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Topic:Intravenous Administration

Intravenous administration in horses involves the delivery of substances directly into the bloodstream through a vein. This method is used to administer fluids, medications, and nutrients efficiently, ensuring rapid distribution throughout the body. It is commonly employed in veterinary practice for rehydration, anesthesia, and treatment of various medical conditions. The technique requires skill and knowledge to ensure proper vein selection and catheter placement, minimizing the risk of complications such as infection or thrombosis. This page compiles peer-reviewed research studies and scholarly articles that explore the methodologies, applications, and potential complications associated with intravenous administration in equine medicine.
The disposition of suxibuzone in the horse.
Journal of veterinary pharmacology and therapeutics    September 1, 1993   Volume 16, Issue 3 283-290 doi: 10.1111/j.1365-2885.1993.tb00175.x
Delbeke FT, Vynckier L, Debackere M.A high performance liquid chromatographic method is described to determine the anti-inflammatory drug suxibuzone (SXB) and its major metabolites phenylbutazone (PBZ) and oxyphenbutazone (OPBZ) in equine plasma and urine. When suxibuzone (6 mg/kg) was administered intravenously (i.v.) or orally (p.o.) no parent drug was detected in plasma or in urine. The disposition of the metabolite PBZ (i.v.) could be described by a 2 compartment model with a beta half-life varying from 7.40 to 8.35 h. Due to severe side effects the use of i.v. suxibuzone should not be encouraged in the horse. PBZ and OPBZ w...
Influence of yohimbine and tolazoline on the cardiovascular, respiratory, and sedative effects of xylazine in the horse.
Journal of veterinary pharmacology and therapeutics    September 1, 1993   Volume 16, Issue 3 350-358 doi: 10.1111/j.1365-2885.1993.tb00182.x
Kollias-Baker CA, Court MH, Williams LL.To determine the effects of yohimbine and tolazoline on the cardiovascular, respiratory and sedative effects of xylazine, four horses were sedated with xylazine and treated with either yohimbine, tolazoline or saline. Xylazine was administered as an intravenous (i.v.) bolus (1.0 mg/kg) followed by a continuous infusion at the rate of 12 micrograms/kg/min. Heart rate, respiratory rate, mean arterial pressure, arterial blood gases, and the chin-to-floor distance were recorded throughout the experiment. After 60 min, either yohimbine or tolazoline was administered i.v. in incremental doses until ...
Disposition, bioavailability and clinical efficacy of orally administered acepromazine in the horse.
Journal of veterinary pharmacology and therapeutics    September 1, 1993   Volume 16, Issue 3 359-368 doi: 10.1111/j.1365-2885.1993.tb00183.x
Hashem A, Keller H.The pharmacokinetics and pharmacological efficacy of orally (p.o.) administered acepromazine were studied and compared with the intravenous (i.v.) route of administration in a cross-over study using six horses. The oral kinetics of acepromazine can be described by a two-compartment open model with first-order absorption. The drug was rapidly absorbed after p.o. administration with a half-life of 0.84 h, tmax of 0.4 h and Cmax of 59 ng/ml. The elimination was slower after p.o. administration (half-life 6.04 h) than after i.v. injection (half-life 2.6 h). The bioavailability of the orally admini...
Hepatic lobe torsion as a cause of colic in a horse.
Veterinary surgery : VS    July 1, 1993   Volume 22, Issue 4 301-304 doi: 10.1111/j.1532-950x.1993.tb00403.x
Turner TA, Brown CA, Wilson JH, Roth L, Rosenstein DS, Schweizer CM, Woodaman KA.A 14-year-old Arabian gelding was examined for colic. An exploratory celiotomy was subsequently performed and the left lobe of the liver was found to be twisted. The lobe was resected using a TA-90 surgical stapling instrument. Histologic examination of the resected liver indicated portal vein and sinusoid dilation and congestion with blood. There were focal areas of necrosis and bacterial cocci and rods throughout the section. The histologic findings were consistent with hepatic lobe torsion. After surgery, the horse was treated with broad spectrum antibiotics, anti-inflammatory drugs, hepari...
Urinary indices of horses after intravenous administration of crystalloid solutions.
