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Pharmacology
Chapter 15 Therapeutic Nutritional, Fluid & Electrolyte Replacements
| Question | Answer |
|---|---|
| Explain the distribution of water in the body. | 50-70% of total body weight in adults; 60% used as average. TBW (total body water)=ICF (60% TBW; 40% body weight) + ECF (40% TBW; interstitial 15% body weight; intravascular/plasma 5% body weight). Intravascular: 90 mL/kg (dogs); 45 mL/kg (cats). |
| Describe the composition of body & therapeutic fluids. | Solutes vary from compartment to compartment. ECF--most cation sodium; most anions chloride & bicarbonate. ICF--major cations potassium, magnesium; major anions phosphates & protein. Therapeutics balanced if they resemble ECF. |
| Describe osmotic pressure as it applies to fluids. | ability of particles to attract water. Osmolality is the determination of the osmotic pressure based on # solute in 1 kg of solution. Osmolarity # particles /liter solvent rather than kg. 1 osmol (osm)=1 g molecular wt/#particles formed by dissociation. |
| Describe tonicity as it applies to fluids. | Total effective osmolarity/osmolality of a solution; effective osmoles-capable of generating pressure; ineffective osmoles cannot. Dog/cat fluids--osmolality 300 mOsm/L; commercial fluids 300 mOsm/L=isotonic; under 300 hypotonic; over 300 hypertonic. |
| Discuss principles of fluid therapy. | Critical but inexact. Hydration status determined by history, exam, basic lab tests. Volume fluid needed= hydration deficit + maintenance + ongoing losses. Hydration deficit = % dehydration x normal weight. Rate & type important. Ideal infused 24 hrs. |
| List routes of potential water loss. | Urine, fecal water, sweat (horses), respiration. |
| List sources of water intake. | Water that is drunk; ingested in food; resulting from metabolism of food. |
| Describe the standard protocol for administering fluids. | Check for correct fluid, not out of date; solution is clear, container not cracked, cap intact; don't contaminate port; close flow clamp, wipe w/ swab, insert set spike; hang bottle, fill set; close flow clamp; attach to IV; open flow clamp & adjust rate. |
| Describe a piggyback fluid administration setup. | Administer two fluids simultaneously. Secondary bag is hung higher than primary bag; both are connected at Y port. |
| What is a three way valve used for? | Permits a three way connection in fluid administration; the flow of fluids depends on the position of the control handle. |
| Describe crystalloids. | Fluid containing electrolytes & non-electrolytes; capable of passing through cell membranes. Rapid equilibrium of fluid between intravascular & interstitial. Isotonic high-sodium (replacement); hypotonic low-sodium (maintenance); hypertonic saline. |
| Describe colloids. | Contain large molecular wt particles, unable to cross cell membranes (confined to vascular space). Hold fluid in vascular space & draw from interstitial space (expands plasma volume). Synthetic starch-based (HES); natural (albumin; fresh frozen plasma) |
| What are fluid additives? | Special substances added to IV to enhance therapeutic effects. Sodium bicarbonate--alkalizing agent, correct metabolic acidosis; potassium chloride (potassium); calcium; 50% dextrose (calories); vitamins. |
| List different oral electrolyte preparations. | Powders mixed w/ water; oral pastes/fluids; oral route useful when owner following vet directions; glucose & glycine enhance absorption for calf scours; may be helpful as follow up to IV therapy for dogs w/ prolonged vomiting/diarrhea. |
| Describe water-soluble vitamin products. | Vitamin B complex--help stressed or debilitated animals; thiamine hydrochloride (B1)--bracken fern poisoning, thiamine destroying factors in rumen, thiaminase in raw fish; cyanocobalamin (B12)--red blood cells fail to mature (rare in veterinary med) |
| Describe fat-soluble vitamins & their uses. | Vitamin A- growth/maint of skin, bones, pigment in retina. D (D2 & D3)--deficiency causes rickets in young, osteomalacia in adults. E--metabolism of sulfur; selenium/E deficiency (white muscle disease, mulberry heart, myositis). K--form prothrombin. |
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kidtaxi9
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