1. PARENTERAL ADMINISTRATION OF DRUGS

2. ROUTES OF ADMINISTRATION
Oral (PO)
Sublingual
Via feeding tube
Types
Orogastric intubation
Nasogastric intubation
Rectal (PR)

3. ROUTES OF ADMINISTRATION
Aural
Topical
Aerosol/Inhalant

4. Parenteral Routes Parenteral: definition
Drugs administered with a needle and syringe
Subcutaneous (SC or SQ)
Intramuscular (IM)
Intravenous (IV)
Intradermal (ID)

5. Parenteral ROUTES Intraosseous (IO) Intraperitoneal (IP)
Intra-arterial (IA)
Epidural/subdural
Intracardiac (IC)
Intramammary

6. ROUTE OF ADMINISTRATION
Depends on many factors:
Health of patient
Symptoms
Absorption rate of drug
Temperament
Ease of administration for Veterinary Professionals and clients

7. ROUTE OF ADMINISTRATION
Drug Factors:
Type of medication/fluid
Formulation of drug
Cost efficiency
Systemic vs. local effect desired
Special handling?
Potential side-effects?

8. Comparison of common parenteral routes of drug administration

10. Skin layers
Epidermis – several layers thick, does NOT contain blood vessels
Dermis – comprised of blood vessels, lymph, nerve fibers, and accessory organs (glands and hair follicles)
Subcutaneous layer (hypodermis) – comprised of connective tissue and large amount of fat
Muscle lies underneath all of these layers

11. Before the injection Gather supplies Needles Syringe
Medication to be injected
Proficient person to restrain the patient

12. Syringes are available in various sizes

13. needles Needle gauge (size) is determined by: Route of administration
Size of patient
Consistency of drug being used
At least TWO (2) needles required:
One to draw up the medication
One to administer the medication
Why?

14. Injectable drugs Supplied as: Sterilized solutions
Powders that must be reconstituted with sterile solution (water or saline)
May be stored in:
Vials (single or multi-use)
Ampules
Fluid bags

15. Intradermal injections
Most common uses:
Desensitize skin
Allergy testing
Skin is usually shaved before administering an ID injection
Drug is NOT dispersed throughout the body

16. ID injection procedure
Skin lifted or pulled taught
25- to 27-gauge needle attached to a syringe inserted with the bevel up into the dermis
Allergy testing: a 0.1 ml volume of allergen is injected
Local anesthetic: dose of drug given by DVM
Injection site will have a translucent lump if injection is performed correctly

17. Subcutaneous injections
Vaccine administration
Fluid administration
Pain medications
Antibiotic injections
Insulin administration
Absorption rate is slow compared to other routes
Some medications/drugs are harmful if injected SC

18. Subcutaneous administration

19. Sc injection sites
Dorsolateral region from neck to the hips is preferred site
Dorsal region of neck and back should be avoided for drug administration
Cat vaccines: the __________________ should be avoided because of the incidence/risk of vaccine-induced tumors
Feline vaccines should be administered in as distal a portion of an extremity as possible

20. Sc injection procedure
Fold of skin is tented and the needle is inserted at the base of the tent.
Aspirate!
Why?
After injection, briefly massage skin to facilitate drug distribution

21. Intramuscular injections
Appropriate route for small volumes of medication
Common uses of IM route:
Sedatives/anesthetics
Pain medications
Heartworm treatment
Conventional route of administration for fractious animals
Generally more painful than SC or IV. Why?

22. Im administration

23. Im injection sites Drugs most often administered in:
Lumbosacral musculature lateral to the dorsal spinous processes
Semimembranosus/semitendinosis muscles of the rear leg
In the hind limb: the needle should enter the lateral aspect of the muscle and be directed caudally.
Why?

24. IM injection sites

25. Avoid the sciatic nerve!!!!

26. Im injection sites
Deep IM injections in the third to fifth lumbar region of the ________________
are used to administer adulticide heartworm treatment (Immiticide).

27. Im injection precedure
Isolate the muscle between the fingers and thumb
Use a 22 to 25 gauge needle attached to a syringe, and insert into the muscle at a __________ angle
Like with a SQ injection the needle hub is checked for blood before administration of the medication. Why? How?
Once in the muscle, inject the medication slowly
Massage the site for a few seconds after injection to help distribute the medication

28. Complications of IM injections
Tissue trauma
Pain at the injection site
Nerve damage

29. Intravenous administration
Drugs and/or fluids may be injected directly into a vein OR through an IV catheter
IV route produces an immediate response
Usually given slowly
Common use of IV route:
Inducing anesthesia
Chemotherapeutic agents
Anti-convulsant drugs
Irritant drugs

30. Intravenous administration
Emergency/resuscitation drugs
Large amounts of volume are needed
Requires a new needle for administration
Why?

31. Iv injection sites DOG: Cephalic Lateral saphenous CAT:
Medial saphenous
Femoral

32. Iv injection procedure
Expel all air bubbles from the syringe prior to inserting the needle into the vein
Restrainer should occlude the vessel with digital pressure or use a tourniquet
Grasp the extremity and pull the skin taut in a distal direction
Swab the skin and hair with an alcohol-soaked cotton ball
Insert a 20- to 25-gauge needle, bevel up into the vein

33. Iv injection procedure (cont’d)
Usually blood will enter the hub of the needle at penetration of the vein (flash), BUT placement is confirmed by aspirating.
What should we see?
Venipuncturist should communicate with the restrainer “I’m in”
Restrainer should release pressure from the vein
Inject the medication into the vein
If large volume of drug or movement of needle:

34. If using a tourniquet Most common:
Nye tourniquet or Penrose drain/rubber material
Can be very dangerous if used improperly
Goal is to visualize and palpate the vein
Must be able to remove before injecting!

35. Possible complications with iv injections
Injecting drug outside of the vein
Hematoma formation
Intra-arterial injection of drug
Hitting a nerve (pain, lameness, paralysis)
Air-embolus
Phlebitis
Septicemia