Top 200 Drug Podcasts - Set 4 - Contraindications

Front 1

Hydrocodone/APAP

Back 1

CNS Depression

Front 2

Atrovastatin

Back 2

1) Active Liver Disease (elevated LFTs (ALT/AST))
2) Pregnancy
3) Breastfeeding

Front 3

Levothyroxine

Back 3

1) Untreated Thyrotoxicosis
2) Untreated Adrenal Insufficiency

Front 4

Lisinopril

Back 4

1) HX of Angioedema
2) Pregnancy
3) Bilateral Renal Artery Stenosis

Front 5

Amoxicillin

Back 5

Hypersensitivity to amoxicillin, penicillin, or other beta lactams

Front 6

Esomeprazole

Back 6

Only Hypersensitivity

Front 7

Clopidogrel

Back 7

1) Active Bleeding
2) Intracranial Bleeding

Front 8

Metoprolol Tartrate

Back 8

1) Bradycardia (HR < 45 bpm)
2) Systolic BP < 100 mmHg
3) 2nd or 3rd Degree Heart Block
4) Cardiogenic Shock
5) Pheochromocytoma (as monotherapy / w/o alpha blockers)

Front 9

Montelukast

Back 9

Only Hypersensitivity

Front 10

Escitalopram

Back 10

1) Concurrent use or use within 2 wks of MAO inhibitors, such as phenelzine, tranylcypromine, and isoprocarboxazid, is contraindicated w/ all SSRIs.
2) Concurrent use of escitalopram w/ pimozide is contraindicated.

Front 11

Albuterol Inhaler

Back 11

Only Hypersensitivity

Front 12

Simvastatin

Back 12

1) Active Liver Disease (elevated LFTs (ALT/AST))
2) Pregnancy
3) Breastfeeding
4) Concomitant use w/ strong 3A4 inhibitors

Front 13

Amlodipine

Back 13

Only Hypersensitivity

Front 14

Azithromycin

Back 14

1) Hypersensitivity to azithromycin or any macrolide antibiotic.
2) Concurrent use w/ cisapride, dronedarone, phenothiazines (mesordazine, thioridazine, etc.), and pimozide is contraindicated.

Front 15

Metformin

Back 15

1) Renal dysfunction (SCr less than or equal to 1.5 mg/dL in men or 1.4 mg/dL in women) and 2) metabolic acidosis (including diabetic ketoacidosis) are both contraindications.
3) Hepatic dysfunction is a relative contraindication.
4) If patient is undergoing radiologic studies involving iodine contrast dyes, then temporarily discontinue metformin 2 days before and after.

Front 16

Metoprolol Succinate

Back 16

1) Bradycardia (HR < 45 bpm)
2) Systolic BP < 100 mmHg
3) 2nd or 3rd Degree Heart Block
4) Cardiogenic Shock
5) Pheochromocytoma (as monotherapy / w/o alpha blockers)

Front 17

Hydrochlorothiazide

Back 17

1) Anuria
2) Concurrent use w/ dofetilide

Front 18

Rosuvastatin

Back 18

1) Active Liver Disease (elevated LFTs (ALT/AST))
2) Pregnancy
3) Breastfeeding

Front 19

Furosemide

Back 19

Anuria

Front 20

Warfarin

Back 20

1) Active bleeding or increased bleeding risk
2) Pregnancy
3) Eclampsia or Pre-Eclampsia
4) Malignant HTN
5) Inadequate Mental State (not able to keep appointments for INR check)
6) Recent Major Surgeries
7) Spinal Puncture

Front 21

Fluticasone & Salmeterol

Back 21

1) Contraindicated for acute asthma or COPD episodes. Patients should use a short acting bronchodilator, such as ProAir HFA, instead.
2) Advair diskus is also contraindicated if the patient has a severe hypersensitivity to milk proteins (b/c the diskus contains lactose).
3) Status Asthmaticus

Front 22

Ibuprofen

Back 22

1) NSAID-Induced Asthma
2) NSAID-Induced Urticaria
3) Aspirin Triad

Front 23

Sertraline

Back 23

1) Concurrent use or use within 2 wks of MAO inhibitors, such as phenelzine, tranylcypromine, and isoprocarboxazid, is contraindicated w/ all SSRIs.
2) Concurrent use of sertraline w/ pimozide is contraindicated.

