LAM Pharmacy Order Form - National Cancer Institute



Laboratory Animal Medicine Veterinary Pharmacy Order Form 12/15/15Qty.ProductDermachlor Rinse Active Ingredient(s): 0.2% Chlorhexidine Gluconate Use: Cleansing Topical Antiseptic for mild-moderate skin wounds. Application: Apply no more than 10 drops to affected area.Caution: Do not use on the animal’s face.Dermachlor Antiseptic OintmentActive Ingredient(s): 0.1% Chlorhexidine Gluconate Use: Topical Antiseptic for mild surface skin wounds. Application: Apply no more than a 3mm wide drop of medication to affected area using a clean cotton swab to spread a thin layer. Caution: Do not use on the animal’s face.CVS Triple Antibiotic + Pain Relief Active Ingredient(s): Neomycin; Polymyxin B; Bacitracin-Zinc; Pramoxine Use: Topical Antibiotic for mild-moderate skin wounds that did not respond to a 7-day Dermachlor treatment regimen or as directed by veterinary staff. Application: Apply no more than a 3mm wide drop of medication to affected area using a clean cotton swab to spread a thin layer. Caution: Do not use on the animal’s face.Triple Antibiotic Ophthalmic Ointment Active Ingredient(s): Neomycin; Polymyxin B; Bacitracin Use: Ophthalmic (eye) antibiotic for wounds of the eye and surrounding tissue. Application: Apply no more than a 3mm wide drop to affected area. Caution: Do not use a swab to apply. Note: Also recommended for use on all areas of the animal’s face.Artificial Tears Lubricant Eye OintmentActive Ingredient(s): Mineral Oil + White petrolatum Use: Ophthalmic (eye) lubricant for use on anesthetized animal to prevent dry eye. Application: Apply no more than a 3mm wide drop to affected area. Caution: Do not use a swab to apply.Kwikstop Styptic Powder Active Ingredient(s): Benzocaine Use: To stop the superficial bleeding resulting from tail tip sampling or broken toe nail. Application: Apply no more than a 3mm wide drop to affected area using a moistened clean cotton swab. Apply pressure to ensure bleeding stops completely. Caution: Do not use in deep wounds or body cavities.PreparationH Hemorrhoidal CreamActive Ingredient(s): Phenylephrine + Pramoxine Use: Treatment for mild-moderate rectal prolapse in mice. Application: Apply no more than a 3mm wide drop to affected area using a clean cotton swab to spread a thin layer. Caution: For external use onlyApplication Instructions for All Medications: Use medications very sparingly.ORDERED BY ___________________________FACILITY _________EXT_______Pharmacy orders are prepared the same day as received and are available for pickup in Bldg. 571/Room 105 (box on the door). LAM: Julie Bosworth x7538/ Dr.Gillian Braden x5195, Dr. Jatinder Gulani x5577 ................
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