Transcript drugs - Dr. Brahmbhatt`s Class Handouts

Veterinary Drug Use, Prescribing, Acquisition,
and Pharmacy Management
L. VanValkenburg, RVT, BASVT
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Chemical name:
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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
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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
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Brand (trade, proprietary)
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
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Occurs when health professionals prepare a
specialized drug product to fill an individual
patient’s needs when an approved drug is
not available
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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
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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
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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
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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
See pgs. 99-102
 Precautions
 Warnings
 Adverse reactions or side effects
 Overdosage information
 Dosage administration
 Storage
 How supplied
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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)
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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)
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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
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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
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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
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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!!!
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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.
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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)
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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.
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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.
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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
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Maintaining a pharmacy is a business that
depends on charging and collecting a fee
for services to continue providing medical
care.
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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.
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Inventory Purchasing
◦ Direct marketing is when a drug is purchased
directly from the manufacturing company.
◦ Distributors or wholesalers 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)
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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