Video
-drugs and prescription
http://www.youtube.com/watch?v=6v1HxdnLVLo
Intro to Pharmacology
Pharmacology Definition
Pharmacology is the study of the nature, uses, and effects of drugs
Drugs affect the body and the body affects the drugs
• Vocabulary of pharmacology
• How drugs interact with the body and how they pass through
the body
• Common classifications of drugs and their characteristics
• Concepts of proper drug administration - concentrations,
dosage, frequency
Bell Work Thursday March 6
1. Pharmacology is the study of________________________.
2. Drugs affect ________________.
3. The body affects _____________.
(Pharmacodynamics and Pharmacokinetics)
Bell Work Tuesday March 18
 What are some of the differences between Over The Counter
drugs and Prescription drugs?
 Purchase
 Directions
 Safety Factor how they are regulated by the FDA
 What 2 major characteristics define a control drug?
 A drug is a chemical compound that is used as an aid in
diagnosis, treatment, prevention of disease or other abnormal
conditions, for the relief of pain and suffering, or to control
or improve any physiologic or pathologic condition.
 A poison is a substance that may cause structural damage or
functional disturbance
 Pharmaceutical vs Nutraceutical
 OTC / Over the counter drugs
 Prescription Drugs
 Control Drugs
 Narcotic
 Drugs used in food animals
Over the Counter drugs
•Can be bought without a prescription
•Can be bought at multiple places (stores)
•Regulated by FDA which monitors what are acceptable
ingredients, doses, formulations, and labeling for
OTC drugs.
OTC Drugs
Tylenol
Triple- antibiotic cream
Peptobismol
Benadryl/ antihistamines
Robitussin
Aspirin
Prescription
•Prescribed by a doctor
•Purchased at a pharmacy
•Prescribed for and intended for only one person / not general use
•Regulated by the FDA: includes all animal and human data and
analyses of the data, as well as information about how the
drug behaves in the body and how it is manufactured…
Prescription Drugs
Amoxicillin
Propranolol
Prednisone
Metronidazole
Enacard
Tylenol 3
Legend Drugs
Prescription drugs are also called legend drugs (they bear one of the
following legends)
Caution: Federal law restricts this drug to be use by or on
the order of a licensed veterinarian
Rx symbol denotes drog product as a legend drug
can be used instead of the caution statement
Labels on Veterinary Prescription
medications
Basic Information on Labels
Name, address, and telephone number of veterinary practice
ABC Animal Care Clinic
1234 Union Hills, Phoenix, Az 85555
928-123-4567
 Name of client
 Angie and Andy Collins
 Identification of animal(s) treated
 Species and numbers of animals treated, when possible
 Name of prescribing veterinarian
 Date of dispensing of drug
 Today’s date
 Name, active ingredient, strength, and quantity of the drug
dispensed
 Dosage and duration
 Route of administration / adequate directions
 Number of refills
 Number of authorized refills, expiration date
 Cautionary statements, as needed
 Slaughter withdrawal and/or milk withholding times, if
applicable
Prescription Labels as part of software
Other…
 Ultimate responsibility for any medication dispensed through
a veterinary practice lies with the authorizing veterinarian
 All medications dispensed must be approved by the
veterinarian
 Federal law requires pharamacists and physicians to dispense
medication in childproof containers. AVMA recommends the
same for veterinary medications!
Example of Drug Withdrawal Time
Label
Drugs in Food Animals
Drug Withdrawal Time (FDA and USDA)
The time needed after drug administration for drug residue to leave a marketable
animal used for meats, eggs, milk, organs, or other edible products.
Drug residues-what is leftover of the drug or chemical components
Each feed or drug manufactured for animal use must carry a label: Withdrawal
time = the length of time the animal must have been off the product for all residues
to have worked their way through and out of the animal’s body.
Adherence to all stated withdrawal times before marketing the animal’s meat or any
products (such as milk or eggs), you will help keep the human food supply safe.
