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Veterinary Clinical medicine
ADMINISTRATION OF
MEDICATIONS
SHARON A .J
2009-03-10
Drug Routes
 Drugs may be administered in various ways.
The route chosen depends on the part of the
body the drug needs to affect, how quickly
the drug needs to work, and the ability of the
owner to give the drug.
Routes of administration
 Oral
 Parenteral
 IV IM IP IC SC
 Other
 Topical
 Rectal
 Intrauterine
 Intramammary
Advantages of Oral
medication
 Usually least painful
 Can be administered by client
 Skin not penetrated, less risk of introducing infection
Disadvantages of Oral medication
 Aspiration of medication - choking,
pneumonia (eg paraffin to cats)
 Variable rate of absorption depending on
patient, contents of gut, etc.
 Vomiting, irritation of gut (eg aspirin)
 Patients may not tolerate administration
 May be difficult to ensure correct dosage
Oral medications
 Tablet
 Capsule
 Granule
 Powder
 Paste
 Liquid
Tablet
 Compressed drug in a carrier such as chalk
or sugar
 Often coated
 to protect drug inside from moisture
 to disguise unpleasant tastes
 to protect from gastric juices, slow down the breakdown
of the drug for a slower release
 to avoid irritation
 to give the tablet a recognizable colour
 Usually scored into halves or quarters for
ease of breakage for more accurate dosing
 Most common form of medication
Tablet Administration
Capsule
 Bullet-shaped, gelatin container
 Contains powder, granules or liquid
 Easier to swallow (smooth)
 No need for 'carrier'
 Gelatin dissolves in stomach
Granules/Powder
 Solid preparations
Dissolved in water
eg Vytrate®
,Lectade®
Mixed with feed
Paste
 Semi solid preparation
 Usually in a water soluble base
 Via syringe
 Easy for owner to use
 Rabbit, guinea pig
 Horse (worming paste)
 Cat (worming paste)
Liquid
 Syrup
 Drugs contained in a concentrated sugar solution. 
 Good for young animals/small doses (eg Clavulox drops).
 Solution
 Drug in liquid form or dissolved in water (eg glucose solution).
 Suspension
 Insoluble particles float in liquid but settle when standing
 Needs to be mixed before use (shaken)
 Emulsion
 Two immiscible liquids (eg water and paraffin).
Routes of enteral liquids
 Directly into the mouth
 By crop needle (birds)
 By stomach tube
 Drugs which burn the mouth
 Very young animals, to reduce the risk of
aspiration
 Large volumes of fluid.
Parenteral Preparations
 These are drugs that can be given by injection. All
drugs in this form must be sterile. The most common
routes of injection of drugs in small animal practice
are iv ,im,ip,sc,ic
 Usually taken to mean ‘by injection’
 Strictly, par-enteral = ‘adjacent the gut’
Injection Route depends on
 Type of drug
 Condition and temperament of patient
 Volume of the drug,
 Required speed of action
Systemic Drugs
 Some drugs cannot be applied directly where
they are needed. Instead they need to travel
through the animal’s system until they get to
where they are needed. These drugs are said
to be given SYSTEMICALLY.
