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First Year Clinical Skills > Drug Doses and Injection Techniques > Flashcards

Drug Doses and Injection Techniques Flashcards

1
Q

Why is the correct drug dosage essential

A
  1. Too low a dose and the drug won’t reach therapeutic levels = ineffective
  2. Too high = dangerous and potentially life threatening
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2
Q

What is therapeutic dose of a drug

A

The amount needed to treat a disease

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3
Q

What are the different ways of drug administration

A
  1. Topical
  2. Enteral
  3. Parenteral
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4
Q

What is Topical?

A
  1. applied to a particular site
  2. May include
    a) epi cutaneous (application to skin) e.g. dermatological preparations
    b) Inhalational e/g/ asthma inhalers
    c) Enema (absorption via rectal mucosa (some anti seizure medications)
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5
Q

What is Enteral

A
  1. Administration via GI
  2. May include:
    a) Oral/ Gastric e.g. tablets or oral liquids
    b) Rectal (considered the same as topical enema preparations) e.g. some anti seizure medications
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6
Q

What is parenteral

A
  1. Non oral, systemic administration
  2. generally considered to be injection
  3. may include:
    a) subcutaneous (under skin)
    b) Intramuscular (into muscle)
    c) Intravenous ( into vein)
    d) Intradermal (into layers of skin)
    e) Intracardiac (into heart)
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7
Q

What are the most common routes for parenteral injection

A
  1. subcutaneous: slowest absorption
  2. intramuscular
  3. intravenous: fastest absorption
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8
Q

To calculate the dose of an Enteral medication what do we need to know?
Then how do you calculate the required number of tablets?

A

ORAL
1. Weight of the patient in kilograms (kg)
2. Dose rate usually in milligrams per kilogram (mg/kg)
3. Drug concentration usually in milligrams per tablet (mg/tablet)
CALCULATION:
Number of tablets = Weight of animal (kg) x Dose rate (mg/kg) /
Drug concentration (mg/tablet)

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9
Q

How do you calculate the appropriate dose of parenteral medication and calcualtion

A
  1. Weight of the patient in kilograms (kg)
  2. Dose rate usually in milligrams per kilogram (mg/kg)
  3. Drug concentration usually in milligrams per millilitre (mg/ml)
    CALCULATION:
Volume of drug (ml) = Weight of animal (kg) x Dose rate (mg/kg) /
 Drug concentration (mg/ml)
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10
Q

How are parenteral medication presented

A

in 2 forms

  1. Solution, a soluble substance dissolved in a solvent
  2. Suspension, an insoluble substance suspended in a solvent
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11
Q

What do you need to remember when usign a suspension medication

A
  1. Insoluble substance may settle out over time so must shake vigorously to ensure even dispersion and NEVER intravenously
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12
Q

What is the prescribing cascade

A
  1. specific guidelines which must be followed when considering which medication to use
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13
Q

Why best to use a veterinary medicine that has been authorised in the UK for treatment of the condition in the species you are treating?

A

Because the medication will have been tested for appropriate safety, quality and efficacy (ability to produce a desired or intended result.)

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14
Q

If there is no suitable medication authorised for this use in the UK what must you follow when selecting medication?

A
  1. A veterinary medicine authorised in the UK for use in another animal species, OR for a
    different condition in the same species
  2. A medicine authorised in the UK for human use, OR a medicine authorised in animals in
    another EU member state
  3. Medicine made up at the time on a one-off basis by a veterinary surgeon or a properly
    authorised person
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15
Q

What checks must you undertake before you administer medication?

A
  1. Do you have the right patient?
  2. Have you selected the right drug?
  3. Have you calculated the right dose?
  4. Have you checked you are administering the medication via the right route?
  5. Are you giving the medication at the right time?
  6. Is the medication being administered at the right frequency?
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16
Q

What is the formula used when calculating the volume to be injected?

