Administration of drugs

Question 1

Main routes of administration meds?

Answer 1

Intravenous 
Intramuscular 
Subcutaneous 
Oral 
Topical

Question 2

Two main ways of administering drugs?

Answer 2

Enteral – involving the Gi tract
- Oral and rectal
Parenteral – not involving GI tract
- IV, IM, SC, topical, intraosseous

Question 3

Reasons for choice of administer route?

Answer 3

Bioavailability – quantity of drug within circulation
Individual patient needs – concurrent therapy, age, hydration and disease status
Speed of onset – how quickly will start working

Question 4

When immediate onset is essential?

Answer 4

• In pain
• seizuring
• allergic reaction
• induction of anaesthesia
• euthanasia

Question 5

When delayed onset is essential?

Answer 5

• Pre medications – sedation and anti-inflammatory

Question 6

Equipment for administration?

Answer 6

Appropriate needle 
Appropriate syringe – always chose smallest possible (easier scale)
Swab – for bottle and for patient 
Pen 
Drug

Question 7

Safe handling and disposal of equipment?

Answer 7

Ensure needle cap is on when walking around
Ensure patient is well restrained
Dispose syringe in pharmaceutical waste bin
Dispose needle in sharps bin
Never re-sheath needles after administration or drawing up medication

Question 8

Injection sites for dogs and cats?

Answer 8

Intravenous 
-	Jugular, cephalic, saphenous 
Intramuscular 
-	Lumbar region, cervical region, quads 
Subcutaneous 
-	Between shoulder blades 
Others 
-	Intraosseous – ilium 
-	Intraperitoneal – caudal abdomen

Question 9

Injection sites for horses?

Answer 9

Intravenous – jugular
Intramuscular
- Gluteal, cervical region, pectorals

Question 10

Injection sites for small mammals?

Answer 10

Subcutaneous 
-	Over lateral thorax 
Intramuscular 
-	Quadriceps – rabbits or guinea pigs 
Intraperitoneal 
-	Caudal abdomen – tilted
Intravenous 
-	Ear or cephalic vein in rabbits 
-	Lateral tail in rats and mice 
-	Cephalic and saphenous in guinea pigs, chinchillas and ferrets

Question 11

Injection sites for bird?

Answer 11

Subcutaneous 
-	Inguinal or axillary regions
Intramuscular 
-	Consider if meat for consumption - damage 
-	Pectoral muscles 
Intravenous 
-	Rare
-	Jugular, brachial vein, medial metatarsal
Intraosseous 
-	Tibiotarsal bone, proximal ulnar

Question 12

Injection sites for snakes?

Answer 12

DON’T INJECT TRHOUGH SCALES – CAUSE PERMANENT DAMAGE – LIFT AND INJECT UNDERNEATH

Subcutaneous 
-	Cranial third of body in lateral area 
Intramuscular 
-	Cranial third of body in epaxial muscles 
Intravenous 
-	Ventral tail vein
Intraosseous 
-	Lateral part of body
-	Dorsal to ventral scales
-	Cranial to cloaca in caudal third of body

Question 13

Injection sites for lizards?

Answer 13

Subcutaneous
-	Lateral thoracic area 
Intramuscular 
-	Proximal part of forearm
Intravenous 
-	Ventral tail vein
Intraosseous 
-	Proximal femur, distal femur and proximal tibia 
Intracoelomic 
-	Caudal abdomen – tilted

Question 14

Injection sites for tortoises?

Answer 14

Subcutaneous 
-	Cranial to fore and hind limbs
Intramuscular 
-	Proximal part of forearm, pectoral muscles 
Intravenous 
-	Jugular, dorsal tail vein 
Intraosseous 
-	Plastron and carapace junction 
-	Caudal to hind legs 
-	Proximal tibia

Question 15

How to administer a subcutaneous injection (small animal)?

