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99 Cards in this Set
- Front
- Back
Define dosage
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Amount of drug per unit of body weight
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Define dose
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Amount of drug given at one time
mls, tabs |
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Define dosage interval
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Frequency of administration
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What is SID?
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1 per day/ once a day
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What is BID?
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twice per day
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What is TID?
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3 times a day
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What is QID?
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Four times a day
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What is EOD?
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Every other day, every 48 hours
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What is PRN?
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as needed
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What is PO?
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give by mouth
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What are some factors that may result in the drug dosage being adjusted?
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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 |
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What are the four classic steps in drug movement through the body?
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First phase:
1. Absorption 2. distribution Second Phase 3. Bio-transformation 4. Elimination |
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In regards to the first phase, first step of drug movement through the body, what is ABSORPTION?
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The passing of the drug from site of administration to systemic circulation
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In regards to the first phase, second step of drug movement through the body, DISTRIBUTION refers to?
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The movement of a drug from systemic circulation to target site.
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In regards to the second phase, third step of drug movement through the body, what is BIOTRANSFORMATION?
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The chemical alteration of a drug in the body.
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In regards to the second phase, forth step of drug movement through the body, what is ELIMINATION?
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Removal of drug from body
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What route is the fastest in regards to absorption and distribution?
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IC
(intracardiac) |
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What route is the slowest in regards to absorption and distribution?
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PO
(oral) |
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List the routes in order of the fastest---> slowest in regards to absorption and distribution.
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IC
IV IO |
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Of the four intermediate routes of medication administration, List the routes in order of the fastest---> slowest in regards to absorption and distribution.
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IM
SQ IP ET |
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Drug solubility determines ___________
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route of administration
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What is a lipophilic drug?
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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 |
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What is a hydrophilic drug?
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Water soluable medications that diffuse well into interstitial (between cells and tissues) fluids.
------>Best administered SQ & IM |
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A drug, once absorbed, must bind to a _____in order to be distributed and one typical transporter protein is ___
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protein
Albumin |
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Binding of a drug to a protein to a protein aids in the maintenance of ________ and _______ level of the drug.
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drug equilibrium
theraputic |
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What is meant by perfusion of tissues?
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the amount of blood passing through tissue s or organ
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What are some highly perfused tissues/organs?
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Lungs, heart, liver, kidneys
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What are some poorly perfused tissues?
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cartilage, fat
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What is the primary site for biotransformation of drugs in the body?
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the LIVER
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Prior to a drug being cleared from the blood, it must first be __________
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biotransformed
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A byproduct of biotransformation are __________ which are chemical components formed as a result of the drug being metabolized.
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metabolites
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Metabolites are important because ___________
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they may be stronger or weaker than the parent drug
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Explain Tylenol toxicity in cats
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Tylenol is not toxic to the cats, the resulting metabolites are.
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What are the secondary sites of biotransformation?
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Intestinal tract, skin, lungs
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What is the primary site of Elimination/excretion of drugs from the body?
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KIDNEY
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What are the secondary sites of Elimination/excretion of drugs from the body?
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liver, lungs, sweat, mammary
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What are the 2 major catagories of routes of administration of medication?
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Enteral-involves the GI tract
PO, Enema, Og & NG tubes Parenteral- bypasses GI tract Injectable, topical |
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What are the types of oral meds?
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Pills
caplets, capsules liquids pastes powders, granules |
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What are advantages of using enteral routes of administration?
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*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 |
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What are the disadvantages of using enteral routes of med admin?
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*possible injury to pt or drug administrator
*Accuracy of dosing *Possibility of aspiration pneumonia |
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What are 3 indications for using oral route of med admin?
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1. Tx for GI disorders such as gastric ulcers
2. When immediate or quick absorption is unnecessary. 3. At home meds |
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What are some contraindications for oral medication med admin?
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1. V/D
2. When rapid absorption IS necessary 3. Possibility of interference w/other drugs. |
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What are the indications for use of an OG tube?
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Nutritional support
Med administration Admin of radiographic contrast material Decompression of stomach gastric lavage To dislodge a foreign body |
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What are some possible OG tube complications?
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Misplacement
Possible esophageal & gastric injuries |
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Describe the procedure for placing an OG tube
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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 |
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What are some considerations of OG tube placement in neonates?
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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. |
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What are some ways to verify OG tube placement?
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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!!*** |
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What is the procedure for removal of the OG tube?
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1. tip head down
2. KINK tube BEFORE removal to avoid possible aspiration pneumonia |
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What are some indications for placement of NG tube?
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***1. To provide longer term access to stomach
2. Nutritional support 3. Decompression of stomach 4. Admin of meds 5. Gastric lavage |
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What are some possible complications of NG tube placement?
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*Misplacement into trachea
*esophageal or gastric injury *Epistaxis |
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There are four types of surgically placed feeding tubes?
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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 |
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What are some indications for surgically placed tubes?
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* Longer term nutritional support
*GI tract / oral injuries *Esophageal injuries or surgery |
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What is the advantage of surgically placed feeding tubes?
