Vet Sci Ii, Admin Of Meds

Front 1

Define dosage

Back 1

Amount of drug per unit of body weight

Front 2

Define dose

Back 2

Amount of drug given at one time

mls, tabs

Front 3

Define dosage interval

Back 3

Frequency of administration

Front 4

What is SID?

Back 4

1 per day/ once a day

Front 5

What is BID?

Back 5

twice per day

Front 6

What is TID?

Back 6

3 times a day

Front 7

What is QID?

Back 7

Four times a day

Front 8

What is EOD?

Back 8

Every other day, every 48 hours

Front 9

What is PRN?

Back 9

as needed

Front 10

What is PO?

Back 10

give by mouth

Front 11

What are some factors that may result in the drug dosage being adjusted?

Back 11

1. species or breed of animal
2. gender-- pregnancy, lactation
3. Age of animal-geriatrics, neonates
-liver function is not as good
4. Pre-x
renal/liver failure, seizures, shock (hypotension, dehydration), drug interactions

Front 12

What are the four classic steps in drug movement through the body?

Back 12

First phase:
1. Absorption
2. distribution
Second Phase
3. Bio-transformation
4. Elimination

Front 13

In regards to the first phase, first step of drug movement through the body, what is ABSORPTION?

Back 13

The passing of the drug from site of administration to systemic circulation

Front 14

In regards to the first phase, second step of drug movement through the body, DISTRIBUTION refers to?

Back 14

The movement of a drug from systemic circulation to target site.

Front 15

In regards to the second phase, third step of drug movement through the body, what is BIOTRANSFORMATION?

Back 15

The chemical alteration of a drug in the body.

Front 16

In regards to the second phase, forth step of drug movement through the body, what is ELIMINATION?

Back 16

Removal of drug from body

Front 17

What route is the fastest in regards to absorption and distribution?

Back 17

IC
(intracardiac)

Front 18

What route is the slowest in regards to absorption and distribution?

Back 18

PO
(oral)

Front 19

List the routes in order of the fastest---> slowest in regards to absorption and distribution.

Back 19

IC
IV
IO

Front 20

Of the four intermediate routes of medication administration, List the routes in order of the fastest---> slowest in regards to absorption and distribution.

Back 20

IM
SQ
IP
ET

Front 21

Drug solubility determines ___________

Back 21

route of administration

Front 22

What is a lipophilic drug?

Back 22

A lipid soluble drug that dissolves in oil and these drugs are known for their ability to easily cross the cell membrane.
---->Best administered PO

Front 23

What is a hydrophilic drug?

Back 23

Water soluable medications that diffuse well into interstitial (between cells and tissues) fluids.

------>Best administered SQ & IM

Front 24

A drug, once absorbed, must bind to a _____in order to be distributed and one typical transporter protein is ___

Back 24

protein

Albumin

Front 25

Binding of a drug to a protein to a protein aids in the maintenance of ________ and _______ level of the drug.

Back 25

drug equilibrium

theraputic

Front 26

What is meant by perfusion of tissues?

Back 26

the amount of blood passing through tissue s or organ

Front 27

What are some highly perfused tissues/organs?

Back 27

Lungs, heart, liver, kidneys

Front 28

What are some poorly perfused tissues?

Back 28

cartilage, fat

Front 29

What is the primary site for biotransformation of drugs in the body?

Back 29

the LIVER

Front 30

Prior to a drug being cleared from the blood, it must first be __________

Back 30

biotransformed

Front 31

A byproduct of biotransformation are __________ which are chemical components formed as a result of the drug being metabolized.

Back 31

metabolites

Front 32

Metabolites are important because ___________

Back 32

they may be stronger or weaker than the parent drug

Front 33

Explain Tylenol toxicity in cats

Back 33

Tylenol is not toxic to the cats, the resulting metabolites are.

Front 34

What are the secondary sites of biotransformation?

Back 34

Intestinal tract, skin, lungs

Front 35

What is the primary site of Elimination/excretion of drugs from the body?

Back 35

KIDNEY

Front 36

What are the secondary sites of Elimination/excretion of drugs from the body?