Front 24

Valsartan

Back 24

1) Pregnancy
2) Relative contraindication for Bilateral Renal Artery Stenosis.

Front 25

Zolpidem

Back 25

Only Hypersensitivity

Front 26

Oxycodone/APAP

Back 26

1) Severe Respiratory Depression
2) Prolonged use or the use of high doses just before birth in pregnancy. [Opioids can cause dependence and respiratory depression in the neonate.]

Front 27

Duloxetine

Back 27

1) Concurrent use or use within 2 wks of MAO inhibitors, such as phenelzine, tranylcypromine, and isoprocarboxazid, is contraindicated w/ all SSRIs.
2) Uncontrolled Narrow Angle Glaucoma.
3) Not recommended in hepatic impairment, or in renal impairment if CrCL is < 30 mL/min.

Front 28

Quetiapine

Back 28

Only Hypersensitivity

Front 29

Venlafaxine

Back 29

Concurrent use or use within 2 wks of MAO inhibitors, such as phenelzine, tranylcypromine, and isoprocarboxazid, is contraindicated w/ all SSRIs. Also, do not initiate an MAO inhibitor within 1 week of discontinuing venlafaxine.

Front 30

Tamsulosin

Back 30

Only Hypersensitivity

Front 31

Alprazolam

Back 31

1) Narrow Angle Glaucoma
2) Use w/ itraconazole or ketoconazole
3) Pregnancy

Front 32

Valsartan / Hydrochlorothiazide

Back 32

1) Pregnancy
2) Anurea
3) Hypersensitivity valsartan or to hydrochlorothiazide or other sulfonamide drugs
4) Relative contraindication for Bilateral Renal Artery Stenosis

Front 33

Trazodone

Back 33

Only Hypersensitivity

Front 34

Pioglitazone

Back 34

New York Heart Association Class III or IV Heart Failure

Front 35

Alendronate

Back 35

1) Hypocalcemia
2) Inability to sit up for 30 minutes after taking the medicine
3) Esophageal Emptying Abnormalities

Front 36

Sulfamethoxazole/Trimethoprim

Back 36

1) Hypersensitivity, including hypersensitivity to any sulfa drug
2) Severe renal or hepatic impairment
3) Near or at term pregnancy
4) Breastfeeding
5) Megaloblastic anemia due to folate deficiency

Front 37

Lansoprazole

Back 37

Only Hypersensitivity

Front 38

Clonazepam

Back 38

1) Severe Hepatic Impairment (Liver Disease)
2) Narrow Angle Glaucoma
3) Pregnancy

Front 39

Tramadol

Back 39

1) Hypersensitivity to tramadol or opioids
2) Opioid dependent patients
3) Acute Alcohol or Drug Intoxication.
4) The Extended Release dosage form is also contraindicated in severe renal or severe hepatic impairment.

Front 40

Levofloxacin

Back 40

Hypersensitivity to levofloxacin or other fluoroquinolones

Front 41

Fluoxetine

Back 41

1) Concurrent use w/ MAO inhibitors. Fluoxetine should not be initiated within 2 wks of MAO inhibitors and MAO inhibitors should not be used within 5 weeks of fluoxetine discontinuation.
2) Concurrent use w/ pimozide or thioridazine are contraindicated.

Front 42

Prednisone

Back 42

1) Systemic Fungal Infections & 2) Live vaccines should not be used within 3 months of prednisone.