FOOD ANIMALS
On drugs dispensed and used in animals that will be used for food Drug Withdrawl
Times must be listed on the label. Any drug given to a food animal can potentially be
transferred to people through ingestion of animal products (meat, milk, organs).
Example Drug Withdrawal Times
Agri-Cillin™ …AgriLabs… Beef Cattle… I.M… 10days
Amoxi-Inject® … Pfizer Animal Health …Beef Cattle… I.M., S.C…. 25days
Ivermectin Injection for Cattle and Swine… Durvet… Beef Cattle… S.C…. 35days
Ivermectin Pour-On…Durvet… Beef Cattle… Topical… 48days
Vira Shield® 2… Novartis (Farm Animal)… Beef Cattle… I.M., S.C… 60days
Vitamin A D B12 Injection… Vedco… Beef Cattle… I.M. …60days
Blood Stop Powder… AgriLabs… Beef Cattle… Topical
Note: Not for use on animals intended
for food purposes
Control Drugs
•Drugs that have the potential to be abused
•Drugs that have the potential to be addictive
•These drugs are classified by the Drug Enforcement Administration
according to abuse potential
•Use and distribution of control drugs are controlled and
monitored, special forms called schedules are filled out
which document the arrival of the drug and it’s departure
from the facility.
Control Drug Classification
C-I
C-II
C-III
C-IV
C-V
•Lower number indicates higher potential for abuse
•Controlling these drugs through intensive documentation
is very effective in reducing abuse, misuse, and diversion of
controlled drugs.
C-I
Schedule I or C-I drugs
•
Drugs with a high abuse risk or highly addictive.
These drugs have NO safe, accepted medical use in the
United States. Some examples are heroin, LSD, PCP,
and crack cocaine
• Research use
•Will not find a C-I controlled drug in a medical
facility and most likely will be an illegal drug if you do
C-II
Schedule II or C-II drugs
•
Drugs with a high abuse risk, but also have safe and accepted
medical uses in the United States.
These drugs can cause severe psychological or physical
dependence. Abuse may lead to severe dependence.
Overdose of many of these drugs is fatal
DEA Form 222 must be filed
Schedule II drugs include certain narcotic, stimulant, and depressant
drugs: Some examples are morphine, cocaine, oxycodone
(Percodan®), oxymorphone, methylphenidate (Ritalin), Sodium
Pentobarbital (inj)
Requires written prescription, no refills
C-III, IV, V
C-III-V
Drugs with an abuse risk less than Schedule II.
These drugs also have safe and accepted medical uses in the United
States.
Schedule III, IV, or V drugs include those containing smaller amounts
of certain narcotic and non-narcotic drugs, anti-anxiety drugs,
tranquilizers, sedatives, stimulants, and non-narcotic analgesics.
Some examples are acetaminophen with codeine (Tylenol® No.3),
hydrocodone with acetaminophen (Vicodin®), diazepam (Valium®),
alprazolam (Xanax®), propoxyphene (Darvon®).
C-III
Abuse risk is less than CI and CII drugs
A DEA registration number is required for the prescribing veterinarian
Written prescription, refills up to 5 times within 6 months
Abuse may lead to moderate dependence
Examples: Tylenol w/ Codeine, Anabolic steroids
C-IV
Abuse risk is considered low
A DEA registration number is required for the prescribing veterinarian
Written prescription, refills up to 5 times within 6 months
Abuse may lead to moderate dependence
Examples: Diazepam (valium) phenobarbital
C-V
Abuse risk is considered low
A DEA registration number is required for the prescribing veterinarian
Written prescription, no DEA limits on refills
Lowest potential for abuse
Ex: Lomotil, Robitussin AC
Narcotic
Definition: a drug (codeine, methadone, or morphine) that in
moderate doses dulls the senses, relieves pain, and induces profound
sleep but in excessive doses causes stupor, coma, or convulsions,
death
…derived from opium or compounds similar to opium. Such drugs
are potent pain relievers and can affect mood and behavior. Longterm use of narcotics can lead to dependence and tolerance
Opiods
•Opiod
• is the preferred medical term for narcotic drugs due to abuse and illegal use associated with
these drugs.
