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Case 2 “Pica,” is a 43 lb. Labrador Retriever puppy. He is post-operative for a foreign body but continues to vomit despite receiving several different drugs to decrease vomiting. At 8 AM rounds, the veterinarian orders you to begin a CRI of metoclopramide at a dosage of 2 mg/kg/day after administering a loading dose of 0.4 mg/kg IV. The concentration of metoclopramide is 5 mg/mL, Pica is receiving 0.9% NaC IV currently. He is still 6% dehydrated and 2 vomited 5 cups overnight. By the time you have completed the calculations, he will be ready for a new 1 L bag of fluids. What is the general name for the group of drugs that prevent vomiting Since it is the start of a new 24 hour cycle, calculate Pica’s fluid requirement for the next 24 hours. b. C. What is his rate per hour? d. What is his flow rate? e. Calculate the loading dose of metoclopramide. f. Calculate how much metoclopramide you will add to the new bag of fluids. As you perform your physical examination on Pica, you note he is tachypneis, tachycardis and growls when you palpate his abdomen. g. What does tachypneic and tachycardic mean? h. What is the most likely cause for these findings? Pica has been receiving morphine (15 mg/mL) IM every 6 hours. The veterinarian decides he should be changed to a CRI at a dosage of 4 ug/kg/min. You are instructed to calculate the dose and administer this using a syringe pump. The syringe pump you have in the hospital can be set to deliver a volume/hr. i. What volume of morphine will you place in the syringe to provide Pica with 8 hours of morphine? j. The syringe pump is connected to the IV line at the lower injection port. Are there any special considerations for morphine? k. Are morphine and metoclopramide compatible?
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