Final Review Flashcards
Dosage
Amount of drug/unit of body weight (mg/kg)
Dose
Amount of drug given at one time (cc/ml)
Dosage Intervals
SID, BID, TID, QID, EOD, PRN, Q2H
Potential Causes of Toxicities
Allergic reaction
Inappropriate species
Inappropriate amount of frequency
Inappropriate route of administration
Reasons to Adjust Drug Dosage
Certain breeds/species
Gender (pregnancy)
Age of animal (older, neonates)
Preexisting conditions
Preexisting Conditions
Renal or liver failure
Seizures
Shock
Drug interactions
Drug Distribution - Biphasic
First phase - Absorption - Distribution Second Phase -Biotransformation Elimination
Absorption
Passage of the drug from the site of administration into the systemic blood circulation
Rate of Absorption
Fastest: IV, IC, IO
Intermediate: ET, IP, IM, SQ
Slowest: PO
Drug Solubility - Lipophilic Drugs
Drugs that dissolve in oil
Cross cell membrane readily because cell membrane is made up of phospholipids.
Best Route: oral, readily absorbed in GI system
Drug Solubility - Hydrophilic Drugs
Drugs that dissolve in water
Diffuse well into and through interstitial fluids.
Best Route: SQ, IM, IV
Distribution
Movement of the drug from the systemic circulation to the target tissue or intended site of action
Binding of a Drug to a Protein
Once absorbed, most drugs bind to a protein (ex albumin within blood plasma)
The unbound portion of the drug will diffuse through cell membrane, metabolize and be excreted
Maintain equilibrium, part of drug is used and excreted while the other is bound to protein and retained until needed.
Perfusion of Tissues
The amount of blood passing through a tissue or organ (carrying O2 and Hgb)
Highly Perfused Tissues and Organs
Heart
Kidneys
Lungs
Poorly Perfused Tissues and Organs
Fat
Cartilage
Biotransfusion
The chemical alteration of a drug in the body
Prior to a drug being “cleared from blood” it must be biotransformed
Metabolites
The chemical component formed from biotransfusion of a drug
Sites of Biotransfusion
Primary: Liver
Secondary: Lungs, skin, intestinal tract
Elimination
The removal of a drug from the body
Sites of Elimination
Primary: Kidneys
Secondary: Liver, lungs, sweat, mammary glands
Major Routes of Drug Administration in the Body
Enteral: involves GI tract
Parenteral: bypasses GI tract
Oral Medications
Pills: tablets (+/- chewables), caplets, capsules
Liquids
Powders, Granules
Paste
Advantages of Using Oral Administration
Less amount of skill required At home administration Less stressful to patient (+/-) Less painful to patient Iatrogenic infections less likely Less adverse reaction
Disadvantages to Oral Administration
Possible injury to patient or administrator
Accuracy of dose
Possibility os aspiration pneumonia (more common with liquid or paste)
3 Indications for Using Oral Administration
Treating a specific GI disorder
When immediate absorption is unnecessary
When dispensing home medications
Contraindications for Oral Administration
V/D
When rapid absorption is needed
When there is possible interference with other drugs
Indications for Using an Orogastric Tube
Nutritional support in anorexic patient Administration of medications Administration of radiograph contrast material Decompression of the stomach Stomach lavage Dislodging a foreign body (not common)
Orogastric Tube Complications
Misplacement of the tube
Esophageal &/or gastric injuries
Orogastric Tube Placement - Measurement for Dog
Tip of nose to the last rib
Orogastric Tube Placement - Measurement for Cat
Tip of nose to 10th or 11th rib
Orogastric Tube Placement
Measure/mark tube
Use speculum/roll of tape
Lube tube
Administer and remove
How to Verify Tube Placement
Swallowing ? Seeing tube go down esophagus Feeling two tubes Listen/smell Coughing Radiograph - best indication
Removal of Orogastric Tube
Tip the head down
Kink the tube
(prevent aspiration)
Indication for Placing NG Tube
Longer term access to stomach than orogastric tube
Nutritional support
Decompression of the stomach
Administration of medications (not primary reason)
NG Tube Complications
Misplacement
Esophageal &/or gastric injuries
Epistaxis
Smaller width
Surgically Placed Feeding Tubes
Ability to bypass affected area of the GI tract
Pharyngostomy/Esophagostomy
Gastrostomy
Enterostomy
Indications for Surgically Placed Feeding Tubes
Prolonged nutritional support
GI tract injuries (oral cavity - intestines)
Complications with Surgically Placed Feeding Tubes
Surgery
Infection
Dislodgment of the tube
Extensive aftercare
Indications for Administering an Enema
Relief of constipation/obstipation
Evacuation of the distal colon
Administration of medications
Complications for Administering an Enema
Rectal trauma
Enema Solutions
Warm water
Warm soapy water
DSS (Diocytl Sodium Succinate)
Mineral Oil
Enema Dose
5-20 mls/lb
Advantages of Injectable Administration
Rapid onset of action
More accurate dosage
Disadvantages of Injectable Administration
Greater skill required
+/- more painful and stressful to patient
Increased risk of infection
Increased risk of adverse reaction
Complications That Can Occur When Giving an Injection
Hemorrhage and hematoma at the site Abscess Granuloma Local irritation Tisue necrosis
SQ Injections - Common Sites
Scruff
Lateral Thorax
Flank
SQ Technique
Upside down dart hold/3 finger hold
Tent skin, needle parallel to body, aspirate, inject
Meds That NEVER Go SQ
Whole blood
Hypertonic solutions
Oil-based meds
Intramuscular Injection Sites
Lumbar (epaxial) Hamstring Gluteals Quadriceps Pectorals (equine/bovine) Triceps (equine/bovine) Cervical (equine/bovine)
Maximum IM Volume
Dogs and Cats: 2cc/site or 4cc/site for large dogs
Large Animals: 10cc/site
List of IV Injection Sites
Cephalic vein Jugular vein Lateral saphenous Femoral Sublingual vein Ear vein
Intraosseous Injection
Needle is placed into the sinusoids within the bone marrow
Most Common IO Injection Sites
Tibial crest
Trochanteric Fossa
Wing of the ilium
Greater tubercle of the humerus
Indications for Using IO Injections
Rapid administration of fluids or medications
When central or peripheral vein is unavailable
When vein is too small to catheterize
Contraindications for IO Injections
Endotoxic patient
Placement in certain pneumatic bones of birds
Placement in a fracture or previous fractured bone
Placement over an abscess
Intraperitoneal Injection
Abdominocentesis
Surgical puncture of the abdomen
Therapeutic or diagnostic
Therapeutic Indications for Intraperitoneal Injection
Fluid therapy
Peritoneal lavage
Peritoneal dialysis
Euthanasia