•Opiods are derived from opium or are synthetically produced.
• Examples: Morphine, oxymorphone, fentanyl, methadone, tobutrol/torbugesic,
hydromorphone, codeine (agonists-moderate to severe pain)
• butorphanol (agonist-antagonist –mild to moderate pain, short acting), bupreorphine (partial
agonist-long acting analgesic)
(apomorphine)
•Used medically for analgesia
• Other medical effects: deep sleep, depress respiration or cough reflex, constrict pupils,
cause smooth muscle spasm, decreased peristatlsis, emesis
•How they work: bind to opiate receptors in the central nervous system (CNS)
•Antagonists: Naloxone
• Displaces opiates fromCNS receptor sites
Activity
DEA Form C-222 (often referred to as form 222)
You need to place an order for your clinic.
The order includes 5 10cc bottles of Diazepam, 2 bottles of 250
mg Injectable Sodium Pentobarbital, and 1 bottle of 62.5 mg
Phenobarbital (1000 tablets)
Which control drug do you need to fill out a Form 222 on?
Classroom Activity
During class, pass around the bottle of “Phenobarbital”.
Log and count out how many pills you needed for the prescription
you are filling.
Pass the log and bottle to next student
Repeat until everyone in class has done this.
Check “inventory” to see if it agrees with the log.
Activity
Keeping a Control Drug Log
Perpetual inventory for EACH control drug (C-II through C-V)
Control drugs in (from purchase) and control drugs out
(prescription) add/ subtract / balance
Client’s name and animal name
The law requires these drugs be stored where in the clinic?
Access limited/ restricted
Records must be “readily retrievable”
 Sodium Pentobarbital is a C-II Drug
 Diazepam and Phenobarbital are C-IV
 Form 222 are used for ordering C-II Control Drugs
 After filling out the 222 what do you do with the copies?
 Do NOT separate the first two copies of the form (color coded
brown and green). Do NOT remove the carbon paper between
the two copies
 Suppliers can only accept forms where these two copies are not
separated and carbons are intact.
 Which Drug?
 C-II Sodium Pentobarbital
 Name of supplier?
 Oak Pharmaceuticals
 Street Address
 6780 E. Atlantic Parkway
 City and State
 Cape Coral, FL 47777
 Date:
 “today’s” date
 Line 1
 No. of packages
 2
 Size of package
 250 mL
 Name of item
 Sodium Pentobarbital
Pharmacokinetics-body works on the
drug
Absorption - the process of a substance entering the blood
circulation.
Distribution- the dispersion or dissemination of substances
throughout the fluids and tissues of the body.
Metabolization (or biotransformation, or inactivation) – the
breakdown of molecules (drugs or medications) into smaller
molecules.
Excretion - the removal of the substances from the body. In rare
cases, some drugs irreversibly accumulate in body tissue
Pharmacokinetics
-how the body acts upon drugs
Absorption
– Enteral Gastrointestinal Tract
Drugs that are taken orally
- Parenteral IM and IV
by -passing the GI system
no absorption through intestines…directly to blood stream
- Transdermal “patches”
absorbed through the skin
- Respiratory droplets
inhaler, nebulizer
Absorption may follow
the flow of blood
circulation From the digestive
system/ intestine, to
the liver (portal shunt)
To venous circulation,
to the (right side) heart,
To the pulmonary
arteries through the
lungs,
To the (left side) heart,
to the aorta (arterial
circulation)
Distribution
Bioavailability – usable by the body - is based upon:
-how much of the drug is available for absorption
-how much of the drug is extracted – usable by the body
*Parenteral dosing by IV route has 100 % because absorption and
extraction are bypassed
Not limited in absorption
Metabolismmodify drug from active to inactive metabolites (result of breaking up the
drug/metabolization)
(drugs are molecules=therefore drugs interacting with body =
chemical reactions between molecules)
Occurs in the LIVER
Chemical changes to the drug are caused by the liver
***First Pass Effect - the liver encounters drug before it enters the system***
(Enteral drugs)
absorption from small intestine, enters blood circulation, specifically
small intestine to hepatic to heart to body (systemic circulation)…reduces
bioavailability
Elimination
metabolites (by products of metabolizing the drug) are
eliminated through excretion
•
kidney – urine
•
GI – feces
Sometimes the metabolites are toxic to the animals kidneys
If liver or kidneys are damaged drugs may not be eliminated efficiently
Some oral drugs are not absorbed and pass right through the intestines
unchanged and are excreted in feces (anthelmintics)
How drugs can be administered
(Routes of administration-how the drug enters body)
Intramuscular (IM)
Subcutaneous (SQ)
Transdermal
Intradermal
Intraosseus
Orally (PO)
Sublingual
Sub mucosal
Intravenous (IV)
Rectal
Topical
Intranasal
Remember: Intra- refers to within (or inside) You would not use inter- because that
means between!