 Examples include oral preparations and
injections
Routes of injection
 Intradermal
 Intramuscular
 Intravenous
 Intraperitoneal
 Intracardiac
 Intrapleural
 Intra-articular
 Epidural
 Subconjunctival
Intradermal (ID)
 Into the dermis
 The living part of the surface layer
 Needs a very fine needle
 Causes a blister like appearance (bleb) if
performed correctly
 allergy testing
 tuberculin testing
Subcutaneous (SC)
 Under the skin
 Most common site
 Loose skin over shoulder blades a
good site
 Less painful than intramuscular
injections
 Only for low irritant drugs
 Slow absorption if dehydrated
 Used for most vaccines
Intramuscular
 Injected deep into the body of a
muscle
 Less likely to cause an overt tissue
reaction
 Insert needle at right angles to the
skin
 Larger volumes may be injected in
the one site than with other routes
 Faster absorption than s/c
Im sites
Intravenous (IV)
 Into the vein directly
 Fastest onset of action
 Can give irritant solutions into the vein which
cannot be given IM or SC     
 Irritant drugs should be given via an
intravenous catheter, (caparsolate,
thiopentone, guifenasin)
Peri-vascular Necrosis
 When irritant solution leaks from a vein
and enters
 area may 'slough‘
Immediately inject the area with
saline (isotonic i.e. 0.9% NaCl) to
dilute the drug  
Intra-peritoneal (IP)
 Into peritoneal cavity
 Usually near umbilicus
 Or half way between umbilicus &
pubis
 Used for
 Rodents
 Birds
 Euthanasia of young difficult patients
Intra-cardiac (IC)
 Injection through the chest wall into the
heart
 Emergency administration of drugs
during cardiac resuscitation
 e.g. adrenaline
 Euthanasia
 Moribund animals
Intrapleural
 Injection into the pleural space through
the chest wall
 Not commonly used
Intra-articular
 Injection into the joint space
 Needs full surgical preparation
 should also wear gloves and draw drug up
in a sterile manner, new unused bottle, etc,
to avoid introduction of infection.
 Used for
 Dogs (eg cortisone with greyhounds,
Cartrophen)
Epidural
 Injection into the epidural space surrounding
the spinal cord usually in the lumbar site
 Full sterile prep needed
 Animal positioned on sternum, with back
legs drawn forwards
 Used for
 Before an orthopaedic procedure on spine
or hindquarters
Pain relief (eg morphine, local anaesthetic
for dog)
Stops straining and gives pain relief,
(lignocaine, xylazine).
Epidural site
Subconjunctival
 Into the conjunctiva of the eye
 Use a fine needle
 Needs good restraint
 Used for
 Ocular conditions
Safety Considerations
 Wear all
proper PPE
for the
procedure.
Supplies Needed
 Before giving an injection, gather the following:
 The drug or substance to be injected.
 Alcohol swab or alcohol moistened cotton
ball
 Correct size syringe
 Correct size needle
 Sharps Container- a hard plastic with a screw-
on or tightly-secured lid
Factors to Consider
 When choosing needle size, syringe size, and injection
site / route of injection there are several factors which
need to be considered:
 The type of the solution / medication.
 The viscosity (Thin / watery? Thick / sticky?)
 The absorption rate for the solution / medication.
 The size of the patient (Beagle? Hound? Something larger?)
 The mobility status of the patient (Anesthetized? Immobile?
Fully conscious?
Venipuncture
 The cephalic vein on the inside of the front
limb below the elbow may be used.
Hold off the vein by gripping
and rolling laterally
.
Prepare the site
 Clip area
 Wipe with alcohol
 Insert needle,
bevel up, into
the vein.
 Gently pull
back.
 Hold off when
completed.
Medial saphenous vein on the
hind limb can also be used.
Factors to Consider: IM
Injections
 Intramuscular injections may be performed
in the thigh muscles on the front of the
rear limb, or using the hamstring muscles on
the back side of the rear leg
 If blood is aspirated, the needle should be
removed as this indicates needle placement
in a blood vessel. Reinsert the needle at a
different site.
 Needle sizes used for IM injections range
from 25 to 20 gauge. Muscle is dense tissue
and can only accommodate small volumes of
fluid
Triceps muscle
The triceps muscle belly located caudal to
the humerus is one IM injection site. The
left thumb is placed on the humerus,
isolating the muscle belly in the left hand.
The needle is placed in the muscle belly.
The plunger is withdrawn to create
negative pressure.
Quadriceps muscle
The quadriceps muscle is located
anterior to the femur. The left
thumb is on the femur. The needle
is inserted at a right angle to the
muscle belly.
Semitendinosis muscle
Administering an injection into the
semimembranous/semitendinosis muscle
group, the tip of the needle (white arrow)
should be directed toward the caudal
aspect of the limb so if the patient moves,
the needle will not advance toward the
sciatic nerve. Notice the left hand is being
used to isolate the muscle group caudel to
the femur.
Lumbar muscle
The dorsal lumbar muscles on
either side of the midline can be
used for IM injections. The thumb
of the left hand is on the transverse
processes of the lumbar vertebrae.
