Unicorns 'n Nursin'

Question 1

amoxicillin (Amoxil)

Answer 1

Unicorn: Warfarin and Oral Contraceptive Interaction

Nursing: Monitor for Superinfection, PO with food

Question 2

cephalexin (Keflex)

Answer 2

Unicorn: Interacts with alcohol, antacids, oral contraceptives

Nursing: Avoid alcohol, Take with food for GI distress

Question 3

imipenem/cilastin (Primaxin)

Answer 3

Unicorn: May cause seizures, avoid Lidocane allergy

Nursing: Admin via IV/IM, monitor for superinfection

Question 4

aztreonam (Azactam)

Answer 4

Unicorn: used for those with penicillin allergy

Nursing: Dedicated IV, monitor for superinfection

Question 5

vancomycin (Vancocin)

Answer 5

Unicorn: Redman’s Syndrome, Trough level 15-20 mcg/mL

Nursing: Freq. labs to monitor renal function, watch for balance, hearing, tinnitus

Question 6

tetracycline

Answer 6

Unicorn: avoid pregnant women, children < 8y/o, causes teeth staining (yellow) and can affect long bone growth

Nursing: avoid dairy products, can cause photosensitivity

Question 7

erythromycin

Answer 7

Unicorn: side effect of ventricular dysrhythmias

Nursing: Enhances warfarin = easier bleeds, take with food for GI distress, watch for hearing, balance, tinnitus

Question 8

gentamicin

Answer 8

Unicorn: big gun, trough lvl <= 1 mcg/mL, toxic lvl >2 mcg/mL

Nursing: can be yellow colored but should always be clear, monitor for oto/nephrotoxicity

Question 9

ciprofloxacin (Cipro)

Answer 9

Unicorn: risk of tendon rupture >65 y/o, hepatotoxicity

Nursing: deliver in dedicated IV, lots of side effects to educate on, confusion/cns issues possible so ensure proper baseline before administering

Question 10

trimethoprim/sulfamethoxazole (Bactrim)

Answer 10

Unicorn: No Alcohol. Stevens Johnson syndrome.

Nursing: Avoid alcohol, increase water intake, stop if red spots appear (SJ Syndrome)

Question 11

nitrofurantoin (Macrobid)

Answer 11

Unicorn: Treats UTIs because it concentrates in urine

Nursing: Milk or food to help w/ nausea, watch for peripheral neuropathy

Question 12

metronidazole (Flagyl)

Answer 12

Unicorn: No alcohol, can cause seizures

Nursing: Dedicated IV, treats parasites

Question 13

acyclovir (Zovirax)

Answer 13

Unicorn: 3 Forms based on herpes type, IV can cause nephrotoxicity

Nursing: Wear gloves for topical, educate on herpes precautions

Question 14

isoniazid (INH) / rifampin (Rifadin)

Answer 14

Unicorn: Peripheral neuropathy due to decreased B6, DRESS (fever, rash, facial edema, lymphadenopathy)

Nursing: LONG dose, must finish, orange/brown body fluids, stained contact lenses - harmless, monitor for hepatotoxicity

Question 15

amphotericin B (Fungizone)

Answer 15

Unicorn: hard on the body (pretreat), hard on veins (use large vein, check for patency)

Nursing: Very nephrotoxic, monitor via labs. Infuse slowly.

Question 16

ketoconazole (Nizoral)

Answer 16

Unicorn: Topical cream, athlete’s foot

Nursing: watch for skin reaction/redness

Question 17

captopril (Capoten)

Answer 17

Unicorn: First choice for hypertension, dry non-productive cough

Nursing: Have patient keep bp log to watch for trends not individual readings, avoid potassium diet, supplements, or potassium-sparing diuretics

Question 18

losartan (Cozaar)

Answer 18

Unicorn: First choice for hypertension if patient has cough, can cause angioedema

Nursing: blood pressure log, orthostatic hypertension

Question 19

aliskiren (Tekturna)

Answer 19

Unicorn: no high fat meals with med, can cause angioedema

Nursing: Avoid potassium in diet, don’t give if pt. has renal dysfunction

Question 20

nefedipine (Procardia)

Answer 20

Unicorn: first choice for hypertension, reflex tachycardia (angina), avoid grapefruit

Nursing: blood pressure log, avoid grapefruit, works better for Black population

Question 21

doxazosin (Cardura)

Answer 21

Unicorn: first dose orthostatic hypotension, reflex tachycardia

Nursing: Do not use with sildenafil (Viagra), move between sitting, standing etc to avoid dizziness and falls

Question 22

atenolol (Tenormin) / metoprolol (Lopressor)

Answer 22

Unicorn: bradycardia, do not stop abruptly (reflex hypertension), heart failure, masks hypoglycemic symptoms

Nursing: bp/hr log, Diabetics watch blood sugar closer, risk of heart failure due to less contractile heart causing backflow

Question 23

clonidine (Catapres)

Answer 23

Unicorn: rebound hypertensive crisis, don’t stop abruptly

Nursing: Take at bedtime, do not drive until you know how it affects you, caution for pt. with recent MI, dec. liver function or renal failure

Question 24

carvedilol (Coreg)

Answer 24

Unicorn: none noted

Nursing: move slowly between lying, sitting, standing, bp/hr log

Question 25

hydralazine (Apresoline)

Answer 25

Unicorn: give via IV during Hypertensive crisis

Nursing: move slowly between sitting, standing to avoid dizziness and falls, bp/hr log