Front 43

Omeprazole

Back 43

Only Hypersensitivity

Front 44

Atenolol

Back 44

1) Sinus Bradycardia (heart rate < 45 bpm)
2) 2nd or 3rd Degree Heart Block
3) Uncompensated Heart Failure
4) Pulmonary Edema
5) Untreated Pheochromocytoma
6) Cardiogenic Shock
7) Pregnancy

Front 45

Insulin Glargine

Back 45

Only Hypersensitivity

Front 46

Amoxicillin / Clavulanate

Back 46

1) Hx of liver dysfunction or cholestatic jaundice w/ amox/clav
2) Extended release, Augmentin XR, is also contraindicated in severe renal impairment (CrCL < 30 mL/min)

Front 47

Fenofibrate

Back 47

1) Severe Renal Dysfunction (CrCL < 30 mL/min)
2) Hepatic Impairment
3) Pre-Existing Gall Bladder Disease

Front 48

Celecoxib

Back 48

1) Hypersensitivity to celocoxib, sulfonamides, aspirin, or NSAIDs
2) CABG peri-operative pain

Front 49

Donepezil

Back 49

Relative contraindication for Bradycardia

Front 50

Ezetimibe & Simvastatin

Back 50

1) Acute Liver Disease
2) Increased transaminases or liver function tests (LFTs)
3) Pregnancy
4) Breastfeeding

Front 51

Cephalexin

Back 51

Only Hypersensitivity

Front 52

Mometasone

Back 52

Only Hypersensitivity

Front 53

Drospirenone & Ethinyl Estradiol

Back 53

1) Heavy Smokers (> 15 cigs/day) who are also older than 35 yo, 2) Pregnancy, 3) Hepatic Impairment, 4) Renal Impairment (CrCL < 50 mL/min), 5) Hx of or current Venous Thromboembolism (VTE), 6) Arterial Thromboembolic Event (Stroke or MI) within the past year, 7) Cornary Artery Disease (CAD), 8) Severe or Uncontrolled HTN, 9) Diabetes w/ vascular involvement, 10) Migraines w/ Focal Symptoms, 11) Prolonged Immobilization, 12) Abnormal Undiagnosed Vaginal Bleeding, 13) Breast Cancer, 14) Endometrial Cancer, & 15) Hx of Jaundice w/ use of oral contraceptives

Front 54

Vitamin D3

Back 54

1) Hypercalcemia
2) Malabsorption Syndrome
3) Vitamin D Toxicity or Hypervitaminosis D

Front 55

Ezetimibe

Back 55

Only Hypersensitivity

Front 56

Gabapentin

Back 56

Only Hypersensitivity

Front 57

Pregabalin

Back 57

Only Hypersensitivity

Front 58

Sildenafil

Back 58

Concurrent use w/ nitrates of any form.

Front 59

APAP/Codeine

Back 59

1) Significant Respiratory Depression
2) Acute or Severe Asthma
3) Paralytic Ileus
4) Hypercapnea (too much CO2 in the blood)

Front 60

Fluconazole

Back 60

Concurrent use w/ cisapride.

Front 61

Intranasal Fluticasone

Back 61

Nasal Ulcers or Trauma

Front 62

Losartan

Back 62

Pregnancy

Front 63

Propoxyphene-N/APAP

Back 63

1) Paralytic Ileus
2) Acute or Severe Asthma
3) Severe Respiratory Depression

Front 64

Valacyclovir

Back 64

Only Hypersensitivity

Front 65

Lorazepam

Back 65

1) Acute Narrow Angle Glaucoma
2) Severe Respiratory Impairment

Contraindications Specific to the Injection Dosage Form:
1) Sleep Apnea
2) Intra-Arterial Injection (can only be given IV or IM).

Front 66

Pantoprazole

Back 66

Only Hypersensitivity

Front 67

Amlodipine/Benazepril

Back 67

1) HX of Angioedema
2) Pregnancy
3) Bilateral Renal Artery Stenosis

Front 68

Conjugated Estrogens

Back 68

1) Pregnancy
2) Abnormal Vaginal Bleeding (unseen / undiagnosed by a physician)
3) Hx or current VTE
4) Current stroke or MI (or one within the last year)
5) Breast Carcinoma (unless for metastatic disease at physician discretion)
6) Estrogen-Dependent Tumor
7) Liver Disease / Dysfunction