Factors to Consider: SC
Injections
 For SQ (subcutaneous) injections, in general, use:
 An 18 or 20 gauge needle, 1 to 1.5 inches long.
 SQ medications are deposited into the loose connective
tissue just below the dermis.
 This tissue is not richly supplied with blood vessels so the
absorption rate is slow.
 There are many pain receptors in this tissue so only non-
irritating, water-soluble medications in small doses should
be given by the SQ route.
The loose skin over the
shoulders and neck is an
ideal site for
subcutaneous injection. 
Procedure for sc injection
Topical medications
 External surfaces
 eg the skin, eyes, ears
 Exposed mucous membranes
 eg gums, nasal mucosa, prepuce and
penis, vulva and vagina.
 Medication may work
 Topically - on only the area to which it is
applied
 (eg ringworm ointment)
 Systemically (eg Spotton, Ivomec Pour On,
DMSO)  
Cream
 CREAMS – the drug is dissolved in water and mixed
with oil or fat. Creams spread easily and penetrate
the outer layers of the skin
 A semi-solid water-soluble emulsion which
penetrates the skin surface
 Tubes or plastic squeeze bottles
 Wash off with water.
Ointment
 OINTMENTS – the drugs are present in a base of wax
or fat. They do not penetrate the skin.
 Semi-solid oil-based preparation, usually with a base
of wax or jelly
 Comes in tubes, jars, etc.
 Does not usually get absorbed by the skin, (eg
prednoderm).
Suspension
 Liquid preparation in which particles suspended in
the liquid
 Will separate out on standing, so needs to be
shaken, (eg calamine lotion, yellow lotion)
Rinse/Wash/Solution
 Liquid which often diluted and poured on an animal
 May have a residual action when dry, (asuntol,
otoderm, ectodex).
Aerosol
 SPRAYS – a way of applying liquids in fine droplet
form
 Liquid under pressure
 Sprayed on as particles of liquid suspended in air,
(eg chloromide, debrisol, frontline, fly repellent)
Powder
 Finely particulate solid preparation which dusted on
 Can be irritant to open wounds
 May help to dry weeping wounds, (eg tricin powder,
pinkeye powder)
MEDICATED SHAMPOOS
 MEDICATED SHAMPOOS – drugs mixed with
detergents which penetrate the coat. Shampoos
are left in contact with the skin for the
recommended amount of time and then should be
rinsed off thoroughly.
EYE & EAR MEDICATION
 EYE & EAR MEDICATIONS – these are both examples
of topical medication.
 Eye medications should be sterile. Once they have
been opened they should be stored only for the
length of time recommended by the manufacturer.
Aural medications
 Drops or Ointments
 The ear is ideally cleaned of wax and
discharge before administration of
medication
Medications per rectum
 Enema
 Suppository
 Fluid replacement
Enema
 Commercial solutions
 Syringe, tube or pack (eg Microlax®
)
 Soapy water
 Funnel and tubing
 Other substances
 paraffin, bloat treatment (Tympanyl®)
)
Suppository
 Bullet shaped, semi solid, glycerine based
 Melts at body temperature
 Can contain antibiotics, laxatives, soothing agents
 May be absorbed systemically
Medications intra-uterine
 Pessaries
 Solutions
Pessaries
 Large tablets
 Usually antibiotic
 May also have a foaming agent
 Administered by hand when the cervix is open for
example, after a calving
Intra-uterine fluids
 Administered via the cervix with a pipette or balloon
(Foley) catheter
 During oestrus when the cervix is relaxed
 Some will remain in the uterus, while others will be
siphoned out again
Health & Safety and
Administering Medicines
 Health and safety should be considered in order to
make sure that we don’t get hurt whilst
administering medicines.
 It is also important to ensure that the animal doesn’t
get hurt or frightened.
What are the risks to animals
when administering
medicines?
