5

1. Nil of significance in the above indication

Question 6

GTN

Answer 6

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

Question 7

Ipratropium Bromide

Answer 7

1. Glaucoma

2. Avoid contact with eyes

Question 8

Methoxyf lurane

Answer 8

1. The Penthrox™ inhaler must be hand-held by the patients so that if
   unconsciousness occurs it will fall from the patient’s face. Occasionally
   the operator may need to assist but must continuously assess the level of
   consciousness
2. Pre-eclampsia
3. Concurrent use with Oxytocin may cause hypotension

Question 9

Midazolam

Answer 9

1. Reduced doses may be required for the elderly/frail, patients 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 patients with COPD
4. Patients with myasthenia gravis

Question 10

Morphine

Answer 10

1. Elderly/frail patients
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 patient is known to be physically dependent on opioids, be prepared for a
   combative patient after administration
2. Neonates

Question 12

Ondansetron

Answer 12

1. Patients with liver disease should not receive more than 8 mg 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 13

Paracetamol

Answer 13

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

Question 14

Prochlorperazine (Stemetil)

Answer 14

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

Question 15

Salbutamol

Answer 15

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