Nursing Cats and Dogs 2

‘6 Rights’ of drug administration

Right patient, right drug, right dose, right route, right schedule, right documentation

Routes of administration

enteral, inhalation, topical, parental

Enteral

oral, tubes

Inhalation

gas, vaporized, nebulized

Topical

dermal, mucous membranes, transdermal

Parental

intradermal, Sub-Q, IM, intraperitoneal, IV, intra-arterial, intracardiac, intra-articular, intraosseous, spinal

forms of enteral meds

tablets (scored), capsules (one dose), liquids (solutions, suspensions, syrups, pastes)

forms of inhalant meds

gas, nebulized, mists

forms of topical meds

emulsions (2 liquids combined), ointments, creams, lotions

forms of parental meds

solutions (IV, IM, Sub Q) , suspensions (IM, Sub Q), oil based (IM)

Implants

injected, slowly broken down into blood stream over time

Enteral Meds

Absorbed through GI mucosa and circulation, slower onset and longer duration

Problems with enteral meds

emesis, slow onset, gastric acid, rapid metabolism, absorption (+/- food)

Why are oral meds convenient

rapid administration

Contraindications of oral meds

emesis, mouth/head trauma, inability to swallow

Liquid meds

dogs and ferrets will take it as long as it tastes good, cats will not

When can you divide tablets

when there is scoring on it

Pilling methods

pilling device or by hand (if cooperative)

How to pill a dog

elevate nose slightly, touch roof of mouth once they open a little so they open mouth all the way, use lips to cover teeth to discourage biting, put pill past the base of the tongue, close mouth, rub throat to induce swallow

How to pill a cat

same as dog except you have to do it fast and you cannot let them taste it or you won’t be able to try again

How to use pilling device

same as using your hand except you have to be careful to not cause trauma

How to administer liquids

put liquid in buccal pouch so it runs down into throat, can elevate head but should avoid in smaller animals

Orogastric tube meds

activated charcoal. gastric lavage, decompression, feeding

Orogastric tube restraint

dogs: moderate physical; cats: sedation

Orogastric tube complications

aspiration (regurgitation, improper placement)

Equipment for orogastric tube

tube (size dependent), speculum (prevents biting), lube (water soluable), syringes

orogastric tube placement

measure (nose to last rib), mark, lube (generous), speculum (2” tape roll), insert, verify its in stomach, deliver meds slowly

Nasogastric/nasoesophageal uses

feeding, meds

Nasogastric/nasoesophageal placement

measurement: stomach- 13th rib; esophagus- 8th rib, ventral medial, topical anesthesia (prevents sneezing)

Nasogastric/nasoesophageal complications

aspiration, dislodged, epistaxis (bloody nose)

Other tubes you can use

esophagostomy (caudal to hyoid), gastrostomy (attached to stomach wall), enterostomy (bypass stomach, straight to intestines), pharyngostomy

Inhalation meds

vaporize- anesthetics; nebulized- antibiotics, respiratory drugs; mists- inhalers

Locations for topical meds

skin, mucous membranes (ocular, oral, rectal, nasal, tracheal, mammary glands)

Local topicals

dips, shampoos, ointments, creams, powders

Systemic topicals

transdermal, solutions, vaccines

Topical absorption

Skin: slow, DMSO (additive to help cross skin barrier); Mucous Membrane: rapid

General principles when giving topicals

gloves, clean sites (+/- clip hair), avoid contact, prevent licking

Giving topicals in ear

make sure tympanic membrane is intact (if not don’t give meds as it can make them deaf), put med in ear, massage it from outside

Cleaning ear

make sure tympanic membrane is intact, otoscope (deep clean), simple clean with solution and cotton swabs/balls, put solution in ear, slosh and shake, clean with cotton swab/ball (if using swab make sure to not go too deep in ear)

Principles of giving eye meds

restraint (control front legs), avoid contact, no sharing between patients, intervals between drugs (3-5 mins)

Technique for giving eye meds

hold eye open (using thumb to pull back eyelid), drop med into eye (without touching container to eye), manually blink eye (slowly)