Routes of Administration
 Orally – will pass through liver (first pass effect)
 IV – enter directly into vein
 IM – enter blood stream slower than directly into vein
 Rectally – enters quicker than oral
 SQ-absorption is slower because subcutaneous tissue is less
vascular than muscle
 Intestine, Liver, Veinous, Left Side Heart, Lungs, Right Side
Heart, Artery, arterial circulation to tissue (target cells or
receptors)
Measuring liquid with syringes
Parts of syringe with needle
Hub
 http://www.youtube.com/watch?v=CtnKuLWFpQ4
How do drugs work video…
Pharmacodynamics
-Drug works on the body
Relationship between drug concentration and resulting effect
•Potency of drug = maximum effect of a drug
•Therapeutic range
below the range = no benefit
above the range = toxic
•Time duration of effect of drug
Physiological effects of drugs
Drug needs to bind with a receptor
-on neurons (CNS)
-cardiac muscle
-within bacteria
Variations in ADME (pharmacokinetics) can affect effectiveness of drug
very young, very old
very thin, obese
other medications
disease (kidney, liver)
MATH (Oh no!)
Math is used to help understand how medications are absorbed into the
body, what happens when medications are there, and how your body gets
rid of them
…because absorption is happening
elimination is happening
time is happening
So, you have variables and differentials (change in function y=f(x) with
respect to independent variables)
This is calculus…I cannot
even begin to explain the
relationship between the
formula above and the
graph. Just know that
there are many variables
with respect to the
function of time. Calculus
is the math that allows a
pharmacist or a drug
researcher/ manufacturer
to predict at what point a
drug might be most
effective!
We can see in the graph the portion where the concentration increases (up to around t = 3) and
levels off. The concentration then decreases to almost zero at t = 24.
Drugs and Medications
Name of the drug – generic name based upon the
chemical structure of the drug
Trade name or “brand”
Grouping of drugs within their classification
Classification or categories of drugs according to
the effect they have on the body
Routes of administration
Species drug is approved for
Categories of Drugs
 Antibiotics/ Antimicrobials
 Analgesics and sedatives
 Anesthetics









(general anesthetic, conscious sedation, regional and
local anesthetics)
Cardiovascular
Respiratory
Gastrointestinal
Anthelmintic
Hormones and endocrine (synthetic hormones)
Vaccines (biologicals)
Topical
Oncological
Euthanizing agents
Antibiotics
How antibiotics work:
•
toxic to bacteria
•
least resistant (weaker) bacteria die first…if full course is not
given, the more resistant bacteria survive and reproduce
•
bacteriocidal (kills)vs bacteriostatic (stops from reproducing)
•
Classes ( “How” they work): aminoglycoside, penicllin,
cephalosporin, chloramphenicol,quinolone, macrolide,
antifungal, antiprotozoal, sulfonamide, tetracycline
Aminoglycosides
• Bacteriocidal
make their way into the bacteria, attach to ribosomes which
are responsible for making proteins, which kills the cell
(bacteria is cellular)
amikacin
gentamicin
Penicillins
• Bacteriocidal
destroys cell wall
amoxicillin
ampicillin
amoxicillin/clavulanate
penicillin G
Polymixins/Polypeptides
• Bacteriocidal