Front 69

Oseltamivir

Back 69

Only Hypersensitivity

Front 70

Tiotropium

Back 70

Only Hypersensitivity

Front 71

Aripiprazole

Back 71

Only Hypersensitivity

Front 72

Methylphenidate

Back 72

1) Idosyncratic Reactions to Sympathomimetic Amines
2) Significant Anxiety, Tension, or Agitation
3) Glaucoma
4) Use within 14 days of MAO inhibitors
5) Family Hx of Tourette's or Tics
6) Diagnosis of Tourette's or Tics
7) Patient is 65 years old or older
8) Cardiac Problems (structural problems, cardiomyopathy, CVD or CAD, arrhythmias)
9) Severe GI Stricture

Front 73

Digoxin

Back 73

Ventricular Fibrillation

Front 74

Fluticasone

Back 74

Nasal Ulcers or Trauma

Front 75

Fexofenadine

Back 75

Only Hypersensitivity

Front 76

Olmesartan

Back 76

Pregnancy

Front 77

Pravastatin

Back 77

1) Active Liver Disease
2) Unexplained Increase in LFTs
3) Pregnancy
4) Breastfeeding

Front 78

Triamterene/Hydrochlorothiazide

Back 78

1) Hypersensitivity, including Hypersensitivity to Sulfonamides
2) Hyperkalemia
3) Anurea
4) Significant Renal Impairment

Front 79

Methylprednisolone

Back 79

1) Systemic Fungal Infections
2) Live vaccines should not be used within 3 months of methylprednisolone.

Front 80

Cyclobenzaprine

Back 80

Most have to do w/ the cardiovascular system:
1) Use within 14 days of MAO Inhibitors
2) Hyperthyroidism
3) Heart Failure
4) Arrhythmias
5) Heart Block (or conduction disturbances)
6) Use within the acute phase of an MI

Front 81

Clonidine

Back 81

Only Hypersensitivity

Front 82

Risedronate

Back 82

1) Hypocalcemia
2) Inability to sit up for 30 minutes after taking the medicine
3) Esophageal Emptying Abnormalities

Front 83

Diazepam

Back 83

1) Severe Hepatic Impairment (Liver Disease)
2) Myasthenia Gravis
3) Narrow Angle Glaucoma
4) Severe Respiratory Insufficiency
5) Sleep Apnea

Front 84

Carisoprodol

Back 84

Acute Intermittent Porphyria (a rare hereditary disorder in which the heme portin of hemoglobin is not made properly)

Front 85

Promethazine

Back 85

1) Coma
2) Treatment of Lower Resipratory Tract Symptoms (including asthma)
3) Children < 2 Years Old
4) Intra-Arterial or Subcutaneous Administration

Front 86

Memantine

Back 86

Only Hypersensitivity

Front 87

Potassium Chloride

Back 87

1) Hyperkalemia
2) GI Tract Obstructions

Front 88

Citalopram

Back 88

1) Concurrent use or use within 2 wks of MAO inhibitors, such as phenelzine, tranylcypromine, and isoprocarboxazid, is contraindicated w/ all SSRIs.
2) Concurrent use of citalopram w/ pimozide is contraindicated.

Front 89

Meloxicam

Back 89

1) Hypersensitivity to Meloxicam or other NSAIDs
2) Perioperative pain due to Coronary Artery Bypass Graft (CABG)

Front 90

Latanoprost

Back 90

Only Hypersensitivity

Front 91

Carvedilol

Back 91

1) Decomposed HF
2) Asthma or Bronchospastic Conditions
3) 2nd or 3rd Degree Heart Block
4) Severe Bradycardia
5) Cardiogenic Shock
6) Severe Hepatic Impairment

Front 92

Oxycodone

Back 92

1) Significant Respiratory Depression
2) Acute or Severe Asthma
3) Paralytic Ileus

Front 93

Paroxetine

Back 93

1) Concurrent use or use within 2 wks of MAO inhibitors, such as phenelzine, tranylcypromine, and isoprocarboxazid, is contraindicated w/ all SSRIs.
2) Concurrent use of paroxetine w/ either thioridazine or pimozide is also contraindicated.

Front 94

Olmesartan/Hydrochlorothiazide

Back 94

1) Pregnancy
2) Anuria
3) Concurrent use w/ dofetilide

Front 95

Tadalafil

Back 95

Concurrent use w/ nitrates of any form.