Journal of veterinary internal medicine    July 1, 1993   Volume 7, Issue 4 241-246 doi: 10.1111/j.1939-1676.1993.tb01014.x
Roussel AJ, Cohen ND, Ruoff WW, Brumbaugh GW, Schmitz DG, Kuesis BS.Saline or glucose solution was infused for approximately 4 hours into six healthy mares in two separate experiments to determine the effect of infusion of crystalloid solutions on fractional excretion (FE) of sodium (Na), chloride (Cl), potassium (K), and phosphorus (P), ratio of urinary creatinine to serum creatinine (UCr/SCr), and ratio of urinary osmolality to serum osmolality (Uosm/Sosm). After intravenous infusion of either saline or glucose solution, FENa, FECl and FEP were significantly increased, whereas UCr/SCr and Uosm/Sosm were significantly decreased. In addition, FEK was significa...
Pharmacokinetics of digoxin administered to horses with congestive heart failure.
American journal of veterinary research    July 1, 1993   Volume 54, Issue 7 1108-1111 
Sweeney RW, Reef VB, Reimer JM.Nine horses with (naturally acquired) congestive heart failure were treated with 2.2 micrograms of digoxin/kg of body weight by the IV route, followed by 11 micrograms/kg administered orally every 12 hours thereafter. Furosemide was administered IV concurrently with IV administered digoxin every 12 hours. Serum concentration of digoxin was measured after the first (IV) and seventh (orally administered) dose. After IV administration, digoxin disposition was described by a 2-compartment model, with a rapid distribution phase (t1/2 alpha = 0.17 hour), followed by a slower elimination phase (beta ...
Clinical evaluation of romifidine/ketamine/halothane anaesthesia in horses.
The Veterinary record    June 5, 1993   Volume 132, Issue 23 572-575 doi: 10.1136/vr.132.23.572
Diamond MJ, Young LE, Bartram DH, Gregg AS, Clutton RE, Long KJ, Jones RS.Romifidine, 100 micrograms/kg administered by intravenous injection, was evaluated as a premedicant to ketamine/halothane anaesthesia in 60 horses. Sedation developed within one to two minutes. In three cases mild staggering occurred within two minutes. Anaesthesia was induced after five minutes by the intravenous administration of ketamine (2 to 2.2 mg/kg). A mean time of 79 seconds elapsed before lateral recumbency was adopted. Fifty-four of the horses sank smoothly to the floor, with occasional steps sideways. Jaw tone, limb rigidity and mild muscle tremors often persisted for short periods...
Pharmacokinetics of single intravenous and single and multiple dose oral administration of rifampin in mares.
Journal of veterinary pharmacology and therapeutics    June 1, 1993   Volume 16, Issue 2 119-131 doi: 10.1111/j.1365-2885.1993.tb00156.x
Kohn CW, Sams R, Kowalski JJ, Powers J, Wallace S.The disposition of rifampin in six healthy mares after single intravenous (i.v.) and oral (p.o.) doses and after seven oral doses of 10 mg/kg administered twice a day was investigated using a high performance liquid chromatographic (HPLC) method. Pharmacokinetic variables for rifampin determined using the HPLC method were comparable to variables reported from earlier studies utilizing a microbiological assay. Desascetylrifampin, a major metabolite of the parent compound, could not be detected in the serum but was detected at low concentrations in urine. Mean trough concentrations of rifampin i...
Clinical effects of detomidine with or without atropine used for arthrocentesis in horses.
The Canadian veterinary journal = La revue veterinaire canadienne    May 1, 1993   Volume 34, Issue 5 296-300 
Jones DL.The effectiveness of detomidine with or without atropine sulfate premedication in producing sedation and analgesia for arthrocentesis was studied in 12 horses. The effects were evaluated by monitoring heart and respiratory rates, borborygmi, distance from the lower lip to the floor, systolic blood pressure, and response to needle insertion. Either atropine or saline (as a placebo) was administered immediately prior to detomidine. All drugs were administered intravenously. Measurements were taken prior to drug injection and at 1, 5, 10, 15, 20, 25, 30, 40, 50, 60, 120, 180 and 240 minutes posti...
Effect of oestradiol on oxytocin-stimulated prostaglandin F2 alpha release in mares.
