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Routes of Administration

Chapter 2

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+What, How, Where, Who, When… Veterinary Technician’s Role in Drug Administration

n Attention to detail n verbal or written drug orders n choosing dosage forms n calculating doses n verifying patient information n selecting the appropriate equipment needed to

administer the medication properly

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+Veterinary Technician’s Role in Drug Administration

n  All applicable routes of administration

n  Proper procedure

n  Function of equipment used to administer the drug

n  Can you list the “Five Rights”?

n  Document, document, document!

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+Drug Orders from the Veterinarian

n  Order – verbal or written

n  Dose administered (initials or signature depending on record) n  Prevents missed/repeat dose

n  Error in administration

n  DVM clarifies incomplete or incorrect orders in patient record

n  NEVER ASSUME!

n  Clean/organized work environment bluedoor, LLC

+Forms of Medication

n Liquids n Suspension n Emulsion n Solution

n Solids n  Tablet (scored or not) n  Chewable (tablet) n  Capsule n  Bolus n  Lozenges n  Powders n  Suppositories n  Implants

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+Forms of Medication

n Gases n Liquids vaporized into gas (anesthetics) n Medications nebulized n Oxygen

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+Forms of Medication

n  Topical Medications - provide local effects (not systemic) n  Cream

n  Ointments

n  Drops

n  Gel

n  Liniment

n  Lotion

n  Ointment

n  Powder

n  Paste

n  Spray (aerosol and not)

n  Transdermal patch

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+Forms of Medication

n  Parenteral Administration (injection) n  Prefilled syringe and needle for injection

n  Liquid solution for injection

n  Powder - reconstituted to liquid using a sterile diluent

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+How Should Drug X Be Given?

n  Factors that influence administration n  Patient information

n  Status of patient

n  Symptoms

n  Need for action of drug

n  Age of patient

n  Health of patient

n  Drug information

n  How is drug labeled for administration (routes)?

n  Duration of effect

n  Available forms or concentrations

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+Onset of Action

n  From administration to target (Once it is “in” the patient, how long until it starts working?)

n  IV à IM à SQ à Transdermal à Rectal à Inhalation à PO

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+Routes of Administration: Enteral

n  By mouth = PO

n  Directly or indirectly into GI tract n  Hand pill

n  Pill syringe

n  Balling gun

n  Frick speculum

n  Syringe

n  Drenching

n  OG or NG tube

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+Routes of Administration: Parenteral

n  “Avoiding absorption by both the stomach and intestines”

n  Injections or infusions n  Liquids

n  Powders (diluent)

n  Implants

n  Aseptic technique

n  Precautions for each route bluedoor, LLC

+Parenteral: Intravenous (IV)

n  Quickest onset n  Vessel (vein or artery) n  Catheter n  Fluid lines n  Injection ports

n  Cephalic

n  Saphenous

n  Jugular

n  Femoral

n  ASPIRATE (flash of blood à proceed)

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+Parenteral: Intramuscular (IM)

n  Canine and Feline n  Epaxial (lumbar) muscles

n  Biceps femoris

n  Large animal sites for injection differ greatly depending on species n  Why?

n  ASPIRATE (no flash of blood à proceed)

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+Parenteral: Subcutaneous (SQ)

n  “Under the skin”

n  “Tent”

n  Most common route for vaccine administration n  Rabies on the RIGHT REAR

n  FeLV on the LEFT REAR

n  Isotonic fluids, some medications, microchip implantation, etc.

n  ASPIRATE (no flash à proceed)

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+Parenteral: Other Routes n  Intraperitoneal (IP)

n  Liver absorption

n  Slow onset

n  Risk of organ laceration

n  Risk for peritonitis

n  Intracardiac (IC) n  Not routine route

n  Emergency or euthanasia

n  Anesthetized patients ONLY

n  Intradermal (ID) n  “Within the skin layers”

n  Allergy testing, local anesthetics, other medications

n  Small gauge needle

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+Parenteral: Other Routes

n  Intra-articular (IA) n  Sterile technique, sterile infusions

n  Diagnostic testing

n  Equine, other species

n  Intra-arterial (IA) n  Not routine route

n  CAUTION (Vein or artery?)

n  Intraosseous/intramedullary (IO) n  Neonates, exotics, avian patients

n  Fluids, colloid infusions

n  Proximal condyle of humerus or femur

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+Parenteral: Inhalation

n  Liquid +/- oxygen = gas, vapor, aerosol

n  O2 can be the vehicle

n  Anesthetics (vaporized chemical) n  Mask

n  Induction chamber

n  Endotracheal tube (best)

n  Nebulizer or inhaler (concentrated medication or saline) n  Mask

n  Chamber

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+Parenteral: Topical

n  Transdermal n  Local or systemic

n  “Fur Factor”

n  Ointments, analgesic patches on skin

n  Ophthalmic, otic ointment/drops

n  Wear gloves (ex. Methimazole)

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+Medication Containers n  Vial

n  Single or multi-use n  Syringe +/- needle n  mL, ounces, grams, etc.

n  Ampules n  Single or multi-use n  Transfer to sterile vial n  Syringe/filter needle (tiny glass shards = L)

n  Blister packs n  Medications or other containers of medications

n  Prefilled syringe and needle

n  Pill/tablet/capsule bottle (quantities, concentrations)

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