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To bypass injured or areas of surgery in the GI tract.
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What are some complications of surgically placed tubes?
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*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 |
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What are 3 indications for the use of an enema?
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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 |
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What are some possible complications of enemas?
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*rectal trauma
*vomiting (esp w/cats when excess fluid is given |
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What is the typical dosage for enemas?
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5-20mls per lb of body weight
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Parenteral administration of drugs refers to those that ________ and this refers to _______
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BYPASS GI tract
injections and topical meds--intranasal drugs, optic, otic meds |
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What are some advantages of injections?
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Rapid onset of action
More accurate dosage |
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What are some disadvantages of injections?
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Greater skill required
May be more stressful for pt Increased risk of infection Increased risk of adverse reactions |
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What are some possible complications of injections?
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Hemorrhage at injection site
Hematoma Abscess Granuloma (small area of inflammation) Tissue necrosis-due to extravascular deposit of IV meds in tissue |
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What are some indications for topical med use?
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Local effect is desired such as skin infestations, infections
When it is needed to bypass systemic effects |
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Mucous membranes of the eye absorb meds ______
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quickly
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When administering topical meds, what are 2 important things to remember?
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WEAR GLOVEs -you are not treating yourself
Prevent med from becoming an oral med--use E -collar to prevent licking |
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What are transdermal drugs?
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Medications to be absorbed through the skin and then are MEANT to be absorbed systemically. (versus-Topical should stay local)
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What are some examples of transdermal drugs?
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Nitroglycerin-vasodilator
DMSO-a vehicle for other meds in large animals Analgesic patches |
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What are three common sites for SQ injections?
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1. Scruff
2. Lateral thorax 3. Flank |
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What are some meds that can NEVER go SQ?
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Whole blood
Hypertonic solutions Oil based meds-lipophilic (should go oral only) |
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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?
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Distal to mid-scapula and hips
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What are the IV injection sites in small animals?
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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 |
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What is the proper technique for IV blood draw?
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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 |
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What is the proper technique for IV injections?
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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 |
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What are some Common sites for Intraosseous injections?
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-Tibial tuberosity
-trochanteric fossa of femur -proximal humerus -wings of illium |
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What are some indications for IO injections?
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-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 |
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What are some contraindications of IO injections?
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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 |
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What are some meds that can be administered by IO route?
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Crystalloid and colloid fluids
blood products including whole blood IV drugs parenteral nutrition |
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What are some theraputic indications for Intraperitoneal injections?
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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 |
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What are diagnostic indicators for IP injections?
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For evaluation of peritoneal fluid for bacterial culture and drug sensitivity
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What is an indication for subconjuctival injections?
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To medicate the globe of the eye
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What are some possible complications of subconjuctival injections?
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1. Irritation
2. Infection 3. Perforation of globe **not often seen in small animal, but more often seen in cattle** |
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Describe the technique for subconjunctival injections?
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1. 25-27g Needle is placed under bulbar conjunctiva
2. Insert needle, if done correctly, there will be a small bleb (bubble) of medication |
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What are some indications for intranasal injections?
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*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 |
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What are some indications for intracardiac injections?
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-Admin of meds-epinephrine is one
-euthanasia -blood collection |
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What are some possible some possible complications of IC injections?
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Trauma to heart, lungs and or myocardium
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What is the basic technique for IC injections?
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Position in R lateral recumbancy
Landmarks are between the 5th and 6th intercostal space Palpate heart beat Insert needle |
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What are some indications for intradermal injections?
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1) TB testing
2) Allergy testing 3) Infusing local anesthetic |
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Complications of ID injections are ______
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Uncommon
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Describe the basic technique for ID injections?
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using a 25-27g needle
inject into dermis-small bleb (bubble) should appear under skin if done correctly |
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What are some indications for administering an intraarticular injections?
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To inject steroids or joint medications, especially in horses
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What are some possible indications for Epidural injections?
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*To anesthetize caudal 3rd of body
-More common in large animal, esp. cattle *To prolong anesthesia and prevent straining and pain |
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What are some possible complications of epidural injections?
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Infection
Lack of desired effect |
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Describe the technique for administering epidural injections.
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*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 |
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What is an Intrathecal injection?
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injection into spinal fluid
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What are some indications for intrathecal injections?
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Obtain CSF for testing for things such as meningitis
To do a myelogram To determine CSF pressure |
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What are some possible complications of intrathecal injections?
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Infections
Herniation of brainstem after removal of CSF (must euthanize) Seizure activity if contrast material reaches brain (head is kept elevated to prevent this) |
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What are some indications for thoracocentesis?
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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 |
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What are some possible complications of thoracocentesis?
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Loss of negative pressure in thorax
Trauma to heart and lungs |
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What are the sites used for IM injections?
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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 |
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What is the maximum IM volume for med inj?
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Dogs and cats-2cc per site
Large breed dog >80 lbs 4cc per site Large animal 10cc per site |