 Overdose
 Allergic reaction
 Wrong administration route selected
 Animal stressed
 Animal gets injured
How can these risks be
minimised
 Follow instructions carefully
 Make sure that the animal is adequately restrained
 Use sprays in a well ventilated area
 Wear appropriate PPEs (e.g. gloves, mask etc)
Administration of medicines in animals

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Administration of medicines in animals

  • 1. Veterinary Clinical medicine ADMINISTRATION OF MEDICATIONS SHARON A .J 2009-03-10
  • 2. Drug Routes  Drugs may be administered in various ways. The route chosen depends on the part of the body the drug needs to affect, how quickly the drug needs to work, and the ability of the owner to give the drug.
  • 3. Routes of administration  Oral  Parenteral  IV IM IP IC SC  Other  Topical  Rectal  Intrauterine  Intramammary
  • 4. Advantages of Oral medication  Usually least painful  Can be administered by client  Skin not penetrated, less risk of introducing infection
  • 5. Disadvantages of Oral medication  Aspiration of medication - choking, pneumonia (eg paraffin to cats)  Variable rate of absorption depending on patient, contents of gut, etc.  Vomiting, irritation of gut (eg aspirin)  Patients may not tolerate administration  May be difficult to ensure correct dosage
  • 6. Oral medications  Tablet  Capsule  Granule  Powder  Paste  Liquid
  • 7. Tablet  Compressed drug in a carrier such as chalk or sugar  Often coated  to protect drug inside from moisture  to disguise unpleasant tastes  to protect from gastric juices, slow down the breakdown of the drug for a slower release  to avoid irritation  to give the tablet a recognizable colour  Usually scored into halves or quarters for ease of breakage for more accurate dosing  Most common form of medication
  • 9.
  • 10. Capsule  Bullet-shaped, gelatin container  Contains powder, granules or liquid  Easier to swallow (smooth)  No need for 'carrier'  Gelatin dissolves in stomach
  • 11. Granules/Powder  Solid preparations Dissolved in water eg Vytrate® ,Lectade® Mixed with feed
  • 12. Paste  Semi solid preparation  Usually in a water soluble base  Via syringe  Easy for owner to use  Rabbit, guinea pig  Horse (worming paste)  Cat (worming paste)
  • 13. Liquid  Syrup  Drugs contained in a concentrated sugar solution.   Good for young animals/small doses (eg Clavulox drops).  Solution  Drug in liquid form or dissolved in water (eg glucose solution).  Suspension  Insoluble particles float in liquid but settle when standing  Needs to be mixed before use (shaken)  Emulsion  Two immiscible liquids (eg water and paraffin).
  • 14. Routes of enteral liquids  Directly into the mouth  By crop needle (birds)  By stomach tube  Drugs which burn the mouth  Very young animals, to reduce the risk of aspiration  Large volumes of fluid.
  • 15. Parenteral Preparations  These are drugs that can be given by injection. All drugs in this form must be sterile. The most common routes of injection of drugs in small animal practice are iv ,im,ip,sc,ic  Usually taken to mean ‘by injection’  Strictly, par-enteral = ‘adjacent the gut’
  • 16. Injection Route depends on  Type of drug  Condition and temperament of patient  Volume of the drug,  Required speed of action
  • 17. Systemic Drugs  Some drugs cannot be applied directly where they are needed. Instead they need to travel through the animal’s system until they get to where they are needed. These drugs are said to be given SYSTEMICALLY.  Examples include oral preparations and injections
  • 18. Routes of injection  Intradermal  Intramuscular  Intravenous  Intraperitoneal  Intracardiac  Intrapleural  Intra-articular  Epidural  Subconjunctival
  • 19.