Back 36

liver, lungs, sweat, mammary

Front 37

What are the 2 major catagories of routes of administration of medication?

Back 37

Enteral-involves the GI tract
PO, Enema, Og & NG tubes

Parenteral- bypasses GI tract
Injectable, topical

Front 38

What are the types of oral meds?

Back 38

Pills
caplets, capsules
liquids
pastes
powders, granules

Front 39

What are advantages of using enteral routes of administration?

Back 39

*Less skill involved
*Easy for at home admin.
*Tends to be less stressful for pt
*less painful
*less risk of iatrogenic infections
*less risk of drug interactions

Front 40

What are the disadvantages of using enteral routes of med admin?

Back 40

*possible injury to pt or drug administrator
*Accuracy of dosing
*Possibility of aspiration pneumonia

Front 41

What are 3 indications for using oral route of med admin?

Back 41

1. Tx for GI disorders such as gastric ulcers
2. When immediate or quick absorption is unnecessary.
3. At home meds

Front 42

What are some contraindications for oral medication med admin?

Back 42

1. V/D
2. When rapid absorption IS necessary
3. Possibility of interference w/other drugs.

Front 43

What are the indications for use of an OG tube?

Back 43

Nutritional support
Med administration
Admin of radiographic contrast material
Decompression of stomach
gastric lavage
To dislodge a foreign body

Front 44

What are some possible OG tube complications?

Back 44

Misplacement
Possible esophageal & gastric injuries

Front 45

Describe the procedure for placing an OG tube

Back 45

1. Measure tube
-Dog--->tip of nose to last rib
-Cat--->tip of nose to 10th or 11th rib
2. Placement
Flex head and neck
Lube the tube
Insert tube (may use oral speculum -roll of tape- with dogs

Front 46

What are some considerations of OG tube placement in neonates?

Back 46

No mouth speculum needed

Very important to warm food or meds to body temp due to neonates inability to thermoregulate

Important to stimulate urination/defecation after tube feeding.

Front 47

What are some ways to verify OG tube placement?

Back 47

1. Swallowing during insertion
2. Visualize tube going down esophagus
3. You should be able to palpate 2 tubes in the throat. (Usually can only palpate trachea)
4. Smell the tube--smells like stomach contents
5. Check for coughing after installation--small amount of sterile saline in tube--->coughing=WRONG tube
6. radiograph
***In doubt, TAKE IT OUT!!***

Front 48

What is the procedure for removal of the OG tube?

Back 48

1. tip head down

2. KINK tube BEFORE removal to avoid possible aspiration pneumonia

Front 49

What are some indications for placement of NG tube?

Back 49

***1. To provide longer term access to stomach
2. Nutritional support
3. Decompression of stomach
4. Admin of meds
5. Gastric lavage

Front 50

What are some possible complications of NG tube placement?

Back 50

*Misplacement into trachea
*esophageal or gastric injury
*Epistaxis

Front 51

There are four types of surgically placed feeding tubes?

Back 51

1. Pharyngostomy-cranial to #2, not used as often as #2
2. Esophagostomy-Sx to place in midcervical esophagus
3. Gastromy-directly to stomach
4. Enterostomy-directly to small intestine

Front 52

What are some indications for surgically placed tubes?

Back 52

* Longer term nutritional support

*GI tract / oral injuries

*Esophageal injuries or surgery

Front 53

What is the advantage of surgically placed feeding tubes?

Back 53

To bypass injured or areas of surgery in the GI tract.

Front 54

What are some complications of surgically placed tubes?

Back 54

*Requires surgical placement
----possible iatrogenic infections
*Dislodgement of tube internally-animal not getting nutirnents and possible resulting infection
*Extensive aftercare needed
*must be surgically removed

Front 55

What are 3 indications for the use of an enema?

Back 55

1. Relief of constipation
2. Evacuation of distal colon
-to do radiographic diagnostic study of lower GI tract
-for Sx procedures in lower GI tract
3. Admin of meds

Front 56

What are some possible complications of enemas?

