Medication Administration & Client Counseling: Student Summary

Name, indication, and route of administration
Frequency of administration and duration of therapy
How to use device and read dose markings
Storage and handling, including caregiver precautions
- Hazardous Drugs
  - Wear gloves when handling the medication and all waste
  - Designate a specific area of the yard to prevent exposure of hazardous waste to others, especially children and other household pets
Disposal of unused drugs
- Police departments
- Community “Drug Take Back” events
Any foods or other products to avoid
- Some medications may need to be separated by a window of two hours (or more) from any dairy products
- Non-prescription products (OTC) can interact with the medications
  - CBD products may cause drug interactions
Emphasize importance of returning to DVM for recheck appointments
Monitor for signs of efficacy (or lack thereof) or toxicity
- Remind of placebo effects
- Vital signs
  - Different by species
- Signs and symptoms can vary from those expressed by humans
  - Example: lip-smacking and inappetence may be a sign of nausea
Adverse event reporting — FDA Form 1932a
For compounded preparations
- Explain the limitations compared to an FDA approved product
- Monitor for any signs of instability (color, consistency, odor, animal refusing medication after initial acceptance)

Clip nails
Wrap in a towel
Place small amount on nose to saturate the olfactory system
Coat capsule or tablet with small amount of butter or cream cheese
Follow with water or moist food (due to horizontal orientation)
- Doxycycline (can cause esophageal stricture)
Create a game with medicated and non-medicated treats
Trial non-medicated samples
Mask taste with empty gelatin capsules
Demo video

Efficacy concerns
- Lack of bioavailability
Topical = systemic
- Cats are constant groomers. Regard anything topical as potentially becoming systemic.
Application location
- Find an area difficult to reach so medication cannot be licked off
- Pinna = hairless, inner part of the ear

Wear gloves
Wash hands
“Drying” time (1-2 hours)
- Utilize walking
- Avoid contact with area (monitor children and other animals)
Monitor for contact irritation
Calibration of devices

Intramuscular (IM) injections
- Greater chance of damaging blood vessels, pain
- < 5ml for big dogs
- < 2ml for cats and small dogs
Injection site sarcomas
- Rotate the injection sites in order to avoid
Insulin – may need to shake some formulations, don’t rub the area after injection, U-40 vs. U-100 syringes
Dismantling pens
- As a cost saving measure and to avoid waste, insulin pens can be dismantled and used as if it where a smaller vial, drawing the dose up through the septum
- Technique frequently employed with insulin glargine (Lantus)

General steps for administration
- Subcutaneous fluids administration demo
- Insulin administration demo
- Application of continuous glucose monitor demo

Wash hands
May require two people
Solutions – one drop at a time
Ointment – use “rice grain” amount
Do not touch the tip to eye – injury and contamination risks
Applying solutions and ointments concurrently – solution should be applied first, followed by ointment at least 5 minutes later
Applying two ointment products
- Wait 30 minutes between application of each product
- Equine patients may have a subpalpebral lavage system (SPL) catheter in place
  - delivers topical liquid medication onto the surface of the equine cornea
  - do not use oil based formulations with these devices due to clogging potential
Patients may salivate if solution gets into oral cavity

Nebulizers
- May create an enclosed area with the help of an empty aquarium or by placing a towel over patient’s cage
Using a metered-dose inhaler with a species-specific spacer demo

Intranasal versus rectal administration
- Impossible to instruct animal patient to retain suppository
Rectal administration
- After the administration, you want to pull the tail down to prevent immediate expulsion
Intranasal administration demo