  • 20. Intradermal (ID)  Into the dermis  The living part of the surface layer  Needs a very fine needle  Causes a blister like appearance (bleb) if performed correctly  allergy testing  tuberculin testing
  • 21. Subcutaneous (SC)  Under the skin  Most common site  Loose skin over shoulder blades a good site  Less painful than intramuscular injections  Only for low irritant drugs  Slow absorption if dehydrated  Used for most vaccines
  • 22. Intramuscular  Injected deep into the body of a muscle  Less likely to cause an overt tissue reaction  Insert needle at right angles to the skin  Larger volumes may be injected in the one site than with other routes  Faster absorption than s/c
  • 24. Intravenous (IV)  Into the vein directly  Fastest onset of action  Can give irritant solutions into the vein which cannot be given IM or SC       Irritant drugs should be given via an intravenous catheter, (caparsolate, thiopentone, guifenasin)
  • 25. Peri-vascular Necrosis  When irritant solution leaks from a vein and enters  area may 'slough‘ Immediately inject the area with saline (isotonic i.e. 0.9% NaCl) to dilute the drug  
  • 26. Intra-peritoneal (IP)  Into peritoneal cavity  Usually near umbilicus  Or half way between umbilicus & pubis  Used for  Rodents  Birds  Euthanasia of young difficult patients
  • 27. Intra-cardiac (IC)  Injection through the chest wall into the heart  Emergency administration of drugs during cardiac resuscitation  e.g. adrenaline  Euthanasia  Moribund animals
  • 28.
  • 29. Intrapleural  Injection into the pleural space through the chest wall  Not commonly used
  • 30. Intra-articular  Injection into the joint space  Needs full surgical preparation  should also wear gloves and draw drug up in a sterile manner, new unused bottle, etc, to avoid introduction of infection.  Used for  Dogs (eg cortisone with greyhounds, Cartrophen)
  • 31. Epidural  Injection into the epidural space surrounding the spinal cord usually in the lumbar site  Full sterile prep needed  Animal positioned on sternum, with back legs drawn forwards  Used for  Before an orthopaedic procedure on spine or hindquarters Pain relief (eg morphine, local anaesthetic for dog) Stops straining and gives pain relief, (lignocaine, xylazine).
  • 33. Subconjunctival  Into the conjunctiva of the eye  Use a fine needle  Needs good restraint  Used for  Ocular conditions
  • 34. Safety Considerations  Wear all proper PPE for the procedure.
  • 35. Supplies Needed  Before giving an injection, gather the following:  The drug or substance to be injected.  Alcohol swab or alcohol moistened cotton ball  Correct size syringe  Correct size needle  Sharps Container- a hard plastic with a screw- on or tightly-secured lid
  • 36. Factors to Consider  When choosing needle size, syringe size, and injection site / route of injection there are several factors which need to be considered:  The type of the solution / medication.  The viscosity (Thin / watery? Thick / sticky?)  The absorption rate for the solution / medication.  The size of the patient (Beagle? Hound? Something larger?)  The mobility status of the patient (Anesthetized? Immobile? Fully conscious?
  • 37. Venipuncture  The cephalic vein on the inside of the front limb below the elbow may be used.
  • 38. Hold off the vein by gripping and rolling laterally
  • 39. . Prepare the site  Clip area  Wipe with alcohol
  • 40.  Insert needle, bevel up, into the vein.  Gently pull back.  Hold off when completed.
  • 41. Medial saphenous vein on the hind limb can also be used.
  • 42. Factors to Consider: IM Injections  Intramuscular injections may be performed in the thigh muscles on the front of the rear limb, or using the hamstring muscles on the back side of the rear leg  If blood is aspirated, the needle should be removed as this indicates needle placement in a blood vessel. Reinsert the needle at a different site.  Needle sizes used for IM injections range from 25 to 20 gauge. Muscle is dense tissue and can only accommodate small volumes of fluid
  • 43. Triceps muscle The triceps muscle belly located caudal to the humerus is one IM injection site. The left thumb is placed on the humerus, isolating the muscle belly in the left hand. The needle is placed in the muscle belly. The plunger is withdrawn to create negative pressure.
  • 44. Quadriceps muscle The quadriceps muscle is located anterior to the femur. The left thumb is on the femur. The needle is inserted at a right angle to the muscle belly.
  • 45. Semitendinosis muscle Administering an injection into the semimembranous/semitendinosis muscle group, the tip of the needle (white arrow) should be directed toward the caudal aspect of the limb so if the patient moves, the needle will not advance toward the sciatic nerve. Notice the left hand is being used to isolate the muscle group caudel to the femur.
  • 46. Lumbar muscle The dorsal lumbar muscles on either side of the midline can be used for IM injections. The thumb of the left hand is on the transverse processes of the lumbar vertebrae.
