DTPs

Question 1

Adenosine Contraindications

Answer 1

1. Hx 2nd or 3rd degree AV block or sick sinus syndrome (except with functioning artificial pacemaker)
2. Sinus node disease
3. Chronic obstructive lung disease (asthma)
4. Known hypersensitivity

Question 2

Adenosine Precautions

Answer 2

1. Current dipyramole therapy
2. Pts on carbamazepine
   Other:
   - Heart transplant pts (1/2 doses)
   - Significant caffeine (may need higher doses)

Question 3

Adrenaline Contraindications

Answer 3

1. Hypovolaemic shock without adequate fluid replacement

Question 4

Adrenaline Precautions

Answer 4

1. Elderly patients
2. Patients with cardiovascular disease
3. Patients on monoamine oxidase (MOA) inhibitors
4. Patients on beta blockers may require higher doses of

Question 5

Amiodarone Contraindications

Answer 5

1. VT
   - inadequate perfusion and rapidly deteriorating
   - pregnancy
2. Known hypersensitivity to amiodarone or iodine
3. TCA overdose

Question 6

Adenosine Precautions

Answer 6

1. Nil of significance in above conditions

Question 7

Aspirin Contraindications

Answer 7

1. Hypersensitivity to aspirin/salicylates
2. Actively bleeding peptic ulcers
3. Bleeding disorders
4. Suspected dissecting AAA
5. Chest pain associated with psychostimulant OD if Bp >160

Question 8

Aspirin Precautions

Answer 8

1. Peptic ulcers
2. Asthma
3. Patients on anti-coagulants

Question 9

Atropine Contraindications

Answer 9

1. Nil of significance in above indications

Question 10

Atropine Precautions

Answer 10

1. Atrial flutter
2. Atrial fibrillation
3. Glaucoma
4. Do not increase heart rate above 100/min (except in children <6y/o)

Question 11

Ceftriaxone Contraindications

Answer 11

1. Known allergy to cephalosporin antibiotics

Question 12

Ceftriaxone Precautions

Answer 12

1. Allergy to penicillin antibiotcs

Question 13

Clopidogrel Contraindications

Answer 13

1. Allergy to clopidogrel
2. Patients who are contraindicated as per Ambulance Tasmania repercussion checklist

Question 14

Clopidogrel Precautions

Answer 14

1. Renal impairment

Question 15

Dexamethasone Contraindications

Answer 15

1. Known hypersensitivity to dexamethasone or other corticosteroids

Question 16

Dexamethasone Precautions

Answer 16

1. Usually only relevant with prolonged use and high doses

Question 17

Diazepam Contraindications

Answer 17

1. Known allergy/adverse reaction to benzodiazepines
2. Myasthenia gravis

Question 18

Diazepam Precautions

Answer 18

1. Hypotension
2. Use in children and elderly
3. Impaired renal or hepatic function
4. Respiratory insufficiency
5. CNS depression or agents including alcohol

Question 19

Ketamine Contraindications

Answer 19

1. Age <1y/o
2. Traumatic Brain Injury (TBI)
3. Hypertension SBp >160 or DBp >100
4. Known hydrocephalus or raised intraoccular pressure
5. Suspected ACS
6. Suspected heart failure
7. Known hypersensitivity

Question 20

Ketamine Precautions

Answer 20

1. Age >60y/o
2. Complex facial fractures or injuries
3. Globe injuries
4. Severe hypovolaemia
5. Impaired respiratory function
6. Acute psychosis symptoms
7. CNS depression/concurrent midazolam

Question 21

Sodium Bicarbonate Contraindications

Answer 21

1. Nil of significance in above indication

Question 22

Sodium Bicarbonate Precautions

Answer 22

1. Administration must be accompanied by effective ventilation and external cardiac compression if required
2. Can cause tissue necrosis, avoid extravasation
3. Because of high pH, do not mix or flush any other drug or solution with sodium bicarbonate

Question 23

Midazolam Contraindications

Answer 23

1. Known hypersensitivity to benzodiazepines

Question 24

Midazolam Precautions

Answer 24

1. Reduced doses may be required for elderly, chronic renal failure, CCF, or shock
2. CNS depressant effects enhanced with narcotics/alcohol
3. Can cause severe respiratory depression in COPD patients
4. Patients with myasthenia gravis