Journal of reproduction and fertility    May 1, 1993   Volume 98, Issue 1 107-112 doi: 10.1530/jrf.0.0980107
Goff AK, Sirois J, Pontbriand D.The objective of this study was to clarify the role of oestradiol in luteal function by examining its effect on the oxytocin stimulation of 15-keto-13,14-dihydro-prostaglandin F2 alpha (PGFM) concentrations in cyclic mares. In the first experiment, three groups of mares (4 per group) were given a bolus injection of 17 alpha-oestradiol (1 mg), oestradiol (1 mg) or vehicle on days 7, 9, 11, 13 and 15 of the cycle. Six hours later the mares were challenged with 10 iu oxytocin intravenously and frequent blood samples were taken from 15 min before to 15 min after for measurement of PGFM. Results sh...
Pharmacokinetics of cefotaxime in neonatal pony foals.
American journal of veterinary research    April 1, 1993   Volume 54, Issue 4 576-579 
Gardner SY, Sweeney RW, Divers TJ.Serum concentrations of cefotaxime and desacetylcefotaxime were measured in 1-week-old pony foals after IV administration of a single dose of cefotaxime. The cefotaxime disposition data conformed to a two-compartment model with elimination half-life of 0.60 hour. The combined cefotaxime and desacetylcefotaxime data was best described by a four-compartment model. The apparent half-life describing the disappearance of desacetylcefotaxime was 1.69 hours. Dosage of 40 mg/kg of body weight given IV every 4 to 6 hours for neonatal foals with gram-negative septicemia and every 2 hours for foals with ...
Blockade of endotoxin-induced cecal hypoperfusion and ileus with an alpha 2 antagonist in horses.
American journal of veterinary research    April 1, 1993   Volume 54, Issue 4 586-590 
Eades SC, Moore JN.Stimulation of alpha 2 adrenergic receptors inhibits colonic motility and may constrict some peripheral vascular beds. Endotoxemia elicits release of sympathetic neurotransmitters and increases sympathetic nerve activity, which may result in stimulation of alpha 2 adrenergic receptors. The objective of this study was to determine whether blockade of alpha 2 adrenergic receptors would restore cecal motility and blood flow during endotoxemia in horses. Strain-gauge force transducers and ultrasonic flow probes were used to measure cecal and colonic mechanical activity and lateral cecal arterial b...
Clostridium septicum septicemia in a neonatal foal with hemorrhagic enteritis.
The Cornell veterinarian    April 1, 1993   Volume 83, Issue 2 143-151 
Jones SL, Wilson WD.Clostridium septicum was isolated by anaerobic culture of blood collected from a 3-day-old foal with hemorrhagic enteritis and signs suggestive of septicemia. The foal responded well to treatment with intravenous fluids, antibiotics, plasma, and oral gastrointestinal protectants. One month after apparent complete recovery from the septicemia and hemorrhagic enteritis, the foal was euthanized during an acute episode of colic that was caused by severe, strangulating intestinal adhesions, thought to have formed as a result of peritonitis secondary to the hemorrhagic enteritis. The value of anaero...
Pharmacokinetic disposition of intravenous and oral pentoxifylline in horses.
Journal of veterinary pharmacology and therapeutics    March 1, 1993   Volume 16, Issue 1 23-31 doi: 10.1111/j.1365-2885.1993.tb00285.x
Crisman MV, Wilcke JR, Correll LS, Irby MH.The pharmacokinetics of pentoxifylline (P) and its alcohol metabolite I (MI) were determined after administration of intravenous pentoxifylline, sustained release pentoxifylline tablets (Trental), and crushed pentoxifylline tablets in corn syrup, to five healthy adult horses. Pharmacokinetics were evaluated in a model-independent manner. After intravenous administration, pentoxifylline was rapidly eliminated (mean residence time 1.09 +/- 0.67 h), had a large steady-state volume of distribution (2.81 +/- 1.16 l/kg), and high clearance (3.06 +/- 1.05 l/kg/h). Oral absorption of pentoxifylline fr...
Pharmacokinetics and applications of ampicillin sodium as an intravenous infusion in the horse.
Journal of veterinary pharmacology and therapeutics    March 1, 1993   Volume 16, Issue 1 63-69 doi: 10.1111/j.1365-2885.1993.tb00290.x
Sarasola P, McKellar QA.A regime for administration of ampicillin sodium by continuous intravenous infusions to horses was designed. The aim was to achieve plasma ampicillin concentrations between 5 and 10 micrograms/ml over a 4-h period. A 2 mg/kg bodyweight loading dose of ampicillin sodium was administered intravenously at the beginning of the infusion in order to achieve steady-state plasma concentrations rapidly. The infusion system subsequently administered ampicillin at a rate of approximately 19.2 micrograms/min/kg bodyweight. The plasma concentrations obtained over the infusion period correlated very well wi...
