Download UNCW Institutional Animal Care and Use

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