last min PPVN cards Flashcards
what is pharmacology ?
The science/study of drugs and their effects on a living organism
what is pharmacokinetic ?
Drug movement- what happens to the drug when it enters the body?
– Absorption, distribution, metabolism and excretion
Pharmacodynamics ?
The effect of the drug on the organism- what does it do to the body?
a drug that acts on the respiratory system?
Butorphanol is an antitussive that effects the respiratory system.
what is the classification of Butorphanol which is a drug that effects the respiratory system?
POM V
what is the Mode of action of Butorphanol which is a drug that effects the respiratory system?
Opioid agonist, antagonist.
decreases coughing
what are the routs of administration of drugs?
topical - skin eyes ears
subcutaneous intrathecal epidural rectal intramuscular intraosseous intra articular intraperitoneal intracardiac intradermal intravenous inhalation nebulization intratracheal oral subconjunctival
what is Enteral administration ?
Absorbed through GI tract into circulation – systemic effect.
– Orally (via the GI tract or ‘per os’ – by mouth)
what oral medications have a local effect within the GI tract ( enteral administration)
Sucralfate
what happens to drugs that are given via oral administration when they enter the body?
Travel through the GI tract and are absorbed in the small intestine Enter hepatic portal system Liver can remove toxic substances before reaching systemic circulation (first pass effect) Some preparations (hard) require dissolving (dissolution) before entering circulation Some drugs are deliberately ‘slow release’
what does Topical administration mean ?
Used to treat local conditions
Applied directly to skin, ears, eyes and mucous membranes.
which topical drugs are absorbed through the skin and into systematic circulation?
Emodeside and anthelmintic
what is parental administration?
administration via any other route other than the GI tract.
why is it important to choose the correct route when administrating drugs?
Some routes may endanger the animal
The drug may be destroyed or inactivated if given by an unsuitable route
Some drugs may cause harm to certain conditions if given by the incorrect route
Different speed of reaction may be required
Patient temperament!
Convenience to the person giving the drug (client vs us)
what are the 4 types of drug classifications?
POM-V - Prescription-only Medicine – Veterinarian; abbreviated to POM-V;
POM-VPS - Prescription-only Medicine – Veterinarian, Pharmacist, Suitably Qualified Person (SQP); abbreviated to POM-VPS;
NFA-VPS - Non-Food Animal – Veterinarian, Pharmacist, Suitably Qualified Person; abbreviated to NFA-VPS;
AVM-GSL - Authorised Veterinary Medicine – General Sales List; abbreviated to AVM-GSL.
What legislation sorts drugs in schedules ?
the Misuse of Drugs Regulations 2001,
what do you require if you possess schedule 1 drugs ?
schedule 1 - possession requires a Home Office licence
what do you require if you possess schedule 2 drugs ?
- drugs obtained and supplied must be recorded in a register for each drug;
which schedule drugs prescriptions are subject to additional requirements?
schedule 2 and 3
what do you require if you possess schedule 4 or 5 drugs ?
drugs are subject to fewer controls. Veterinary surgeons should take extra care when prescribing controlled drugs, to ensure that the medicines are used only for the animals under treatment.
what is the cascade system for prescribing drugs and when can it be used?
Where there is no suitable veterinary medicine authorised in the UK for the specific condition in the animal being treated, vets are permitted to use their clinical judgement to treat animals under their care in accordance with the cascade.
to avoid unacceptable suffering
it is a risk based decision tree
who is a suitably qualified person?
A Suitably Qualified Person (SQP) is a legal category of professionally qualified persons who, under the Veterinary Medicines Regulations, are entitled to prescribe and/or supply certain veterinary medicines (POM-VPS and NFA-VPS).
SQP should ensure that the medicine is correctly prescribed and advise on the choice of medicine.
drug calculation!!!
Dose prescribed (mg) x patient weight (kg) (mg/kg)
÷
Concentration (mg/ml)
Drug calculation example ?
a 10 kg patient requires 60mg of a drug by injection
The drug strength is 100mg/ml
dose x weight ÷ concentration
e.g. a 10 kg patient requires 60mg of a drug by injection
The drug strength is 100mg/ml
60mg x 10kg ÷ 100mg/ml = 6ml
what should you do if an animal has an adverse reaction to a drug?
The reaction can be reported using the suspected adverse reactions surveillance scheme (SARSS)
VS/pharmacists/VN’s are not legally required to report adverse reactions although this process is important for ensuring drug safety and efficiency. also consider codes of conduct.
Reports can be made directly to the VMD online or by completing the yellow form in the back of the compendium
the equation for fluid therapy calculations
Maintenance requirement ÷ 24 = mls / hour
mls / hour ÷ 60 = mls / minute
mls / minute X drip factor = drops / minute
60 ÷ drops / minute = drops / second
drip factor
standard = 20 drops/ml
Paediatric=60 drops/ml
how much do animals pee per hr per kg.