Pharmacokinetic profile of sulphamonomethoxine-trimethoprim in horses after intravenous, intramuscular and oral administration.
Research in veterinary science    March 1, 1993   Volume 54, Issue 2 184-188 doi: 10.1016/0034-5288(93)90054-j
Carli S, Sonzogni O, Villa R, Bignazzi R, Montesissa C.The pharmacokinetic profile of a sulphamonomethoxine-trimethoprim (SMM-TMP) combination was investigated in five horses. The combination was administered intravenously, intramuscularly and orally at a constant dose of 20 mg SMM plus 4 mg TMP kg-1 bodyweight. Following intravenous administration both drugs dispersed rapidly with distribution half-lives of about 12 minutes for SMM and about 18 minutes for TMP. Elimination half-lives for intravenous, intramuscular and oral administration were closely similar, indicating that elimination was independent of administration route. Bioavailability of ...
Clearance of infused triglyceride by resting horses.
Comparative biochemistry and physiology. Comparative physiology    February 1, 1993   Volume 104, Issue 2 361-363 doi: 10.1016/0300-9629(93)90330-7
Moser LR, Lawrence LM, Novakofski J, Powell DM.1. Clearance of infused lipid was observed in six mature resting horses, 2 to 6 hr after receiving a meal of alfalfa hay. 2. Intralipid, a 10% triglyceride emulsion, was infused at a rate of 0.2 ml/kg into the jugular vein. 3. Blood samples were obtained for 80 min post-infusion and assayed for plasma triglyceride concentration. 4. Clearance rate of the infused lipid was very slow (mean t1/2 = 269 min). 5. The clearance rate of the infused lipid in these horses was much slower than has been observed in other species. 6. The slow clearance of infused triglyceride in horses may suggest an inabil...
Kinetic analysis of D-xylose distribution after intravenous administration to mares.
American journal of veterinary research    January 1, 1993   Volume 54, Issue 1 147-151 
Ferrante PL, Freeman DE, Ramberg CF, Kronfeld DS.Multicompartmental analysis was applied to study the kinetics of D-xylose distribution after IV administration to healthy mares deprived of food for 12 and 96 hours. Urinary excretion of D-xylose was measured over a 15-hour period after administration. The plasma D-xylose concentrations in this study were in the range found after oral tolerance testing. The disposition of D-xylose was described by a two-compartment model with linear kinetic characteristics. Total volume of distribution decreased significantly (P < 0.025) from 0.270 L/kg of body weight after the 12-hour period of food depriv...
Vancomycin kinetics in plasma and synovial fluid following intravenous administration in horses.
Journal of veterinary pharmacology and therapeutics    December 11, 1992   Volume 15, Issue 4 351-363 doi: 10.1111/j.1365-2885.1992.tb01027.x
Orsini JA, Ramberg CF, Benson CE, Dreyfuss DJ, Vecchione JA, Kunz CC.Vancomycin hydrochloride was infused intravenously (i.v.) over a 30-min period in five horses at doses of 6.6, 11.0 and 15.4 mg/kg. Vancomycin concentration in plasma and synovial fluid samples was measured using a polarization immunoassay. A pharmacokinetic model was developed to accommodate the special features of the present study. The data were described by a two compartment open model with synovial fluid as an additional compartment in exchange with plasma. Minimum inhibitory concentration (MIC) and minimum bacterial concentration (MBC) were measured for Staphylococcus aureus and Enteroco...
Identification of a benzhydrolic metabolite of ketoprofen in horses by gas chromatography-mass spectrometry and high-performance liquid chromatography.
Journal of chromatography    December 2, 1992   Volume 583, Issue 2 167-173 doi: 10.1016/0378-4347(92)80549-6
Benoit E, Jaussaud P, Besse S, Videmann B, Courtot D, Delatour P, Bonnaire Y.A benzhydrolic metabolite of ketoprofen, formed by reduction of the keto group of the drug, has been identified by gas chromatography-mass spectrometry in equine plasma and urine. After partial synthesis, its structure has been confirmed by UV, IR and 1H NMR spectroscopy. The kinetics of ketoprofen and this metabolite have been monitored in plasma by high-performance liquid chromatography. The two products were quantified in plasma up to 4 and 3 h, respectively, and were detected in urine up to 72 and 24 h, respectively, after a single intravenous administration to horses at the dose of 2.2 mg...