A

Patient weight [kg] x dosage [mg/kg] /

concentration [mg/ml]

17
Q

If the drug dosage is expressed as ml/kg how do you calculate the volume?

A

Dosage [ml/kg] x patient weight [kg]

18
Q

What do you need to do before take drug

A
  1. swab the top of the drug bottle as the rubber seal can get dirty = could be drawn up into the syringe
19
Q

Once got the correct volume of medication then what

A
  1. DEtach the needle from the syringe and replace with a new one of appropriate length adn gauge as ensures it is sharp so less painful for animal and sterile
20
Q

How do you carry out a subcutaneous injection?

A

WASH HANDS

  1. injected under skin usually in dorsal cervical area (scruff)
  2. restrained in sternal recumbency, sitting or standing
  3. Draw up accurate dose
  4. swab injection site with skin disinfectant to remove debris
  5. Pick up fold of skin by pinching between thumb and finger
  6. insert needle subcutaneously up to hub
  7. observe the needle hub for blood
  8. connect syringe to needle hub
  9. inject in moderate controlled fasion
  10. remove needel adn syringe and massage
21
Q

When inserting needle if resistance is felt what does this mean and what should you do

A
  1. it is being inserted intradermally or intramuscularly so should be redirected
22
Q

Why should you observe the needle hub for blood

A
  1. ensures the agent isn’t being injected intravascularly as some agents can cause a severe reaction and/ or death if intravascularly
23
Q

Why massage the site

A

to ensure dispersal of agent and helps alleviate irritation

24
Q

Where to inject intramuscular on canine and horse

A 
canine = quads, lumbo dorsal muscles (either side of lumbar vertebrae) or triceps.
equine = superficial pectorals, lateral neck, gluteals, semimembranosus and semitendinous
25
Q

What msucle to avoid when injecting intramuscular on dog

A

HAMSTRING because risk of sciatic nerve damage

26
Q

How to inject intramuscularly

A
  1. identify site for intramuscular injection
  2. restrain patient appropriately
  3. Clean hands
  4. prepare injection (draw up accurate dose)
  5. Observe needle hub for blood - ensure not intravascularly
  6. connect syringe
  7. inject material in moderate controlled fashion
  8. remove needle
27
Q

What do you need to remmeber about injecting into muscle

A
  1. muscle is dense and cannot accomodate large volumes of liquid
  2. 2ml in a cat
  3. 3-5 ml in a dog
  4. 10 mls in equine neck, 20-30 in pectorals gluteals)
28
Q

How to take a intravenous injection/ taking blood

A
  1. ask assistant to raise vein
  2. clean hadns
  3. Swab injection site with disinfectant
  4. Identify vein by palpation adn stabilise it by placing thumb of free hand along it
  5. hold needle with bevel facing up and insert through skin and into raised vein at approx 30 deg to skin up to half needle length
  6. dark venous blood drips from needle
  7. advance needle along vein up to hub
  8. inject stuff
  9. remove needle and syringe and apply swab under pressure to injection site
29
Q

Where can intravenous injections be injected

A
  1. Jugular, cephalic, lateral saphenous or femoral vein
30
Q

What position should the patient be in when taking blood from jugular

A
  1. Sternal or lateral recumbency, limbs forward, head turned away from injector, injector responsible for raising vein
31
Q

What position should patient be in when taking blood from cephalic vein?

A

Sitting or sternal recumbency, limb held
forward with restrainer’s hand behind
elbow and thumb used to raise the
vein. Vein raised by injector just above elbow using rubber band and secured tight with artery forceps

32
Q

How do you know if you have inserted the needle correctly when intravenous

A
  1. Dark venous blood should drip from hub if the needle has successfully entered a
    vein.
  2. bright red blood exits
    under pressure = inadvertently = entered an artery = very dangerous. Apply pressure above the insertion site, withdraw needle, start again.

First Year Clinical Skills (5 decks)

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