Peroral, subcutaenous, intramuscular and intravenous drug application, microship

Question 1

Application route of choice depending on

Answer 1

• drug formulation
• product labelling
• required onset of action
• (place of action)
• routes available

Question 2

Peroral medications

• indications

Answer 2

• usually for long-term mediations (owner)
• drug effect on the GI tract (probiotics, activated charcoal)
• drugs with systemic effect

Forms:

• peroral formulated drugs (pills, liquids)
• radiography contrast - GI tract studies
• forced feeding

Question 3

Peroral application

• contraindications

Answer 3

• Head and neck trauma
• tissue or bone injury, damaged innervation, decreased mental state
• Decreased mental state (shock, stupor, coma, seizure)
• inabilty to swallow (properly)
• recent surgery
• stomach/bowel: <12-24hr; eosophagus: longer
• known/suspected injury of GI (perforation, foreign body/ileus)
• Vomiting/regurgitation, dysphagia
• antiemtics, feeding position
• non-cooperative patient (risk of injury)

Question 4

Intramuscular drug application

• contraindications

Answer 4

• hemorrhagic diathesis (thrombocytopenia,- pathia, coagulopathy)
• myositis; muscle stiffness e.g tetanus

Question 5

I.V injections - complications

Answer 5

• Local reactions:
• hemorrhage, hematoma
• phlebitis, thrombophlebitis, thrombosis
• paravenous injection and necrosis
• systemic reactions
• hypersensitivity reactions - anaphylaxis
• septicaemia
• air embolism
• drug side effects are more likely if given too rapidly (e.g apnea - propofol, barbiturates; bradycardia, cardiac arrest - potassium, calcium etc.)

Question 6

Indications for gastric tubing

Answer 6

• Diagnostic –> GDV
• Therapeutic –> gastric lavage in case of intoxication

Question 7

Types of feeding tubes

Answer 7

• nasoesophageal (nasogastric tube)
• esophagostomy tube
• gastostomy tube

Question 8

Nasoesophageal tube

• advantages and disadvantages

Answer 8

• only until disstal part of esophagus, ventro-medial direction.
• advantages:
• non-invasive, easy to place
• minimal/no sedation/ local anaeshesia
• animal can eat/drink
• can be managed at home by the owner
• disadvantges:
• NOT for vomiting, sedated, unconscious animals
• easily dislodged (e.g vomiting)
• E-collar needed
• short term use (max 5-10 days)
• small diameter –> only liquid formulation

Question 9

Esophagostomy tube

• advantages and disadvantages

Answer 9

• Advantages
• Larger tube, blenderized wet food can be given
• Well-tolerated
• Can be used mid-term (to longterm)
• animals are able to eat/drink
• can be managed at home by the owner
• Disadvantges
• Generall anesthesia, simple surgical procedure
• may be difficult to place in very large or obese animals
• Stoma site infection/inflammation
• NOT for vomiting, unconscious animals, esophageal disease

Question 10

Gastrostomy tube

• advantages and disadvantages

Answer 10

• Advantages
• wide diameter tube, blenderized wet-food can be given
• well tolerated
• can be used mid to long-term
• animals are able to eat/drink
• can be managed at home by the owner
• Disadvantages
• General anesthesia, surgical procedure, laparotomy/laparascopy/endoscopy
• NOT for vomiting, GI obstruction
• Stoma site infection/inflammation
• severe complications if dislodged (peritonitis)
• delayed feeding utnil 12-24ht post surgery