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UNCW Institutional Animal Care and Use Supplement to Application to Use Live Vertebrate Animals in Research or Educational Programs For IACUC Use Only Protocol #: ______ Refer to main application for approval/expiration dates. DRUG ADMINISTRATION APPENDIX: Attach to main application if drugs will be administered. Project Title 1. What is the estimated time period the animal will be anesthetized per exposure to the anesthetic drugs? 2. If neuromuscular blocking agents are used, how will the plan of anesthesia be monitored? 3. Describe the tracking and security of controlled drugs (Drug Enforcement Administration requirements). Table A. Anesthetic drugs (including neuromuscular blocking agents) administered to live animals. Drug (generic name) Initial Dose (mg/kg) Additional Maintenance Route Dose (mg/kg) EXPIRATION DATE: Table B. Post Surgical/post Procedural Analgesic or Tranquilizing Drugs Drug (generic name) Dose (mg/kg) Route Frequency of Administration Table C. All other Drugs or Agents (Experimental or therapeutic.) Drug/Agent Dose (mg/kg) Route Frequency (generic name) Principal Investigator Signature Date Estimated Duration of Treatment