Changes the permeability of cell wall so the cell dies
Bacitracin
Polymixin B
Tetracylcines, Chloramphenicol,
Macrolides, Lincosamides
• Bacteriostatic
Prevent protein synthesis so cell doesn’t reproduce
Tetracycline
Doxycycline
Oxytetracycline (Terramycin)
Chloramphenicol
Azithromycin
Erythromycin
Clindamycin
Cephalosporins
• Bacteriocidal
affects bacterial cell wall
Cefazolin
Cefalexin
Sulfonamides
•
Bacteriostatic
Prevents nuceic acids from building dna and rna/ cells can’t reproduce
Trimethoprim-Sulfamethoxazole (Co-trimoxazole)
(TMP-SMX)
(SMZ-TMP)
Sulfa drugs
Sulfasalazine
Creates light sensitivity, also possible kidney failure
Quinolones/Fluoroquinalones
Bacteriostatic
interference with DNA or RNA
enrofloxacin (Baytril)
ciprofloxacin
levofloxacin
orbifloxacin (Orbax)
marbofloxacin (Zeniquin)
Can cause birth defects, retinal myopathy in cats, CNS (if CNS
already affected), usually not used in very young
Metronidazole, Grisofulvin,
Ketoconazole
Bacteriostatic
Metronidazole
-Produces toxic free radicals that disrupt DNA and proteins.
This non-specific mechanism is responsible for its activity
against a variety of bacteria, amoebae, and protozoa.
• Bacteriostatic: Interference with DNA and RNA
Griseofulvicin anti fungal
Ketoconazole antifungal
Clotrimazole antifungal
•
Bell Work Monday March 24
How do antibiotics work?
Bacteriocidal
Bacteriostatic
What is the reason for telling the client that their pet needs to take
all of the antiobiotics prescribed for that pet?
Antibiotics will start to work on the least “strongest” bacteria and
patient starts to feel better…however; the “stronger” bacteria are
still residing in the body. If antibiotics are discontinued the stronger
bacteria live and multiply creating a more resilient/ stronger
bacteria.
•Anesthesia is a state of unconsciousness induced in an animal. The three
components of anesthesia are analgesia (pain relief), amnesia (loss of
memory) and immobilization.
• Often multiple analgesic and sedative drugs are combined to induce the state of anesthesia
•
•
•
•
(cocktail)
Classes : Inhalant, dissociative, opiate, barbiturate, sedative/hypnotic
Overdose of some general anesthetics are used for euthanasia
Any general anesthetic can be fatal if overdose occurs
Anesthesia involving state of induced unconsciousness is often referred to
as general anethesia
Analgesics, Sedatives, Anesthetics
•Analgesia is the relief of pain.
•Sedation provides skeletal muscle relaxation, anxiolysis (antianxiety), and amnesia. They have no
direct analgesic properties.
Classes of analgesics and sedatives:
Tranquilizers, NSAIDS, Opiods, alpha 2 agonist (produce sedative and
analgesic properties), corticosteroids
An agonist-activates the neuronal receptor that it attaches to (can stimulate or inhibit within
CNS)
An antagonist- deactivates receptor (reverses)
Morphine-> Naloxone
Xylazine-> Yohimbine
Anesthetic agents (Injectibles)
1.
Barbituates
1.
2.
3.
Phenobarbital
Pentobarbital (Nembutal)
Thiopental Pentothal
Slow onset, long duration (long to “wear off ”) of some barbituates
Sedative, hypnotic, control seizures
CNS depression resulting in mild sedation – surgical plane of anesthesia
No analgesic properties
Barbituates do cross placenta barrier and will affect fetus in utero
Anesthetic agents (Injectibles)
1.
Dissociative anesthetics
1.
