Term
| 2006 ACLS Contraindications to Oxygen. |
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Definition
-Observe closely when using with pulmonary patients known to be dependent on hypoxic respiratory drive (very rare).
-Pulse oximetry may be inaccurate in low cardiac output states, with vasoconstriction, or with carbon monoxide exposure. |
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Term
| 2006 ACLS Contraindications to Epinephrine. |
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Definition
-Raising blood pressure and increasing heart rate may cause myocardial ischemia, angina, and increased myocardial oxygen demand.
-High doses do not improve survival or neurologic outcome and may contribute to postresuscitation myocardial dysfunction.
-Higher doses May be required to treat poison/drug induced shock. |
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Term
| 2006 ACLS Contraindications to Atropine. |
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Definition
-Use with caution in presence of myocardial ischemia and hypoxia. Increases myocardial oxygen demand.
-Avoid in hypothermic bradycardia.
-Will not be effective for infranodal (type II) AV block and new third-degree block with wide QRS complexes. (In these patients may cause paradoxical slowing. Be prepared to pace or give catecholamines.)
-Doses of atropine <0.5 mg may result in paradoxical slowing of heart rate. |
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Term
| 2006 ACLS Contraindications to Lidocaine. |
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Definition
-Prophylactic use in AMI is contraindicated.
-Reduce maintenance dose (not loading dose) in presence of impaired liver function or left ventricular dysfunction.
-Discontinue infusion immediately if signs of toxicity develop. |
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Term
| 2006 ACLS Contraindications to Procainamide. |
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Definition
-If cardiac or renal dysfunction is present, reduce maximum total dose to 12 mg/kg and maintenance infusion to 1 to 2 mg/min.
-Proarrhythmic, especially in setting of AMI, hypokalemia, or hypomagnesemia.
-May induce hypotension inpatients with impaired LV function.
-Use with caution with other drugs that prolong QT interval. Expert consultation advised. |
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Term
| 2006 ACLS Contraindications to Vasopressin. |
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Definition
-Potent peripheral vasoconstrictor. Increased peripheral vascular resistance may provoke cardiac ischemia and angina.
-Not recommended for responsive patients with coronary artery disease |
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Term
| 2006 ACLS Contraindications to Adenosine. |
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Definition
| Poison/drug-induced tachycardia or second- or third-degree heartblock |
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Term
| 2006 ACLS Contraindications to Magnesium. |
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Definition
-Occasional fall in blood pressure with rapid admnistration.
-Use with caution if renal failure is present. |
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Term
| 2006 ACLS Contraindications to Sodium Bicarbonate. |
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Definition
-Adequate ventilation and CPR, not bicarbonate, are the major “buffer agents” in cardiac arrest.
-Not recommended for routine use in cardiac arrest patients. |
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Term
| 2006 ACLS Contraindications to Morphine. |
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Definition
-Administer slowly and titrate to effect
-May cause respiratory depression
-Causes hypotension in volume-depleted patients
-Use with caution in right ventricular infarction
-May reverse with naloxone (0.4 to 2 mg IV) |
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Term
| 2006 ACLS Contraindications to Norepinephrine. |
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Definition
-Increases myocardial oxygen requirements, raises blood pressure and heart rate.
-May induce arrhythmias. Use with caution in patients with acute ischemia, monitor cardiac output.
-Extravasation causes tissue necrosis.
-If extravasation occurs administer phentolamine 5 to 10 mg in 10 to 15 mL saline solution, infiltrated into area. |
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Term
| 2006 ACLS Contraindications to Dopamine. |
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Definition
-Correct hypovolemia with volume replacement before initiating dopamine.
-Use with caution in cardiogenic shock with accompanying CHF. |
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Term
| 2006 ACLS Contraindications to Dobutamine. |
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Definition
-Contraindication: Suspected or known poison/drug induced shock.
-Avoid with systolic blood pressure < 100 mmHg and signs of shock.
-May cause tachyarrhythmias, fluctuations in blood pressure, headache, and nausea.
-Do not mix with sodium bicarbonate. |
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Term
| 2006 ACLS Contraindications to Isoproterenol. |
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Definition
-Do not use for treatment of cardiac arrest.
-Increases myocardial oxygen requirements, which may increase myocardial ischemia.
-Do not give with epinephrine; can cause VF/VT
-Do not give to patients with poison/drug induced shock (except for B-blocker poisoning)
-May use higher doses for B-blocker poisoning |
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Term
| 2006 ACLS Contraindications to Nitroglycerin. |
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Definition
-Hypotension (SBP <90 mmHg or more than 30 mmHg below baseline)
-Severe bradycardia (<50 bpm) or tachycardia (>100 bpm)
-RV infarction
-Use of phosphodiesterase inhibitors for erectile dysfunction (eg sildenafil and vardenafil within 24 hrs; tadalafil within 48 hours) |
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Term
| 2006 ACLS Contraindications to Furosemide. |
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Definition
-Dehydration
-Hypovolemia
-Hypotension
-Hypokalemia
-Or other electrolyte imbalance may occur. |
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Term
| 2006 ACLS Contraindications to Tissue Plasminogen Activator. |
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Definition
-Active internal bleeding (except menses) within 21 days
-History of cerebrovascular, intracranial, or intraspinal event within 3 months (stroke, arteriovenous malformation, neoplasm, aneurysm, recent trauma, recent surgery).
-Major surgery or serious trauma within 14 days.
-Aortic dissection
-Severe, uncontrolled hypertension
-Known bleeding disorders
-Prolonged CPR with evidence of thoracic trauma
-Lumbar puncture within 7 days
-Recent arterial puncture at noncompressible site.
-During the first 24 hours of fibrinolytic therapy for ischemic stroke do not administer aspirin or heparin. |
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Term
| 2006 ACLS Contraindications to Nitroprusside. |
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Definition
-May cause hypotension, thiocyanate toxicity, and CO2 retention.
-May reverse hypoxic pulmonary vasoconstriction in patients with pulmonary disease, exacerbating intrapulmonary shunting, resulting in hypoxemia.
-Other side effects include headaches, nausea, vomiting, and abdominal cramps.
-Caution with posphodiesterase inhibitors (eg sildenafil) |
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