Answer 15

Raise a fold of skin 
Moisten skin with spirit swab
-	To flatten hair and remove bacteria 
Insert needle under skin and withdraw plunger slightly 
-	If blood appears then venepuncture has occurred 
-	Then alternative site must be chosen 
Slowly inject drug and withdraw needle 
Massage site gently to disperse drug

Question 16

How to administer an intravenous injection (small animal)?

Cephalic vein

Answer 16

Ask assistant to retrain patient
- Hold head
- Extend leg and apply pressure to raise vein
Clip and prep with antiseptic
- Then wipe with spirit
Stabilise the vein and insert needle
- Blood should flow into syringe
Once blood flows back ask assistant to release vein
Administer drug gently
- Can draw back part way to check still in vein
Remove the needle and apply pressure to vein
- Min 30 seconds – ideally 2 mins

Question 17

How to administer an intravenous injection (equine)?

Jugular vein

Answer 17

Make sure patient is well restrained 
Prep area with antiseptic and spirit 
Raise the vein with one hand 
Insert the needle at 45 degrees to the skin 
-	Flatten out once in vein 
Withdraw plunger slightly 
-	Blood should flow into syringe 
Administer drug gently 
Remove needle and apply pressure 
-	Minimum of 30 seconds 
-	Ideally 2 mins

Question 18

How to administer a intramuscular injection (small animal)?

Answer 18

Ask assistant to restrain patient
- Identify muscle
If using quads stabilise muscle between index finger and thumb
Introduce needle slowly
- At a right angle to skin
Withdraw the punger to check for venepuncture
- If blood is drawn back reposition
Inject drug slowly
If patient moves draw back again to check for venepuncture
Remove needle and massage site

Question 19

How to administer an intramuscular injection (equine)?

Answer 19

Make sure patient is well restrained 
Tap area with hand a few times 
-	Not to spook horse 
Introduce needle rapidly
-	At a right angle to skin 
Withdraw plunger slightly to check for venepuncture 
-	If blood then reposition 
Gently administer drug 
If patient moves draw back again to check for venepuncture 
Remove needle and massage site

Question 20

Needle angle for S/C?

Answer 20

45°

Question 21

Needle angle for I/M?

Answer 21

90°

Question 22

How to administer oral medication (small animal)?

Answer 22

Ask assistant to restrain patient
- Large dogs may need third person to stop moving backwards
Tilt head back so mouth will open slightly
Place tablet at back of tongue
- If needed us pill giver
- Or small syringe of water to encourage swallowing

Question 23

How to administer oral medication (equine)?

Answer 23

Place head collar and lead rope
- Don’t use bridal as drug will get stuck around bit
Ask assistant to restrain horse
If possible dissolve tablets in water and put them in a dosing syringe
- Place syringe in corner of mouth and administer on tongue
Once administered hold head up to prevent spitting out

Question 24

How to administer topical medications (small animal)? Eye drops?

Answer 24

Position self behind patient
Place one hand under chin and angle head up
- This should open their eyes
Use little finger of hand holding drops to hold upper eyelid back
Drip required amount directly into eye
Keep patient up for a few seconds so drops are absorbed

Question 25

How to administer topical medications (small animal)? Eye ointment?

Answer 25

Use fingers in one land to draw lower eye lid down
Using other hand apply a line of the ointment inside lower eye lid
Or if tolerated, apply in same way as eye drops

Question 26

How to administer topical medications (equine)? Eye drops?

Answer 26

Can be administered directly into horses eye
- Not always well tolerated
Can use eye lavage systems
- Placing tube through eye lid
- Drops are injected into tube
- flushed into the eye with either saline or air

Question 27

How to administer topical medications (small animal)? Ear meds?

Answer 27

Take care with handling 
-	most preparation contain steroids
hold ear pinna to expose ear canal 
clean away any wax or debris 
insert nozzle into external ear canal 
apply medication 
massage distal to the ear to dispense medication

Question 28

How to administer topical medications (small animal)? Rectal medications?

Answer 28

Insert nozzle into the patient rectum as far in as comfortable
Depress the tube/syringe to administer the drug
Remove the tube/syringe being careful not to allow drug to flow