Veterinary Pharmacology and the Veterinary Technician Chapter 1

Pharmacology and technicians: LVT vs OJT LVTs know WHY a particular drug was prescribed LVTs are aware of ADVERSE DRUG REACTIONS LVTs are aware of a drug’s beneficial effects LVTs know whether a patient is properly responding to anesthesia LVTs know how to monitor a hospitalized patient’s response to medication LVTs know how to interpret a client’s description of their pet’s reaction to medication

RULES to live by: 1. All drugs are ________________. -How a drug is administered can be beneficial or detrimental to the animal’s health 2. No drug is a ________________ _______________. -Will alter physiology, which may not be functioning normally in that animal 3. All doses are ________________. -The published dose may need to be altered 4. Complacency ____________. -If same meds are used frequently, a false sense of security may develop

What’s in a name? CHEMICAL NAME Describes the chemical composition/ molecular structure of the drug (structure is sometimes seen on package inserts) Long, wordy, hard to say Rarely used by the veterinary professional 2(Diphenylmethoxy)-N,N-dimethylethylamine hydrochloride

What’s in a name? GENERIC NAME Also called the _____________________ name Written in LOWER case Official identifying name of the drug Describes the active drug(s) in the product Easier to pronounce and shorter than the chemical name diphenhydramine hydrochloride

What’s in a name? Benadryl TRADE NAME Also called the ____________________________ name Written in capital letters or begins with a capital letter Considered a proper noun Name is used only by the manufacturer that it is registered to Have _____ or _____ next to the name to imply that the name is registered This name is optional Benadryl

GENERIC EQUIVALENTS When a company receives FDA approval to market a new drug, that company is the only one who can manufacture the product for _______ years once the patent is approved. Once the product is on the market, it uses its funds to recover the costs of research, development, marketing, and testing.

GENERIC EQUIVALENTS When the waiting period is over, other companies may manufacture the product using a different trade name (called the generic equivalent) . These products are cheaper because these companies are not recouping money from drug development. Bioequivalence must be at least _______%

Therapeutic agents that are composed of _____________ or _________________ parts instead of synthesized chemicals. Extracts must produce consistent effects from bottle to bottle. If a company markets a product as a ________________________ (nutritional supplement) instead of an extract, FDA registration is not required and potency may vary from bottle to bottle. EXTRACTS

LEGEND VS OTC The FDA determines whether a drug will be LEGEND (prescription) or OTC Decision is based on toxicity of drug, method of use, and how well directions can be written for drug’s usage Over the counter drugs contain an ingredient that is deemed safe or is in a low enough concentration to not likely cause harm.

Legend/prescription drugs are prescribed by licensed veterinarians and have potential toxic effects or must be administered in a way that requires the services of trained personnel. Prescription drugs must state: “Caution: Federal law restricts this drug go use by or on the order of a licensed veterinarian.” Although LVTs cannot prescribe medications, they can fill drug orders and dispense medications under the direction of a licensed veterinarian. Do not automatically refill medications without the permission of the prescribing veterinarian.

VETERINARIAN-CLIENT-PATIENT RELATIONSHIP **A valid VCPR is required before a drug can be prescribed to a patient.** The veterinarian assumes responsibility for making decisions regarding the patient’s health. The client agrees to follow the veterinarian’s instructions.

VETERINARIAN-CLIENT-PATIENT RELATIONSHIP The veterinarian knows enough about the patient to make a preliminary diagnosis or has examined the patient recently. The veterinarian is available for follow-up care or has arranged for emergency care. The veterinarian oversees treatment, compliance, and outcome. Patient records are maintained.

Dosage forms- SOLIDS _______________ – powdered drug + excipient compressed into disk ______________: chewable, mixed with a sugar and flavored ______________-coated: coating protects the drug against the acidity of the stomach; allows it to remain intact until the small intestines. ______________-release/________________-release: tablet dissolves slowly, meds are released gradually

Dosage forms- SOLIDS _______________– powdered drug compressed into capsule-shaped tablet ______________(aka CAPSULE)- container made of gelatin/starch/cellulose that houses a powder. _______________ (aka lozenge) – drug is in a hard, candy-like tablet that is kept in the mouth and slowly dissolved

Dosage forms- SOLIDS ____________________– medication placed in the rectum where it is dissolved and absorbed _______________- large rectangular tablets given to large animals with a balling gun ______________- semisolid that keeps its form at body temperature

Dosage forms- LIQUIDS ___________________- drug is completely dissolved in a liquid and does not settle out when left standing ___________________: IV drugs are added to ions (K, Cl, Na) to facilitate dissolving. ___________________: drug is dissolved in sugar solution for taste and preservation. Sugar-free syrups use artificial sweeteners. NO _________________ in dogs ___________________: drug is dissolved in alcohol and flavored. Rarely used in animals due to taste.

Dosage forms- LIQUIDS ___________________- drug does not dissolve within liquid, but settles at the bottom of a container. Needs to be shaken to evenly re-suspend. Cloudy. Emulsion: liquid drug is mixed with a liquid fat or an oil

Dosage forms- TOPICALS ________________- alcohol solution applied to the skin ________________- drugs in an oil base that are rubbed into the skin ________________-emulsion of oil and water applied to the skin by dabbing; provides soothing effect ________________ – semisolid of oil and water that liquefies on the skin at room temp

Dosage forms-INJECTABLES ________________- small, airtight glass containers with a neck. Must be broken to access drug. Single dose. _____________- glass bottles with rubber stoppers that must be punctured by a needle Multidose: contain preservatives to extend shelf life (antibiotics, anesthetics, anti-inflammatories) Single-dose: discarded after one use (vaccines) ____________________/DEPOT – formulated to prolong absorption from the site of administration IMPLANT- pellet containing a chemical or hormone that is inserted subcutaneously and absorbed over time.

Extra-label/Off-label drug use Using a medication in a manner that is not approved by FDA Different species, dosage, route of administration, disease being treated than what the package insert indicates AMDUCA allows off-label drug use if “the health of the animal is threatened, or suffering or death may result from failure to treat.” Only allowed when: There is no approved drug to treat the animal's condition or the approved drug's dosage is not effective. A careful diagnosis has been made and a valid VCPR exists. The identity of the animal being treated is carefully maintained. The withdrawal time is extended. The drug is properly labeled to ensure safety.

SOURCES OF DRUG INFORMATION Text books Written by experts, but out of date by publication. Good source of extra-label info PDR (Physician’s Desk Reference) Human drug resource Can be useful for basic info if an animal accidentally ingests a human medication Veterinary journals Case studies and clinical trials Conference proceedings

SOURCES OF DRUG INFORMATION Internet Remember: anyone can make a website Reliable sites: List the author’s name, their credentials, contact info List a (recent) date that the website was last updated Cite references Ends in .gov or .edu or is tied to a reputable college/university Questionable sites: Misspellings/poor grammar Cheap looking Sponsored by a biased group Use hyperboles Advertise unrelated products

SOURCES OF DRUG INFORMATION Package inserts, Formularies Info that may be listed (Heading): The copyright or trademark name of the drug Whether or not the drug is over the counter or prescription (Rx) Whether or not the drug is a controlled substance and if so which schedule Phonetic spelling of name Nonproprietary name Dosage form USP designation

SOURCES OF DRUG INFORMATION Info that may be listed (after Heading): Active and inert ingredients Indications Precautions, warnings, and contraindications (ADR) Black box warnings How to treat an overdose Dosage and administration Pharmacology (Pharmacodynamics and Pharmacokinetics)