Drugs to know for Day 1

[futuredvm297]

What drugs did you find essential for beginning your journey as a day 1 new grad? Anyone have any lists with dosages/concentrations that they made they could send me?

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[JaynaAli]

What drugs did you find essential for beginning your journey as a day 1 new grad? Anyone have any lists with dosages/concentrations that they made they could send me?

About all you need to know off the top of your head in my opinion are diazepam, pentobarbital, furosemide, and maybe an opioid of your choice. The rest you’ll have time to go look up until you start remembering. I started making a list my first week as an intern but after a week or two you’ll quickly start remembering the ones you use all the time. I’m not sure someone else’s list will be that helpful since inventory and what’s available will vary clinic to clinic.

 

[CalliopeDVM]

There's not much you won't have time to look up........and the ones you'll use frequently will become obvious to you. If there isn't one already, make a list of emergency drugs (diazepam, furosemide, dextrose) to tape to the treatment room wall in case there's an emergency (seizures, congestive heart failure, hypoglycemia).

 

[Trilt]

Cerenia and convenia doses are the weight in kg, but move the decimal point. (4kg cat? 0.4mL cerenia).

Diazepam/midazolam is also like that. 25kg dog(ish) comes in seizing? 2.5mL.

Calcium and dextrose can easily be ballparked at 1mL/kg (assuming you have 10% calcium! I just half it because we keep the 23%).

I think a memorized dose of torb (0.1mL/10lbs) and some O2 is more likely to keep an animal alive than a memorized furosemide dose in an acute emergency, tbh.

It takes seconds to look up a dose. Have resources available (even if that's just a computer with VIN) but absolutely do not stress too much about memorizing things. You'll remember with repetition.

 

[genny]

I use my Plumbs app daily. Worth it for me. But making a list based on your clinic’s inventory also works.

 

[DVMDream]

I'd say recalling a dextrose dose and maybe an anticonvulsant or two. Practically anything else you'll have time to look up. And you'll start remembering the common ones you use really quickly.

 

[battie]

I knew gabapentin and carprofen on my first day, and thats it. Now I know the ones I use all the time.

Agree about knowing emergency drugs if your clinic/hospital will see emergencies

 

[Minnerbelle]

There's not much you won't have time to look up........and the ones you'll use frequently will become obvious to you. If there isn't one already, make a list of emergency drugs (diazepam, furosemide, dextrose) to tape to the treatment room wall in case there's an emergency (seizures, congestive heart failure, hypoglycemia).

Paper copy, but I also like to make an excel spreadsheet that you put weight of animal in one spot and calculates out all the drugs for all types of emergencies including what calliope put there but also anaphylaxis.

I put it in the desktop of all treatment computers. That way a trusted tech can start drawing up stuff if it takes you a hot minute to run out of an exam room or scrub out of a sx or something.

 

[Minnerbelle]

I use my Plumbs app daily. Worth it for me. But making a list based on your clinic’s inventory also works.

Yes that! And what your local pharmacies carry.

Downfall of plumbs newbies is that it lists all formulations that may or may not be available (or some that exist but costs $1000 instead of $20, or vet formulations not available at human pharmacies, etc…). It takes a while to realize which drugs you have on your hospital shelf are only available through vet channels vs can be rx out to human pharmacy. Cross check with goodrx before sending the client to the pharmacy and they get annoyed that the pharmacist has to call you because your rx doesn’t make sense.

 

[Minnerbelle]

Also, very important to know the concentrations of drugs available in your clinic. When you are in school it may seem like things only come in one concentration so you start dosing based off that. And sometimes 90% of clinics always use one formulation and people just don’t know others exist. I ****ed up a few times from that. First going from school to practice, then next bouncing between different clinics. Nothing fatal thankfully. But it’s a super easy error to make.

 

[Trilt]

Also, very important to know the concentrations of drugs available in your clinic. When you are in school it may seem like things only come in one concentration so you start dosing based off that. And sometimes 90% of clinics always use one formulation and people just don’t know others exist. I ****ed up a few times from that. First going from school to practice, then next bouncing between different clinics. Nothing fatal thankfully. But it’s a super easy error to make.