Back 56

*rectal trauma
*vomiting (esp w/cats when excess fluid is given

Front 57

What is the typical dosage for enemas?

Back 57

5-20mls per lb of body weight

Front 58

Parenteral administration of drugs refers to those that ________ and this refers to _______

Back 58

BYPASS GI tract

injections and topical meds--intranasal drugs, optic, otic meds

Front 59

What are some advantages of injections?

Back 59

Rapid onset of action

More accurate dosage

Front 60

What are some disadvantages of injections?

Back 60

Greater skill required

May be more stressful for pt

Increased risk of infection

Increased risk of adverse reactions

Front 61

What are some possible complications of injections?

Back 61

Hemorrhage at injection site
Hematoma
Abscess
Granuloma (small area of inflammation)
Tissue necrosis-due to extravascular deposit of IV meds in tissue

Front 62

What are some indications for topical med use?

Back 62

Local effect is desired such as skin infestations, infections

When it is needed to bypass systemic effects

Front 63

Mucous membranes of the eye absorb meds ______

Back 63

quickly

Front 64

When administering topical meds, what are 2 important things to remember?

Back 64

WEAR GLOVEs -you are not treating yourself

Prevent med from becoming an oral med--use E -collar to prevent licking

Front 65

What are transdermal drugs?

Back 65

Medications to be absorbed through the skin and then are MEANT to be absorbed systemically. (versus-Topical should stay local)

Front 66

What are some examples of transdermal drugs?

Back 66

Nitroglycerin-vasodilator
DMSO-a vehicle for other meds in large animals

Analgesic patches

Front 67

What are three common sites for SQ injections?

Back 67

1. Scruff
2. Lateral thorax
3. Flank

Front 68

What are some meds that can NEVER go SQ?

Back 68

Whole blood
Hypertonic solutions
Oil based meds-lipophilic (should go oral only)

Front 69

Due to cats being predisposed to vaccine induced sarcoma, to make it easier to remove the sarcoma, SQ injection of Rabies and Feline Leukemia are given where?

Back 69

Distal to mid-scapula and hips

Front 70

What are the IV injection sites in small animals?

Back 70

1. Cephalic- usually reserved for indwelling catheter use
2. Jugular vein- preferred site for blood collection in large and small animal
3. Lateral saphenous/recurrent tarsal-good site for blood collection for a fractious animals
4. Femoral Vein/medial saphenous-used primarily in cats for small volume blood draws (1/2 cc)
5. Sublingual vein- used only under anesthesia
6. Ear vein-rabbits

Front 71

What is the proper technique for IV blood draw?

Back 71

Must have proper restraint
*Occlude vessel TOWARD the heart
*Insert needle toward heart, bevel UP
*Draw sample while vessel is still being occluded
*release hold
*remove needle
*Put pressure on site for hemostasis

Front 72

What is the proper technique for IV injections?

Back 72

Must have proper restraint
*Occlude vessel TOWARD the heart
*Insert needle toward heart, bevel UP
*Aspirate to verify needle is in vessel
*RELEASE HOLD/vessel occlusion***
*Give injection
*pull needle out
*put pressure on injection site/hemostasis

Front 73

What are some Common sites for Intraosseous injections?

Back 73

-Tibial tuberosity
-trochanteric fossa of femur
-proximal humerus
-wings of illium

Front 74

What are some indications for IO injections?

Back 74

-Rapid admin of meds/fluids (typically used for shock)
-When a central or peripheral vein is unavailable
-When vein is too small to catheterize such as in avian, reptile and neonates

Front 75

What are some contraindications of IO injections?

Back 75

1. Should not be used in endotoxic pts as systemic bacteremia may lead to osteomyelitis
2. Should not be placed in pneumatic bones of birds-will drwon them although great for O2 supplementation
3. Should not be placed in a fractured or previously fractured bone due to scar tissue.
4. should not be placed over abcess

Front 76

What are some meds that can be administered by IO route?

Back 76

Crystalloid and colloid fluids
blood products including whole blood
IV drugs
parenteral nutrition

Front 77

What are some theraputic indications for Intraperitoneal injections?

