Transcript Chapter 5 - Delmar Cengage Learning

Chapter 5
Veterinary Drug Use, Prescribing,
Acquisition, and Pharmacy Management
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Brand Name (®) or Not?
• Chemical name:
– Provides scientific and technical information
– Is a precise description of the substance
– Example: 7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4benzodiazepin-2-one
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Brand Name (®) or Not?
• 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: diazepam
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Brand Name (®) or Not?
• Brand (trade, proprietary) name:
– Establishes legal proprietary recognition for the
corporation that developed the drug
– Is registered with the U.S. Patent Office and is used
only by the company that registered the drug
– Is written in capital letters or begins with a capital
letter and has a circled, superscript R by its name
– Example: Valium
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Compounding
• 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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Compounding
• Uses of compounding
– Creating discontinued drugs
– Creating dosages and strength specific to a dog’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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Compounding
• 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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Sources of Drug Information
• 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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Sources of Drug Information
• Drug label must contain:
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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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Sources of Drug Information
• Package insert
– Provided with drugs to meet regulatory requirements
• 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
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Sources of Drug Information
• 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 Dates
• Expiration date is the date before which a drug
meets all specifications and after which the drug
can no longer be used
• Expiration dates are assigned based on the
stability of or experience with the drug
• Expiration dates for drugs that are mixed in the
clinic vary depending on the reconstitution and
refrigeration status of the drugs
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Dispensing vs Prescribing
• 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
• 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/Client/Patient
Relationship
• 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
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Veterinary/Client/Patient
Relationship
– 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
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Prescriptions
• 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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Label on the Prescription
• 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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Parts of a Prescription Label
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Dispensing Drugs
• Prescription drugs may be dispensed by
pharmacists or trained veterinary staff
• Veterinary prescription drugs should be properly
labeled when dispensed
• Remember that veterinary staff members cannot
refill or dispense medications without
veterinarian approval
• Medications must be dispensed in childproof
containers
• Labels with cautionary statements may also be
used on the prescription
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Electronic and Paperless Record
Keeping
• Veterinarians write the medication order in a
paper file or type it into an electronic record
• As the medication is it recorded into the medical
record with the date, time, and the initials of the
person giving the drug
• The numbers of veterinary hospitals that utilize a
completely paperless electronic medical record
system is increasing
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Electronic and Paperless Record
Keeping
• 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
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Electronic and Paperless Record
Keeping
– 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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Pharmacy Economics
• 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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Pharmacy Economics
• Inventory and Control Maintenance
– Time invested in maintenance of appropriate stock
levels benefits the overall business health of the
veterinary practice
– The 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 earning
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Pharmacy Economics
• Inventory Purchasing
– Direct marketing is when a drug is purchased directly
from the company that manufacturers it
– 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
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Pharmacy Economics
• Inventory Management
– Managing pharmaceuticals includes
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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
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