Pharmacokinetics of intravenously and orally administered pyrimethamine in horses.
American journal of veterinary research    December 1, 1992   Volume 53, Issue 12 2292-2295 
Clarke CR, Burrows GE, MacAllister CG, Spillers DK, Ewing P, Lauer AK.Single-dose pharmacokinetic variables of pyrimethamine were studied in horses. Pyrimethamine (1 mg/kg of body weight) was administered IV and orally to 6 adult horses, and plasma samples were obtained at frequent intervals thereafter. Plasma pyrimethamine concentration was assayed by gas chromatography, and concentration-time data were analyzed, using a pharmacokinetic computer program. The IV and oral administration data were best described by 3-compartment and 1-compartment models, respectively. The median volume of distribution at steady state after IV administration was 1,521 ml/kg and the...
Distribution studies of theophylline: microdialysis in rat and horse and whole body autoradiography in rat.
Journal of veterinary pharmacology and therapeutics    December 1, 1992   Volume 15, Issue 4 386-394 doi: 10.1111/j.1365-2885.1992.tb01030.x
Ingvast-Larsson C, Appelgren LE, Nyman G.After intravenous administration of theophylline, microdialysis has been used for studying the non protein bound theophylline concentration in blood and in lung tissue in the rat as well as in two horses. The distribution pattern of 14C-theophylline in the rat was also investigated. When the distribution of theophylline was completed the time course of free drug in the interstitial fluid in lung tissue was in good agreement with the total concentration-time profile in plasma in both species. In the rat the free concentration of theophylline in the lung was slightly lower than the free concentr...
Idiopathic, aseptic, effusive, fibrinous, nonconstrictive pericarditis with tamponade in a standardbred filly.
Journal of the American Veterinary Medical Association    November 15, 1992   Volume 201, Issue 10 1593-1598 
Robinson JA, Marr CM, Reef VB, Sweeney RW.A Standardbred filly was admitted for evaluation of pleuritis and pneumonia. Heart rate was 80 to 120 beats/min, and the pulse was barely palpable. Thoracic and abdominal ultrasonography and echocardiography revealed substantial pericardial effusion with cardiac tamponade, fibrinous pericarditis, pleural effusion, and ascites. Initial electrocardiography revealed normal sinus rhythm with decreased amplitude of the QRS complexes consistent with pericardial effusion. Following thoracentesis, echocardiogram-guided pericardiocentesis was performed. Bacterial culture yielded no growth from any of t...
Effects of xylazine on airway function in ponies with recurrent airway obstruction.
American journal of veterinary research    October 1, 1992   Volume 53, Issue 10 1813-1817 
Broadstone RV, Gray PR, Robinson NE, Derksen FJ.The effect of IV administration of the alpha 2-adrenoceptor agonist xylazine hydrochloride (0.5 mg/kg of body weight) was examined in ponies with recurrent obstructive pulmonary disease, commonly called heaves. Six ponies with the disease (principals) were studied during clinical remission and during an acute attack of airway obstruction precipitated by stabling and feeding of dusty hay. Six control ponies were also studied. In principal ponies with airway obstruction, xylazine administration significantly (P < 0.05) decreased pulmonary resistance and increased dynamic compliance, but did n...
Pharmacokinetics of metronidazole and its concentration in body fluids and endometrial tissues of mares.
American journal of veterinary research    October 1, 1992   Volume 53, Issue 10 1807-1812 
Specht TE, Brown MP, Gronwall RR, Rib WJ, Houston AE.Serum concentrations of metronidazole were determined in 6 healthy adult mares after a single IV injection of metronidazole (15 mg/kg of body weight). The mean elimination rate (K) was 0.23 h-1, and the mean elimination half-life (t1/2) was 3.1 hours. The apparent volume of distribution at steady state was 0.69 L/kg, and the clearance was 168 ml/h/kg. Each mare was then given a loading dose (15 mg/kg) of metronidazole at time 0, followed by 4 maintenance doses (7.5 mg/kg, q 6 h) by nasogastric tube. Metronidazole concentrations were measured in serial samples of serum, synovia, peritoneal flui...