I work an ER job and a GP job. My ER job works in kilos and the hydro is 2mg/mL. The GP job works in lbs and our hydro is 10mg/mL. Even years out it's seriously a struggle and I double-triple check everything.

 

[Minnerbelle]

I work an ER job and a GP job. My ER job works in kilos and the hydro is 2mg/mL. The GP job works in lbs and our hydro is 10mg/mL. Even years out it's seriously a struggle and I double-triple check everything.

Yeah seriously. Dexdomitor, atropine also being common ones. Inexplicably some places that work with cats/dogs only also use the torbugesics 2mg/mL… and the Nemex pyrantel that is only 4.54mg/mL rather than equine strongid 50mg/mL that can easily be doses 1mL per 10lb

The working in Kg or lb doesn’t really bother me much. I feel comfortable with both and I think in mg/lb for some drugs, and the rest in mg/kg, and some liquid drugs in mL/kg or mL/lb. I do mind though when I work at a clinic where the stupid scale reads in lb and oz… but the staff is not trained well and they use it interchangeably with a decimal pt. So a pt that’s actually 2lb 12oz is written down as 2.12lb. And they also don’t know that 16oz = 1lb. That’s usually how I know my day is going to be a struggle and that I’ll be working as my own technician…

 

[Trilt]

Yeah seriously. Dexdomitor, atropine also being common ones. Inexplicably some places that work with cats/dogs only also use the torbugesics 2mg/mL… and the Nemex pyrantel that is only 4.54mg/mL rather than equine strongid 50mg/mL that can easily be doses 1mL per 10lb

The working in Kg or lb doesn’t really bother me much. I feel comfortable with both and I think in mg/lb for some drugs, and the rest in mg/kg, and some liquid drugs in mL/kg or mL/lb. I do mind though when I work at a clinic where the stupid scale reads in lb and oz… but the staff is not trained well and they use it interchangeably with a decimal pt. So a pt that’s actually 2lb 12oz is written down as 2.12lb. And they also don’t know that 16oz = 1lb. That’s usually how I know my day is going to be a struggle and that I’ll be working as my own technician…

I literally made, printed and laminated a small chart for oz -> lb conversions next to the scale at my GP because it confused new people enough that I'd have to double check weights constantly.

 

[Minnerbelle]

I literally made, printed and laminated a small chart for oz -> lb conversions next to the scale at my GP because it confused new people enough that I'd have to double check weights constantly.

You’d think every clinic would do that right? I always wonder about the clinics that perpetually get per weights wrong and don’t realize that it’s a problem.

 

[pinkpuppy9]

Get Plumbs for your phone - I use it every day! It has a feature where you can jot notes for each drug too - shortcuts for CRIs, your preferred dosages, etc.

It depends on your scope of practice, honestly. I work ER, so often have to have dosages off the top of my head - midazolam, furosemide, butorphanol, methadone (or your analgesic opioid of choice), Cerenia, ondansetron, diphenhydramine, dextrose, lidocaine, Dex-SP, hypertonic saline, crystalloid boluses, etc. are the most common things I'm reaching for when I am stabilizing a patient on the table. If you're practicing in a state with venomous snakes/your hospital stocks antivenin, I'd have antivenin dilutions as a note in your phone as well - a lot of the guys with neck/mouth bites need a bolus on presentation because of the swelling. Minutes mean life or death in those cases.

 

[Drjc1977]

What drugs did you find essential for beginning your journey as a day 1 new grad? Anyone have any lists with dosages/concentrations that they made they could send me?

You will discover, depending on the type of medicine/surgery practice you are in, that you will use 6-10 drugs 90% of the time. Within 6 months or less, you will have the dosages, concentrations, etc. memorized. For everything else carry a formulary with you or use Plumb's app from your phone. Do not make this harder on yourself than necessary. Best of wishes on your practice journey.