  • 47. Factors to Consider: SC Injections  For SQ (subcutaneous) injections, in general, use:  An 18 or 20 gauge needle, 1 to 1.5 inches long.  SQ medications are deposited into the loose connective tissue just below the dermis.  This tissue is not richly supplied with blood vessels so the absorption rate is slow.  There are many pain receptors in this tissue so only non- irritating, water-soluble medications in small doses should be given by the SQ route.
  • 48. The loose skin over the shoulders and neck is an ideal site for subcutaneous injection. 
  • 49. Procedure for sc injection
  • 50. Topical medications  External surfaces  eg the skin, eyes, ears  Exposed mucous membranes  eg gums, nasal mucosa, prepuce and penis, vulva and vagina.  Medication may work  Topically - on only the area to which it is applied  (eg ringworm ointment)  Systemically (eg Spotton, Ivomec Pour On, DMSO)  
  • 51. Cream  CREAMS – the drug is dissolved in water and mixed with oil or fat. Creams spread easily and penetrate the outer layers of the skin  A semi-solid water-soluble emulsion which penetrates the skin surface  Tubes or plastic squeeze bottles  Wash off with water.
  • 52. Ointment  OINTMENTS – the drugs are present in a base of wax or fat. They do not penetrate the skin.  Semi-solid oil-based preparation, usually with a base of wax or jelly  Comes in tubes, jars, etc.  Does not usually get absorbed by the skin, (eg prednoderm).
  • 53. Suspension  Liquid preparation in which particles suspended in the liquid  Will separate out on standing, so needs to be shaken, (eg calamine lotion, yellow lotion)
  • 54. Rinse/Wash/Solution  Liquid which often diluted and poured on an animal  May have a residual action when dry, (asuntol, otoderm, ectodex).
  • 55. Aerosol  SPRAYS – a way of applying liquids in fine droplet form  Liquid under pressure  Sprayed on as particles of liquid suspended in air, (eg chloromide, debrisol, frontline, fly repellent)
  • 56. Powder  Finely particulate solid preparation which dusted on  Can be irritant to open wounds  May help to dry weeping wounds, (eg tricin powder, pinkeye powder)
  • 57. MEDICATED SHAMPOOS  MEDICATED SHAMPOOS – drugs mixed with detergents which penetrate the coat. Shampoos are left in contact with the skin for the recommended amount of time and then should be rinsed off thoroughly.
  • 58. EYE & EAR MEDICATION  EYE & EAR MEDICATIONS – these are both examples of topical medication.  Eye medications should be sterile. Once they have been opened they should be stored only for the length of time recommended by the manufacturer.
  • 59. Aural medications  Drops or Ointments  The ear is ideally cleaned of wax and discharge before administration of medication
  • 60. Medications per rectum  Enema  Suppository  Fluid replacement
  • 61. Enema  Commercial solutions  Syringe, tube or pack (eg Microlax® )  Soapy water  Funnel and tubing  Other substances  paraffin, bloat treatment (Tympanyl®) )
  • 62. Suppository  Bullet shaped, semi solid, glycerine based  Melts at body temperature  Can contain antibiotics, laxatives, soothing agents  May be absorbed systemically
  • 64. Pessaries  Large tablets  Usually antibiotic  May also have a foaming agent  Administered by hand when the cervix is open for example, after a calving
  • 65. Intra-uterine fluids  Administered via the cervix with a pipette or balloon (Foley) catheter  During oestrus when the cervix is relaxed  Some will remain in the uterus, while others will be siphoned out again
  • 66. Health & Safety and Administering Medicines  Health and safety should be considered in order to make sure that we don’t get hurt whilst administering medicines.  It is also important to ensure that the animal doesn’t get hurt or frightened.
  • 67. What are the risks to animals when administering medicines?  Overdose  Allergic reaction  Wrong administration route selected  Animal stressed  Animal gets injured
  • 68. How can these risks be minimised  Follow instructions carefully  Make sure that the animal is adequately restrained  Use sprays in a well ventilated area  Wear appropriate PPEs (e.g. gloves, mask etc)