Back 77

1. Fluid therapy-omentum acts as filter/sponge
--tends to be used more in pocket pets
2. Peritoneal lavage
3. Peritoneal dialysis due to renal failure
4. Euthanasia-pocket pets and possibly fractious cats or dogs
4

Front 78

What are diagnostic indicators for IP injections?

Back 78

For evaluation of peritoneal fluid for bacterial culture and drug sensitivity

Front 79

What is an indication for subconjuctival injections?

Back 79

To medicate the globe of the eye

Front 80

What are some possible complications of subconjuctival injections?

Back 80

1. Irritation
2. Infection
3. Perforation of globe

**not often seen in small animal, but more often seen in cattle**

Front 81

Describe the technique for subconjunctival injections?

Back 81

1. 25-27g Needle is placed under bulbar conjunctiva

2. Insert needle, if done correctly, there will be a small bleb (bubble) of medication

Front 82

What are some indications for intranasal injections?

Back 82

*Some vaccines are better absorbed
*Bordetella-dogs
*Strangles-horses
*FIP-cats
*Admin of certain meds
-O2
-Epinephrine through ET tube when CVS is not functioning efficiently

Front 83

What are some indications for intracardiac injections?

Back 83

-Admin of meds-epinephrine is one
-euthanasia
-blood collection

Front 84

What are some possible some possible complications of IC injections?

Back 84

Trauma to heart, lungs and or myocardium

Front 85

What is the basic technique for IC injections?

Back 85

Position in R lateral recumbancy

Landmarks are between the 5th and 6th intercostal space

Palpate heart beat

Insert needle

Front 86

What are some indications for intradermal injections?

Back 86

1) TB testing

2) Allergy testing

3) Infusing local anesthetic

Front 87

Complications of ID injections are ______

Back 87

Uncommon

Front 88

Describe the basic technique for ID injections?

Back 88

using a 25-27g needle

inject into dermis-small bleb (bubble) should appear under skin if done correctly

Front 89

What are some indications for administering an intraarticular injections?

Back 89

To inject steroids or joint medications, especially in horses

Front 90

What are some possible indications for Epidural injections?

Back 90

*To anesthetize caudal 3rd of body
-More common in large animal, esp. cattle

*To prolong anesthesia and prevent straining and pain

Front 91

What are some possible complications of epidural injections?

Back 91

Infection

Lack of desired effect

Front 92

Describe the technique for administering epidural injections.

Back 92

*Sites in small animals are the lumbosacral joint
*Large animal-it is placed between last sacral vert and 1st caudal vert
OR between 1st and second caudal vert
**Always a sterile procedure

Front 93

What is an Intrathecal injection?

Back 93

injection into spinal fluid

Front 94

What are some indications for intrathecal injections?

Back 94

Obtain CSF for testing for things such as meningitis

To do a myelogram

To determine CSF pressure

Front 95

What are some possible complications of intrathecal injections?

Back 95

Infections

Herniation of brainstem after removal of CSF (must euthanize)

Seizure activity if contrast material reaches brain (head is kept elevated to prevent this)

Front 96

What are some indications for thoracocentesis?

Back 96

1. To aspirate air or fluid from thorax followed by drain placement.
2.For diagnostic purposes-to obtain pleural fluid for culture and sensitivity tests
3. Pneumothorax-air in pleural space

Front 97

What are some possible complications of thoracocentesis?

Back 97

Loss of negative pressure in thorax

Trauma to heart and lungs

Front 98

What are the sites used for IM injections?

Back 98

1. Lumbar-epaxial muscles for vaccines and pre-anesthetic drugs
2. Hamstrings-semimembranosus, semitendinosus, biceps femoris
3. Gluteals and quadriceps are least used
4. Pectorals -more in large animals
5. Triceps-more in cattle
6. Cervical-more in horses

Front 99

What is the maximum IM volume for med inj?

Back 99

Dogs and cats-2cc per site

Large breed dog >80 lbs 4cc per site

Large animal 10cc per site