2.
Ketamine
Tiletamine (Telazol)
Cataleptic state (lack of response, muscular rigidity)
CNS stimulant (not depressant)
Analgesia, immobility, dissociation from environment, amnesia
Anesthetic agents (Injectibles)
Propofol (Rapinovet, Propoflo)
causes CNS depression by decreasing brain activity
Rapid onset, rapid recovery
potent respiratory depressant
safe particularly for C-sections
Anesthetic agents (Inhalent)
Halothane- 1950s, general CNS depressant, crosses the placenta
Isoflurane – 1970s, general CNS depressant, crosses the placenta
Sevoflurane-1990s, CNS depressant,
Very small amount of drug is metabolized by liver in Iso and Sevo
Analgesics, Sedatives, Anesthetics
•Analgesia is the relief of pain.
•Sedation provides skeletal muscle relaxation, anxiolysis (antianxiety), and amnesia. They have no
direct analgesic properties.
•Classes of analgesics and sedatives:
Tranquilizers – Acepromazine, Diazepam (Valium), Midazolam (Versed)
•
•
Muscle relaxing, calming, low sedation
•
NSAIDS – Flunixin meglumine (Banamine), Carprofen (Rimadyl), Ketoprofen
•
Opiods- morphine, hydromorphone, codeine, etc
•
alpha 2 agonist (produce sedative and analgesic properties)-xylazine
(rompun),medetomidine (domitor), detomidine (dormosedan)
•
corticosteroids (act as analgesics by reducing tissue swelling) Dexamethasone,
Prednisone
•
local anesthetics (block nerve sensation)-lidocaine, marcaine, bupivicaine
An agonist-activates the neuronal receptor that it attaches to (can stimulate
or inhibit within CNS)
An antagonist- deactivates receptor (reverses)
Morphine-> Naloxone
Xylazine-> Yohimbine
Bell Work Tuesday March 25
Match the following classification of drugs to their definition:
Anesthetic Drugs
Analgesic Drugs
Sedatives
relaxes, calms the patient
produces a state of unconsciousness
relieve pain
Why do medical professionals often combine drugs when placing a patient
under anesthesia?
Cardiovascular, Respiratory,
Gastrointestinal Drugs
•Cardiovascular
Antiarrhythmics, Diuretics, Positive Inotropes and
Catecholamines (increase the strength of contractions), Vasodilators
•Respiratory
Antitussives, Expectorants, Bronchodilators, Antihistamines
•Gastrointestinal
Emetics, Antiemetics, Antidiarrheal, Laxatives, Antacids, Antiulcer
Anthelmintics
Anthelmintics kill or inactivate parasites-external and internal
•Fenbendazole (Panacur)
•Ivermectin (Ivomec, Heartguard))
•Melarsomine (Immiticide)
•Metronidazole (Flagyl)
•Praziquantal (Droncit, Droncit
•plus)
•Pyrantel Pamoate (Nemex) (Pyrantel Tartrate=Strongid)
•Pyrethrins (chrysanthemum) and Permethrins (synthetic) (Many topical
OTC products)
Measuring and Calculating Drugs
When talking about Weight (Mass)
Gram – G
(Gx1000) = 1 Kilogram – Kg
(G/ 1000) = 1 Milligrams - Mg (x1000) = 1 Gram (1/1000th)
You need to know an animal’s weight in order to decide how much of a
drug to give to it…
Weight
One of the most common conversions in medicine is pounds to kilograms
Example:
50 lb dog = 22.7 kg
23.3 pounds =
11 lb cat = 5 kg
79.5 pounds =
860 lb horse = 390.9 kg
220.1 pound=
Small weights
Really small animals!
Increments under a pound as decimal or as ounces
0.5 pound rat = 0.227kg
Math: 0.5 lb / 2.2 =0.227kg
8 oz rat=0.227 kg
Math: 8 oz/ 16= 0.5lb, then 0.5 lb/ 2.2= 0.227kg
(If given in ounces, convert to decimal then divide by 2.2)
4 oz puppy = 0.114 kg (which = 114 grams) [ 0.114 kg x1000 =114 g)
1 lb pocket pet = 0.45 kg ( 45 grams)
1 ounce = 0.028kg (028 grams) (you don’t really write the zero)
Examples
1.
