Prescribing Safety Assessment (PSA) Practice Exam

When is cyclizine contraindicated?

1. In patients with asthma

2. In cardiac cases

3. In elderly patients

4. In patients with renal impairment

The correct answer is: In cardiac cases

Cyclizine is primarily contraindicated in cardiac cases due to its potential anticholinergic effects and the ability to cause increased heart rate and arrhythmias. In patients with pre-existing cardiac conditions, such as those who have heart disease or arrhythmias, the administration of cyclizine could exacerbate these issues, leading to serious complications. This makes careful consideration essential before prescribing cyclizine to individuals with any form of cardiac impairment or history of heart problems. The other scenarios, such as asthma, renal impairment, or prescribing to elderly patients, are considerations but are generally not absolute contraindications. In asthma, caution is advised due to potential effects on bronchial muscles; however, cyclizine can still be prescribed with careful assessment. In elderly patients, while there is an increased risk of side effects from anticholinergic drugs, it does not constitute a strict contraindication but requires careful monitoring. For renal impairment, dosage adjustments may be necessary, but it is not outright contraindicated. Therefore, the specific risk factors associated with cardiovascular health make cardiac cases a particular concern when prescribing cyclizine.