Veterinary Drug Use, Prescribing, Acquisition, and Pharmacy Management

L. VanValkenburg, RVT, BASVT

Chemical name:Chemical name:◦ Provides scientific and technical information◦ First name received during drug development◦ Is a precise description of the substance◦Example:

7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benzodiazepine-2-one

Generic (nonproprietary) name:Generic (nonproprietary) name:◦ Official identifying name of the drug (assigned

by the U.S. Adopted Names Council)◦ Describes the active drug◦ Written using lowercase letters◦Example: carprofen

Brand (trade, proprietary) Brand (trade, proprietary) name:name:◦ Establishes legal proprietary

recognition for the corporation that developed the drug

◦ Registered with U.S. Patent Office; approved by FDA

◦ Used only by company that registered the drug

◦ Written in capital letters or begins with a capital letter and has a circled, superscript R by its name

Example: Rompun

Occurs when health professionals prepare a specialized drug product to fill an individual patient’s needs when an approved drug is not available

Uses of compounding◦ Creating discontinued drugs◦ Creating dosages and strength specific to

patient’s weight and health◦ Creating alternative dose forms such as

liquids, ointments, or chewable tablets◦ Adding flavoring to drugs to make them more

appealing to animals◦ Customizing formulas that combine multiple

drugs for one dose administration

Concerns◦ Small compounding changes may turn an FDA

approved drug into an unapproved drug◦ Compounded drugs are made without FDA

oversight and may pose a risk to the patient◦ Compounded drugs may not be sterile and

can cause infections to patients that use them◦Errors in preparing compounded drugs may

result in disease or death in patients who use them

United States Pharmacopoeia (USP)◦ Publication that is the legally recognized drug

standard of the United States◦ Describes the source, appearance, properties,

standards of purity, and other requirements of the most important pure drugs

◦ The FDA requires that all drugs meet USP standards of purity, quality, and uniformity

Package insert◦ Provided with drugs to meet regulatory

requirements. Includes: Registered trade name, generic name, controlled

substance notation if warranted Description or composition statement Clinical pharmacology, actions, or mode of action Indications and usage Contraindications Precautions Warnings Adverse reactions or side effects Overdosage information Dosage administration Storage How supplied

See pgs. 99-102

Drug label must contain:◦ Drug names (generic and

trade)◦ Drug concentration and

quantity◦ Name and address of

manufacturer◦ Manufacturer’s control or lot

number◦ Expiration date of drug◦ Withdrawal time (if

warranted)◦ Controlled substance status

of drug (if warranted)

Drug References◦ Bound book of information on package inserts

Physician’s Desk Reference (PDR): human-approved drugs

Veterinary Pharmaceuticals and Biologicals (VPB) Compendium of Veterinary Products (CVP)

Expiration date is the date before which a drug meets all specifications and after which the drug can no longer be used.

Assigned based on the stability of or experience with the drug

Vary for drugs that are mixed in the clinic depending on the reconstitution and refrigeration status of the drugs

Veterinary drugs are those approved only for use in animals.

Human drugs are approved by the FDA and guidelines for their use in food-producing animals are provided in the Compliance Policy Guide (CPG)

A veterinarian/client/patient relationship must be established before any medication is prescribed for an animal◦ For guidelines for veterinarian/client/patient

relationships refer to Table 5-2 in your textbook

Veterinary prescription drugs are labeled for use only by or on the order of a licensed veterinarian

A veterinary/client/patient relationship (VCPR) exists when the following conditions have been met:◦ The veterinarian has assumed responsibility for

making clinical judgments and the client has agreed to follow

◦ The vet has sufficient knowledge of the animal to at least make a preliminary diagnosis

◦ The veterinarian is readily available for follow-up evaluation in the event of adverse reaction or failure of the treatment regimen

Veterinary prescription drugs must be properly labeled before being dispensed

Dispensing and treatment records must be maintained

Drugs should be dispensed only in quantities required for the treatment of the animals

You are responsible for knowing ALL abbreviations and meanings listed!!!

A prescription is an order to a pharmacist, written by a licensed veterinarian, to prepare the prescribed medicine, to affix the directions, and to sell the preparation to the client.

The label on the prescription should be complete and contain:◦ The name and address of the

dispenser◦ The client’s name (+/- address)◦ The animal’s name and species◦ The drug name, strength, and

quantity◦ The date of the order◦ Directions for use◦ Any refill information (if

warranted)

Prescription drugs may be dispensed by pharmacists or trained veterinary staff.

Veterinary prescription drugs should be properly labeled when dispensed.

Staff members cannot refill or dispense medications without DVM approval.

Medications must be dispensed in childproof containers.

Labels with cautionary statements should also be used on the prescription.

See pg. 110 for some examples.See pg. 110 for some examples.

The medication order is written in a paper file or typed into an electronic record.

The medication is recorded along with date, time, and the initials of the person dispensing the drug.

The numbers of veterinary hospitals that utilize a completely paperless electronic medical record system is increasing.

Advantages of using an electronic system include:◦ Improved efficiency

No lost records Immediate access to records Ability to pull up all prescriptions on one screen

◦Space saving No file cabinets, storage boxes

◦Cost saving Less filing No time needed to retrieve records

◦Avoidance of errors Prompts for patients with allergic reactions Information on drug interactions Identification of clients with special considerations

◦Automated input Laboratory data automatically transfers into patient

record Prescription instructions can be entered into the

computer in advance

Maintaining a pharmacy is a business that depends on charging and collecting a fee for services to continue providing medical care.

Inventory and Control Maintenance◦ Goal is to stock quantities of each item as low

as possible to reduce overhead and inventory costs, but now low enough to have a shortage

◦ The longer inventory sits on the shelf, the longer it costs the practice in hidden costs.

◦ Too much inventory also ties up money that could be invested and used for earnings.

Inventory Purchasing◦ Direct marketingDirect marketing is when a drug is purchased

directly from the manufacturing company.◦ DistributorsDistributors or wholesalerswholesalers are agencies that

purchase the drug from the manufacturers and resell it to the veterinarians

◦ Other sources of drugs include veterinary practices, buying groups of several veterinary practices, and pharmacies (vet or human)

Inventory Management includes:◦ Maintaining an adequate

stock◦ Organizing so items are

easy to locate◦ Identifying products that

need to be reordered◦ Receiving and inspecting

shipments◦ Rotating stock and

monitoring expiration dates◦ Maintaining and organizing

MSDS sheets