Gypsy weighs 32 pounds. How much does she weigh in kilograms?
2.
The Chihuahua weighs 13 pounds…how many kilograms?
3. A newborn puppy weighs 3 ounces…how many kilograms?
4. My friend has a rat that weighs 2 kg. How much does it weigh in
pounds?
Make it simple? Kg to grams
0.90 kg = how many grams
Remember 1000…1 kilogram is 1000g (1 x 1000= 1000)
1 gram is 1000mg
0.9 kg is 900g (0.9 x 1000= 900)
0.45 kg is 450 g (0.45 x 1000 = 450)
0.258 kg is 258 g
0.035 kg is 35 g
0.900 move decimal 3 places to right
0.450 move decimal 3 places to right
0.258 move decimal 3 places to right
0.035 move decimal 3 places to right
Calculating Drug Dosages for Patient
Drug dosage is expressed units of drug per body weight of the patient.
Drug dosage usually looks like mg/ kg (milligrams per kilograms) when
working with solid medications (tablets, capsules, caplets, pills)
Drug dosage looks like mL/ kg when working with liquid medications
DRUG DOSAGE IS FOUND ON LABEL ON THE BOTTLE
Drug xyz dosage is 10 mg / kg
10 milligrams (of drug) per kilogram (patient)
Need pet’s weight – 35 pounds
Dose
Need to know the weight of an animal in order to know how much of a drug to
give it. Many dosages for oral drugs are given in mg/ kg
Example: Carprofen (Rimadyl)
Dose is listed as 4.4mg of drug/kg =?
Cefalexin
Dose is listed as 10 – 25 mg of drug/ kg every 8-12 hours =?
Diphenhydramine (Benadryl)
Dose is listed as 2 mg/ kg of drug every 6-8 hours=?
Pills
Pills (any oral form of medication except liquid) tablets, capsules, caplets
Pills are available in premeasured doses
Example
Carprofen is available in 25mg, 75 mg, 100mg
Cefalexin is available in 250 mg and 500 mg
Diphenhydramine is available in 25 mg
Furosemide is available in 12.5mg, 20mg, 40mg, 50mg, 80mg
•If the tablet is “scored” you may break in half for more accurate dosing
•The mg in a drug is actual weight of the drug in that tablet.
How much drug? How many pills?
Dog weighs 46 pounds
Dose of drug is listed as 6 mg/kg every 12 hours
•46 pounds/2.2 = 20.90kg
•20.90 kg x 6 mg/kg = 125.4 mg
•Drug is available in 75 mg, 125 mg, and 300mg
•Will give the dog 1 125mg tablet every 12 hours
More examples
•15 pound dog
Dose 2 mg/kg
Available as 25 mg, 50mg, and 100 mg scored tablets
•56 pound dog
1mg/kg
Available as 12.5 mg, 30 mg, 75mg
•67 pound dog
Dose 25- 30 mg/kg
Available as 150, 300, 500 mg
Bell Work Tuesday April 1
•27 pound dog
Dose 9 mg/kg every twelve hours
Available as 12.5 mg, 30 mg, 75mg
How many tablets of which size?
If you are sending home 1 weeks worth of medication, how many
tablets will you send home?
If the drug is administered every 8 hours?
Bell Work Wednesday April 2
Dog weighs 20 lbs
Amoxicillin is 11 mg/ kg every 12 hours.
Available in 50 mg, 100mg, 200mg, 400 mg unscored tablets. There is no
100mg Amoxilcillin on the shelf due to manufacture backorder.
How mg should this dog receive?
Which size tablet is your best choice and why?
You need to send home 10 days worth of medication.
How many tablets will you send home?
