Drug Indications & Contras

Adrenaline Indications

• Anaphylaxis

• Asthma (life threatening)

• Bradycardia with poor perfusion

• Cardiac arrest

• Croup (severe)

• Shock

• Orolingual oedema secondary to tPA infusion

Aspirin Contraindications

Nil

Aspirin Indications

ACS

Aspirin Contraindications

• Hypersensitivity to aspirin/ salicylates

• Actively bleeding peptic ulcers

• Bleeding disorders

• Suspected dissecting aortic aneurysm

• Chest pain associated with psychostimulant OD if SBP >160

Ceftriaxone Indications

• Meningococcal septicaemia

• Sepsis

  • Adults: transport time >60 mins

  • Paeds: consult only

Ceftriaxone Contraindications

• Cephalosporin allergy

• Preterm neonates

Dexamethasone Indications

• Anaphylaxis

  • Associated with bronchospasm

• Asthma

• COPD

• Covid

• Croup

• Non-foreign body obstruction stridor

Dexamethasone Contraindications

Nil

Droperidol Indications

Moderate agitation or behavioural disturbance

Droperidol Contraindications

Nil

Fentanyl Indications

• Analgesia

• Sedation to facilitate or maintain

  • Intubation

  • Transthoracic pacing

  • Synchronised cardioversion

Fentanyl Contraindications

• Serotonin toxicity

• MAOI use within 14 days

• Late 2nd stage labour

GTN Indications

• Chest pain in ACS

• Hypertension associated with acute coronary syndrome

• Acute cardiogenic APO

• Autonomic dysreflexia

• Preterm labour

GTN Contraindications

• BP <100

• HR >150

• HR <50 (except in autonomic dysreflexia)

• VT

• PDE5 inhibitors

• Riociguat

• Bleeding in pregnancy

Ipratropium Bromide Indications

• Anaphylaxis

  • Associated with bronchospasm

• Asthma

  • Severe

  • Life threatening

• COPD

Ipratropium Bromide Contraindications

Nil

Ketamine Indications

• Intubation

• Analgesia

• Sedation (Agitation & patient moving during CPR)

Ketamine Contraindications

Nil

Methoxyflurane Indications

Analgesia

Methoxyflurane Contraindications

• Pre existing renal disease

• Known (or genetic susceptibility) to malignant hyperthermia

1. Midazolam Indications

• Status epilepticus

• Acute behavioural disturbance

• Drug-induced hyperthermia

• Alcohol withdrawal syndrome

• Sedation to facilitate or maintain

  • Intubation

  • Transthoracic pacing

  • Synchronised cardioversion

Midazolam Contraindications

Benzodiazepine hypersensitivity

Morphine Indications

• Pain relief

• Sedation to maintain intubation

• Sedation to facilitate intubation (where fent not appropriate)

Morphine Contraindications

• Hypersensitivity

• Renal impairment/ failure

• Late 2nd stage labour

Olanzapine Indications

Mild agitation

Olanzapine Contraindications

Nil

Ondansetron Indications

• Undifferentiated nausea & vomiting

• Prophylaxis where vomiting could be clinically detrimental e.g. spinally immobilised, penetrating eye trauma

Ondansetron Contraindications

Apomorphine

Paracetamol Indications

• Mild pain, or pain relief combinations with other analgesics

• Headache

Paracetamol Contraindications

• Children <1 month of age

Prochlorperazine Indications

• Nausea & vomiting in patient >21 years of age, specifically for:

  • Known allergy or C/I to ondansetron

• Headache (irrespective of nausea/ vomiting)

Prochlorperazine Contraindications

• CNS depression

• Patients <21 years of age

Salbutamol Indications

• Anaphylaxis

  • Associated with bronchospasm

• Asthma

• COPD

• Hyperkalaemia

• Oleoresin capsicum spray exposure

  • Associated with bronchospasm

• Smoke inhalation

  • Associate with bronchospasm

Salbutamol Contraindications

Nil