Front 96

Sitagliptin

Back 96

Only Hypersensitivity

Front 97

Ciprofloxacin

Back 97

Concurrent use w/ tizanidine

Front 98

Amitriptyline

Back 98

1) Concurrent use or use within 2 wks of MAO inhibitors, such as phenelzine, tranylcypromine, and isoprocarboxazid
2) Acute Recovery Period after MI
3) Concurrent use w/ Cisapride

Front 99

Naproxen

Back 99

1) Hypersensitivity to Naproxen or other NSAIDs
2) Perioperative pain due to Coronary Artery Bypass Graft (CABG)

Front 100

Niacin ER

Back 100

1) Active Liver Disease or Significantly Increased LFTs
2) Peptic Ulcer Disease
3) Arterial Hemorrhage

Front 101

Allopurinol

Back 101

Only Hypersensitivity

Front 102

Losartan/Hydrochlorothiazide

Back 102

1) Pregnancy
2) Anuria
3) Concurrent use w/ dofetilide

Front 103

Tolterodine

Back 103

1) Urinary Retention
2) Gastric Retention
3) Uncontrolled Narrow Angle Glaucoma

Front 104

Lisinopril/Hydrochlorothiazide

Back 104

1) HX of Angioedema
2) Pregnancy,
3) Bilateral Renal Artery Stenosis
4) Anuria,
5) Concurrent use w/ dofetilide

Front 105

Norgestimate & Ethinyl Estradiol

Back 105

1) Heavy Smokers (> 15 cigs/day) who are also older than 35 yo, 2) Pregnancy, 3) Hepatic Impairment, 4) Hx of or current Venous Thromboembolism (VTE), 5) Arteriol Thromboembolic Event (Stroke or MI) within the past year, 6) Cornary Artery Disease (CAD), 7) Severe or Uncontrolled HTN, 8) Diabetes w/ Vascular Involvement, 9) Migraines w/ Focal Symptoms, 10) Prolonged Immobilization, 11) Abnormal Undiagnosed Vaginal Bleeding, 12) Breast Cancer, 13) Endometrial Cancer, 14) Hx of Jaundice w/ use of Oral Contraceptives

Front 106

Penicillin VK

Back 106

Only Hypersensitivity

Front 107

Codeine & Guaifenesin

Back 107

Asthma

Front 108

Glyburide

Back 108

1) Type 1 Diabetes Mellitis, 2) Diabetic Ketoacidosis, 3) Use w/ Bosentan

Front 109

Fluticasone Inhaler

Back 109

Use as primary treatment of status asthmaticus or acute bronchospasms. Inhaled corticosteroids do not take effect fast enough to treat a current attack and should only be used for longterm therapy.

Front 110

Rabeprazole

Back 110

Only Hypersensitivity

Front 111

Lisdexamfetamine

Back 111

1) Advanced Arteriosclerosis
2) Symptomatic Cardiovascular Disease
3) Moderate-To-Severe HTN
4) Hyperthyroidism
5) Glaucoma
6) Hx of Drug Abuse
7) Concurrent use w/ or use within 2 wks of MAO inhibitors (phenylzine, tranylcypromine, isoprocarboxazid, etc.)

Front 112

Isosorbide Mononitrate

Back 112

Concurrent use w/ phosphodiesterase-5 inhibitors: sidenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)

Front 113

Lamotrigine

Back 113

Only Hypersensitivity

Front 114

Olanzapine

Back 114

Only Hypersensitivity

Front 115

Lovastatin

Back 115

1) Active Liver Disease
2) Unexplained Increase in LFTs
3) Pregnancy
4) Breastfeeding

