Precautions-Table 1

Question 1

Question

Answer 1

Answer

Question 2

Oxygen

Answer 2

Use caution with COPD patients; Monitor long-term high concentrations in neonates as retronatal fibroplasia may develop; open flames

Question 3

Diazepam (Valium)

Answer 3

Can cause local irritation, therefore, use large vein when possible. seizure activity may reoccur due to its lipid solubility; use with caution in patients with myasthenia gravis, impaired renal or hepatic function, obstetrical patients and the elderly.

Question 4

Lorazepam (Ativan)

Answer 4

Hypersensitivity to benzodiazepines, acute narrow-angle glaucoma, coma, shock acute alcohol intoxication

Question 5

Midazolam (Versed)

Answer 5

Hypersensitivity to Benzodiazapines, acute narrow-angle glaucoma, coma shock, and acute alcohol intoxication.

Question 6

Succinylcholine (Anectine)

Answer 6

Never paralyze without adequate sedation

Question 7

Epinephrine (Adrenalin)

Answer 7

Protect from Light; Can be deactivated by sodium bicarbonate, flush IV line between administration of EPI and bicarb, Effects can be intensified by antidepressants

Question 8

Vasopressin (Pitressin)

Answer 8

Use with caution in patients with epilepsy, migraine, asthma, heart failure, or angina pectoris

Question 9

Lidocaine (Xylocaine)

Answer 9

CNS depression may occur in doses greater than 300mg/hr liver or renal disease, CHF, hypovolemia, shock, myasthenia gravis

Question 10

Amiodarone (Cordarone)

Answer 10

Use with caution in severe liver disease, pregnancy, nursing mothers

Question 11

Atropine Sulfate

Answer 11

May worsen bradycardia associated with 2nd Degree Mobitz II and 3rd Degree AV block thus consider TCP first. Use with caution in patients with signs and symptoms of acute myocardial ischemia, myocardial infarction, glaucoma.

Question 12

Adenosine (adenocard)

Answer 12

Place patient in semi-Fowler position as patients will typically develop arrhythmias at the time of conversion. Use cautiously in patients with asthma.

Question 13

Diltiazem (Cardizem)

Answer 13

Avoid patients receiving oral beta-blockers; Monitor for hypotension resulting from peripheral vasodilation. Use with cation in CHF

Question 14

Metoprolol (Lopressor, Toprol-XL)

Answer 14

Impaired hepatic or renal function, CHF controlled by digitalis or diuretics, do not mix with IV calcium channel blockers.

Question 15

Dopamine (Intropin)

Answer 15

In doses 20 mcg/kg/min or greater, its alpha effects dominates and it causes severe vasoconstriction. Monitor BP q 3-5 minutes. Can be deactivated by sodium bicarbonate.

Question 16

Dobutamine (dobutrex)

Answer 16

Can increase myocardial oxygen demand. Can be deactivated by sodium bicarbonate. Preexisting HTN or A-Fib. Hypotension from hypovolemia; always try volume restoration first.

Question 17

Aspirin

Answer 17

Peptic ulcer disease, asthma

Question 18

Nitroglycerin (Nitrostat, Nitro-Bid, Tridil)

Answer 18

Protect from light and air; Monitor vitals closely as it may cause orthostatic hypotension. Phosphodiesterase-type 5 (PDE-5) inhibitors: Viagra (sildenafil), Cialis (Tadalafil), Levitra (Vardenafil)

Question 19

Sodium Bicarbonate (NaHCO3)

Answer 19

Not recommended for routine use in cardiac arrest; Dosage must be specific to prevent metabolic alkalosis and is thus weight-based.

Question 20

Magnesium Sulfate

Answer 20

Renal Failure, patients taking digoxin, concomitant used of other CNS depressants or neuromuscular blocking agents.

Question 21

Oxytocin (Pitocin)

Answer 21

Can cause over stimulation of the uterus resulting in uterine rupture thus vitals and uterine tone should be mentioned.

Question 22

Albuterol (Proventil, Ventolin)

Answer 22

Consider monitoring peak expiratory flow rates (PEFR) monitor vitals and respiratory status during treatments.

Question 23

Ipratropium Bromide (Atrovent)

Answer 23

Use with caution in pregnancy and lactation

Question 24

Methylprednisolone

Answer 24

Paitients with peptic ulcer disease, CHF and TB

Question 25

50% Dextrose in Water D50W

Answer 25

Use with caution in patients with increasing ICP as added glucose may worsen the cerebral edema. Consider blood glucose monitoring before and after administration. Monitor for localized venous irritation.

Question 26

Glucagon (GlucaGen)

Answer 26

Glucagon is only effective if there are sufficient stores of glycogen in the liver.

Question 27

Diphenhydramine (Benadryl)

Answer 27

Not considered a primary drug for the treatment of severe allergic reactions or anaphylaxis. Use with caution if the patient has narrow-angle glaucoma.

Question 28

Haloperidol (haldol)

Answer 28

History of seizures, parkinson’s disease

Question 29

Naloxone (narcan)

Answer 29

Use Caution on narcotic physically-dependant patients as naloxone can cause abrupt reversal of narcotic effects.

Question 30

Furosemide (Lasix)

Answer 30

Usage in pregnancy should be limited to life-threatening situations as furosemide may cause fatal abnormalities. Protect from light. Renal or hepatic insufficiencies

Question 31

CyanoKit (hydroxocobalamin)

Answer 31

Transient severe hypertension secondary to infusion.

Question 32

Calcium Chloride

Answer 32

Flush IV line between calcium chloride and bicarbonate use as precipitate will form. Monitor for tissue necrosis at injection site.

Question 33

Activated Charcoal (Actidose)

Answer 33

Protect airway and monitor mental status and vitals. Use caution in patients with an altered mental status unless nasogastric tube is in place and airway is protected.

Question 34

Morphine Sulfate

Answer 34

Administer slowly and titrate to effect; undiagnosed abdominal injury.

Question 35

Fentanyl Citrate

Answer 35

Increased ICP, severe respiratory disorders, hypotension, bradydysrhythmias

Question 36

Ketorolac (Toradol)

Answer 36

Use cautiously with CHF and cirrhosis patients due to renal failure.

Question 37

Acetaminophen (Tylenol, APAP)

Answer 37

Anemia, hepatic and renal disease, alcoholism

Question 38

Ibuprofen

Answer 38

Pregnancy, peptic ulcer disease, pulmonary edema, HTN

Question 39

Procainamide

Answer 39

Do not administer for PVC’s associated with bradycardia, hypotension, CHF, MI, Hepatic or renal insufficiency.