Effect of hypertonic and isotonic saline solutions on plasma constituents of conscious horses.
American journal of veterinary research    October 1, 1992   Volume 53, Issue 10 1844-1849 
Bertone JJ, Shoemaker KE.Blood constituents and vascular volume indices were determined in 5 standing horses by use of 2-period crossover experimental design. Horses were either administered hypertonic (2,400 mosm/kg of body weight, i.v.) or isotonic (300 mosm/kg, i.v.) saline solution. Each solution was administered at a dosage of 5 ml/kg (infusion rate, 80 ml/min). Samples for determination of PCV, plasma volume, blood volume, plasma osmolality, total amount of plasma protein and plasma concentrations of protein, Na, K, and Cl were collected at 0 hour (baseline, before fluid infusion) and 0.5 hour (at the end of flu...
Effect of xylazine on cerebrospinal fluid pressure in conscious horses.
American journal of veterinary research    September 1, 1992   Volume 53, Issue 9 1558-1561 
Moore RM, Trims CM.Lumbosacral CSF pressure was measured in 6 horses via a catheter inserted through the lumbosacral space. Heart rate, facial artery pressure, central venous pressure, and CSF pressure were measured before IV injection of a saline solution control, for 15 minutes after saline solution injection, and for 60 minutes after the IV injection of 1.1 mg of xylazine/kg of body weight. Arterial pH and blood gases were analyzed before saline solution injection, 15 minutes after saline solution injection, and at 15, 30, and 60 minutes after xylazine injection. Constant craniocervical posture was maintained...
Bioavailability of oral penicillins in the horse: a comparison of pivampicillin and amoxicillin.
Journal of veterinary pharmacology and therapeutics    September 1, 1992   Volume 15, Issue 3 221-230 doi: 10.1111/j.1365-2885.1992.tb01010.x
Ensink JM, Klein WR, Mevius DJ, Klarenbeek A, Vulto AG.The pharmacokinetics of ampicillin and amoxicillin following intravenous administration at a dose rate of 15 and 10 mg/kg respectively were studied in four healthy adult horses. Pharmacokinetics of pivampicillin and amoxicillin were studied after oral administration to four healthy adult horses. Pivampicillin, a prodrug of ampicillin, was administered orally to starved and fed horses at a dose rate of 19.9 mg/kg, which is equivalent on a molecular basis to 15 mg/kg ampicillin. Amoxicillin was administered orally to starved horses only, at a dose rate of 20 mg/kg. Ampicillin and amoxicillin con...
Effect of probenecid on disposition kinetics of ampicillin in horses.
The Veterinary record    August 22, 1992   Volume 131, Issue 8 173-175 doi: 10.1136/vr.131.8.173
Sarasola P, McKellar QA.The effect of an oral dose of probenecid on the disposition kinetics of ampicillin was determined in four horses. An intravenous bolus dose (10 mg/kg) of ampicillin sodium was administered to the horses on two occasions. On the first occasion the antibiotic was administered on its own, and on the second occasion it was administered one hour after an oral dose of 75 mg/kg probenecid. The plasma concentration of probenecid reached a mean (+/- se) maximum concentration (Cmax) of 188-6 +/- 19.3 micrograms/ml after 120.0 +/- 21.2 minutes and concentrations greater than 15 micrograms/ml were present...
Plasma concentration of furosemide versus specific gravity of urine in predicting dose of administration in race horses.
Research communications in chemical pathology and pharmacology    August 1, 1992   Volume 77, Issue 2 201-218 
Uboh CE, Soma LR, Rudy JA, Morgan E, Mengeringhausen K, Sams R.This study was undertaken to determine the applicability of plasma concentration of furosemide and specific gravity (SG) of urine in regulating the use of furosemide administered 4 hours prior to race time in Exercise-Induced Pulmonary Hemorrhage (EIPH) race horses. Nonbleeders (CTL) and certified bleeders (FUR) actively racing in Illinois (IL) and Pennsylvania (PA) were used in the study. Various doses (less than 250, 250, 300, 350, 400 and 500 mg) were administered either as a single intravenous (IV) dose or as a combination (IV-IM) of IV and intramuscular (IM) administrations 4 hours before...
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