Case Study Guide

Information That Should Always Be Included:

Medication Details

When it comes to discussing medications you MUST include the following details for each and every medication and administration:

  • Name of drug (active ingredient name must be used)
  • Reason for administration
  • Dose rate and calculation for that patient (if necessary)
  • Dose given (in mg)
  • Route of administration
  • How you recorded this information (chart, file, invoice etc)
  • Schedule for the drug, and who can prescribe/dispense/administer (only required once for each schedule mentioned).

Any time you mention a medication, it is important you use the actual active ingredient name, so instead of Metacam you need to put in ‘meloxicam’, or instead of Noroclav, you must put ‘clavulonic acid/amoxycillin’.

If you do need to mention a brand name as the active ingredient is not available, you must put the manufacturer in brackets afterwards- ‘Metacam (Merial)’.

You must also include the strength of the drug, so if you were administering 1 x 250mg tablet of Noroclav twice per day, you would need to put is as:

clavulonic acid/amoxicillin 25mg PO BID

The first time for each case study you mention an abbreviation like PO BID you need to explain the abbreviation in full so:

clavulonic acid/amoxicillin 25mg PO BID (PO is for Per Os where you administer the medication orally, and BID is a medical abbreviation for twice per day, or every 12 hours.

If you were giving an injectable medication you must give the total dose administered in mg. So if you gave 2mLs of a drug that was 10mg/mL, you write it as ‘20mg’. It is not acceptable to write that you have 2mLS of a drug, as this does not give an accurate dose.

When discussing a particular dose rate, such as 5mg/kg, you must explain how to calculate that out to the correct total dose for that patient. You should never refer to a dose rate as something like 1mL/10kg, always look for the proper dose. If this is not on the bottle or packaging, it will be found in the product insert or any drug manual.

Carprofen 2mg/kg was prescribed. For this patient at 12kg, this is 2mg x 12kg = 24mg. Carprofen comes in 25mg tablets, so the patient was administered 1 x 25mg tablet PO BID. This was recorded on the patients hospitalisation chart directly after being administered.

Remember, you must also mention the schedule of each drug and discuss who can prescribe etc (for the first time only). So for this example you would write:

Carprofen 2mg/kg was prescribed. For this patient at 12kg, this is 2mg x 12kg = 24mg. Carprofen comes in 25mg tablets, so the patient was administered 1 x 25mg tablet PO BID. This was recorded on the patients hospitalisation chart directly after being administered. Carprofen is a schedule 4 drug which means it must be prescribed by a registered veterinary surgeon. A veterinary nurse can dispense and administer the drug under the supervision of a veterinary surgeon.

If this was the second or subsequent time you mentioned a schedule 4 drug, just writing ‘Carprofen is a schedule 4 drug.’ is fine.

If the patient is being discharged with any medications then you must discuss the dispensing of these medications (including the correct packaging and labelling), how you communicated the administration instructions to the client (and what these instructions were) and the information included on the dispensing label. Make sure you consider any legislative or OHS requirements.

An example of how to discuss how a drug works (for Diploma students):

Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) of the oxicam class, and is prescribed as an analgesic, especially where there is an inflammatory component. Meloxicam inhibits cyclooxygenase (COX), the enzyme responsible for converting arachidonic acid into prostaglandin H2—the first step in the synthesis of prostaglandins, which are mediators of inflammation. Meloxicam has a long half-life which permits once-day dosing. Meloxicam use can result in gastrointestinal toxicity and bleeding, so patients should have their bowel movements monitored for occult blood.