Activity Part 1
Take one bottle per group of 3-4 students
Find the Dosage according to the label
Strip of paper with weight of animal and how many sizes available
Find out how many tablets of this medication (per 24 hours) should
be prescribed for the animal.
THEN find out how many pills for a 10 day course of this
medication.
Vials for medications
A dram is a pharmacy unit of measure and is used in sizing
prescription vials. 1 dram equals approximately 18 oz.
Common sizes are:
6 dram
8 dram
13 dram
16 dram
20 dram
30 dram
40 dram
60 dram
Same drug - different strengths
(use the three check system every time!)
Counting and Dispensing Pills
3 Check system
1-Look at drug name and
concentration or strength
as you pull the bottle off
the shelf
2-Look again as empty
pills onto tableau
3-Look again when putting
back on shelf
Activity Part 2 Counting Accuracy
Counting pills
Bottles will be filled with Skittles
Count…check accuracy
Place in proper vial
#14
#30
#90
#120
#180
Liquid, oral medications
1 mL = 1 cc
Sometimes medications are only available in a liquid, or often,
smaller doses are available as liquid (usually called a suspension),
more accurate dosing.
Dosed similar to pills, except instead of using weight of drug (mg)
placed in a solid tablet you will use weight of a drug placed in a
volume of liquid (mL or cc)
Example
Amoxicillin in liquid form (also available in 50 mg, 100 mg, 250 mg,
400 mg tablets)
Dose is 15 mg/kg
As a liquid it is available as 50mg /mL
9 pound Maltese poodle mix
1. Weight is 9/2.2=4.09kg
2. Dose is 15 mg/kg
3. 4.09kg x 15 mg/kg =61.35 mg
4. Now what? Divide by 50… 61.35mg / 50 mg/ml =1.23 mls
Measuring liquid with syringes
Bell Work Monday April 7
Dog weighs 98 pounds
Dose of drug is 12mg/kg
1. How much does this dog get (Dose)?
Available as liquid 250 mg/ ml
2. How many mLs of this drug do you need to give this dog?
Bell Work Wednesday April 9
1.
5 pound puppy
1.
2.
3.
4.
Liquid Amoxicillan 50mg / mL
Dose is 15 mg/ kg every twelve hours
How much liquid Amoxicillin will you give the puppy
Sending home two weeks worth of medicine. How many mLs will you send
home?
Activity
Cups of water to practice pulling up various amount in various syringes.
First practice drawing up measured amounts.
Figure out dosing instructions
Draw up correct amount.
Fluids and Liquids
When talking about liquids (volume)
Milliliter – mL
Liter – L There are 1000 mL in 1 Liter
1 cc is exactly the same as 1 mL
Used interchangeably
Examples: Half a liter is how many mLs?
How many cc’s in a half liter?
Each number on a bag of fluids is 100 cc
Intravenous Fluids
Bags of fluids for dogs and cats come in 1Liter size
bags, also 500 mL and in some cases 250 mL.
The amount of fluids given to an animal can help or
harm it so the correct amount given over the course
of time is very important!
Simple IV Fluid calculations
You have decided to put Fluffy on what is called maintainance IV fluid
therapy as part of your treatment plan. Fluffy weighs 18 pounds.
The amount of IV fluids Fluffy will get is based upon the following
“doseage” of 30 mL/ kg. (This is just what you use as a general rule of
thumb for mainainance.) This amount will be given over a period of 24
hours.
The IV pump is programmed by putting the amount of fluids per hour
Fluffy should receive.
liquid drug preparations
1. creams, and ointments are expressed as percentage concentrations
2. a certain quantity of the drug is contained in the final quantity of
the product
a. 1 % hydrocortisone cream contains 1 g of hydrocortisone in
100 g final product (the actual drug plus the cream)
b. 5% sodium chloride solution contains 5 g sodium chloride
in 100 ml final product ( NaCl and distilled water)
c. 1 gram in 100 grams or 1/100 equal to 0.01, or 1%
d. 5 grams in 100 milliliters equal to 5/100 or 0.05, or 5%