Dosage forms- topicals ________________- alcohol solution applied to the skin ________________- drugs in an oil base used to counter irritation or pain ________________- applied to the skin by dabbing; provides soothing effect ________________ – semisolid of oil and water; water evaporates and leaves drug on skin

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 by the body over time. _________________- therapeutic agent composed of plant or animal parts

SOURCES OF DRUG INFORMATION Package inserts, Text books, Formularies, PDR Info that may be listed in drug references: The copyrighted or trademarked name of the drug Whether or not the drug is over the counter or prescription Whether or not the drug is a controlled substance and if so which class Phonetic spelling of name Nonproprietary name Dosage form USP Drug characteristics and inert ingredients Indications Precautions, warnings, and contraindications (ADR) How to treat an overdose Dosage and administration Pharmacology (Pharmacodynamics and Pharmacokinetics)

Drug container labels must have the following info: Generic and trade names Drug concentration and quantity Name and address of manufacturer Controlled substance status Manufacturer’s lot number Expiration date Instructions, warnings, and withdrawal time (if applicable) must also be listed, however size of the label often prevents this from fitting. It is common to find these on the package insert, or a tear-off portion of the bottle.

Extra-label/Off-label drug use Using a medication in a manner that is not listed as approved by FDA Different __________________________________________________________________________________________ AMDUCA gave veterinarians the authority to use approved animal drugs in an extra-label manner 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

What is a 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. The veterinarian knows enough about the patient to make a preliminary diagnosis and 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.

CH 2 Pharmacy Procedures, Drug Handling, and Dosage Calculations

The veterinary profession is regulated by the DEA, FDA, USDA, and EPA. The FDA determines whether a drug will be Rx or OTC Decision is based on toxicity of drug, method of use, and how well directions can be written for drug’s usage A prescription drug (aka legend drug) has potential toxic effects or must be administered in a way that requires the services of trained personnel. Prescription drugs must contain the label “_____________________________________________ _______________________________________________________________________________________” An over-the-counter drug is considered safe for the animal, the person administering the medication, people who come into contact with the animal, the human food chain, and the environment Some drugs are OTC in certain dose forms or concentrations and Rx in others 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. It is illegal to fill a prescription from another veterinary practice.

Labels from veterinary hospitals should contain: Name of prescribing veterinarian Name, address, and phone number of clinic Name of patient or ID of patient with and client’s last name Drug name, concentration, and number of units dispensed Date (also thorough to have expiration date) Refills Dose, frequency, route of administration, duration of treatment Cautionary statements Withdrawal or discard times (food animals)

Containers and storage Childproof containers vs. pill envelopes Temperature of storage environment Cold, Cool, Room Temp, Warm, Excessive Heat Amber bottles Silica packets Reconstituted meds and bacterial growth

CONTROLLED SUBSTANCES (SCHEDULE DRUGS) A substance that has the potential for physical addiction, psychological addiction, and/or abuse C-I: extreme potential for abuse, no approved veterinary purpose (heroin, LSD, marijuana, ecstasy) C-II: high potential for abuse/dependence (hydrocodone, cocaine, morphine, pentobarbital, Ritalin, Adderall, Demerol, OxyContin) C-III: some potential for abuse/low moderate dependence (ketamine, Tylenol with codeine, testosterone) C-IV: low potential for abuse/limited dependence (butorphanol, Valium, Tramadol, Ambien, Xanax) C-V: lowest potential for abuse. Antitussives and antidiarrheals (Lomotil, Robitussin AC, Lyrica)