Front 116

Ethinyl Estradiol & Etonogestrel Vaginal Ring

Back 116

1) Hx of Venous Thromboembolic Disorders, such as Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE), 2) Major Surgery w/ Prolonged Immobilization, 3) Cerebral Vascular Disease, 4) Cornary Artery Disease (CAD), 5) Valvular Heart Disease w/ Complications, 6) Severe HTN, 7) Diabetes Mellitus w/ Vascular Involvement, 8) Migraines w/ Focal Symptoms , 9) Presence or Personal Hx of Breast Cancer Pregnancy, 10) Endometrial Cancer, 11) Undiagnosed Abnormal Genital Bleeding, 12) Active Liver Disease or Tumor, 13) Cholestatic Jaundice of Pregnancy, 14) Hx of Jaundice w/ use of Hormonal Contraceptives, 15) Heavy Smokers (> 15 cigs/day) who are also older than 35 yo, 16) Pregnancy

Front 117

Bupropion

Back 117

1) Seizure Disorder
2) Hx of Anorexia or Bulimia
3) Concurrent use or use within 2 wks of MAO inhibitors
4) Currently undergoing abrupt discontinuation of ethanol or sedatives
5) Patient receiving other dosage forms of bupropion.

Front 118

Doxycycline

Back 118

Children < 8 yo (unless used as treatment for anthrax exposure or tickborne rikettsial disease)
[Reason: It can cause permanent tooth discoloration.]

Front 119

Enalapril

Back 119

1) HX of Angioedema
2) Pregnancy

Front 120

Irbesartan

Back 120

1) Pregnancy
2) Relative contraindication for Bilateral Renal Artery Stenosis.

Front 121

Amphetamine & Dextroamphetamine

Back 121

1) Advanced Arteriosclerosis
2) Symptomatic Cardiovascular Disease
3) Moderate-To-Severe HTN
4) Hyperthyroidism, 5) Glaucoma
6) Hx of Drug Abuse
7) Concurrent use w/ or use within 2 wks of MAO inhibitors (phenylzine, tranylcypromine, isoprocarboxazid, etc.)

Front 122

Ibandronate

Back 122

1) Hypocalcemia
2) Inability to sit up for 60 minutes after taking the medicine
3) Esophageal Emptying Abnormalities

Front 123

Eszopiclone

Back 123

Only Hypersensitivity

Front 124

Ipratropium & Albuterol Inhaler

Back 124

Only Hypersensitivity

Front 125

Folic Acid

Back 125

Only Hypersensitivity

Front 126

Meclizine

Back 126

Only Hypersensitivity

Front 127

Ethinyl Estradiol & Norethindrone

Back 127

1) Breast Cancer or other estrogen- or protestin-dependent neoplasms, 2) Hepatic Tumors, 3) Pregnancy, 4) Undiagnosed, abnormal uterine bleeding, 5) Those at high risk of venous thromboembolism, including patients who have cardiovascular disease, coronary artery disease, diabetes w/ vascular disease, Hx of deep vein thrombosis (DVT) or pulmonary embolism (PE), 6) Hypercoagulopathies, 7) Headaches w/ focal symptoms, 8) Migraines in patients greater than 35 yo, 9) Uncontrolled HTN, 10) Valvular or rhythm abnormalities of the heart, 11) Women who are greater than 35 years old who also smoke cigarettes.

Front 128

Buprenorphine & Naloxone

Back 128

Only Hypersensitivity

Front 129

Raloxifene

Back 129

1) Hx of Venous Thromboembolic Disorders, such as Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE)
2) Pregnancy
3) Breastfeeding
[Raloxifene is only for women who are postmenopausal.]

Front 130

Omega-3-Acid Ethyl Esters

Back 130

Only Hypersensitivity

Front 131

Lidocaine Patch 5%

Back 131

Hypersensitivity to local anesthetics of the amide type, or to any component of the product.

Front 132

Ramipril

Back 132

1) HX of Angioedema
2) Pregnancy

Front 133

Benazepril

Back 133

1) HX of Angioedema
2) Pregnancy

Front 134

Verapamil

Back 134

1) Bradycardia
2) 2nd or 3rd Degree AV Block
3) Sick Sinus Syndrome
4) Congestive Heart Failure (CHF)
5) Patients w/ atrial flutter or atrial fibrillation and an accessory bypass tract (e.g. Wolff-Parkinson-White Syndrome or Lown-Ganong-Levine Syndrome)
6) Ventricular Tachycardia

Front 135

Ranitidine

Back 135

Only Hypersensitivity