Estimating urine output
1-2mls/kg/hr
an example of a urine output calculation for 30kg dog .
urine output per hr is 1-2mls/kg/hr
30kg x 1 = 30mls/hr
30mls x 24hours =720mls/24hours
30kg x 2 = 60mls/hr
60 x 24hrs = 1440mls/24 hours
Final answer: 720mls – 1440mls/24 hours
How does the RCVS protect the public interest and safeguard animals health and welfare?
The RCVS Veterinary Surgeons Act 1966,
Royal Charter and the Veterinary Nurse Conduct and DisciplineRules 2014
Only those appropriately registered with the RCVS have the right to practise veterinary nursing in the UK.
Since 2012 all those who register with the RCVS have to make a declaration. What are some key points in this declaration?
” I PROMISE AND SOLEMNLY DECLARE that I will pursue the work of my profession with integrity and accept my responsibilities to the public, my clients, the profession and the Royal College of Veterinary Surgeons, and that, ABOVE ALL, my constant endeavour willbe to ensure the health and welfare of animals committed to my care.”
integrity
responsibility to public, clients RCVS and profession
I WILL ENSURE THE HEALTH AND WELFARE OF ANIMALS COMMITTED TO MY CARE.
What should a VS being thinking about when asking a VN or a SVN to carry out a schedule 3 procedure ?
how difficult the procedure is and the risks
weather the nurse is qualified to treat the species
weather the nurse understands the risks
and if the nurse has the necessary experience
the VS should also be able to come if the VN needs assistance
what are the principles of practice listed in the code of professional conduct for Veterinary nurses?
Principles of practice - RVN’s seek to ensure the health and welfare of animals committed to their care and to fulfil their professional responsibilities, by maintaining five principles of practice:
- Professional competence
- Honesty and integrity
- Independence and impartiality
- Client confidentiality and trust
- Professional accountability
some legislation/acts of parliament a SVN would have broken if they injected an animal with a drug without being confident about what the drug was and ended up overdosing the patient?
The 1966 Veterinary surgeons act section 19
Schedule 3
The 1968 medicines act
what is a generic name ?
the concise name given to a specific chemical compound e.g. Fipronil is the generic name for Frontline
what is a trade name?
the name by which the drug is marketed
e.g. Frontline
what are drugs classified by?
Their mode of action (effect on the body)
Which body system they act upon e.g Cardiovascular, respiratory
what is a drug?
A chemical that has a known biological effect on a living organism
how do drugs work?
Drugs produce their effects through their actions on specific cells of the body.
Particular molecules within, or on the surface of the cells combine with the drug to initiate a response.
These molecules within or on the surface of the cells are known as receptors.
what do agonist drugs do?
act in the same way that natural body chemicals would act
what do antagonist drugs do?
Where the drugs block or reduce the action of natural body chemicals, they are known as antagonists.
drugs can act on different pathways within the body, what are the main 2 pathways?
enzymes
ion channels
what do drugs often do to enzymes?
reduce their activity
what do drugs often do to ion channels ?
they control what can enter and leave the cell through the cell membrane. the drugs modify the cell membranes action.
how are most drugs absorbed if they are NOT designed to have a local effect at the cite of administration?
the drug will be absorbed into the bloodstream in order to travel to the intended site of action.
Absorption takes place via simple diffusion, or by active transport.
what is simple diffusion ?
Simple diffusion is where drug molecules pass across the gastro-intestinal mucosa from an area of HIGH concentration to an area of LOW concentration.
How are drugs moved into the blood stream via active transport? from a low concentration to a high concentration?
In active transport, energy is used to transport the drug molecules from the gastro-intestinal tract to the bloodstream.
As energy is used this means that the drug can move from an area of low concentration to an area of high concentration, going against the concentration gradient.
where does most drug metabolism occur?
Most drug metabolism (biotransform) occurs in the liver
what is a drug side effect?
Side effect = An effect secondary to the one intended, either therapeutic or adverse.
what is a drug adverse reaction?
Side effect = An effect secondary to the one intended, either therapeutic or adverse.
what are some key pieces of legislation linking to drugs?
Veterinary Medicines Regulations (VMR) 2013
The Misuse of Drugs Act 1971
–The Misuse of Drugs Regulations 2001
what does COSHH stand for and what year is it?
Control of Substances Hazardous To Health 2002
Veterinary Medicines Regulations 2013
Governs licensing, prescribing, supply and labelling of veterinary medicinal products in the UK
Ensures safety, quality and efficacy
safe and effective use of veterinary medicines
Misuse of drugs act 1971
Controls production, supply, possession and storage of dangerous drugs
Deals with CD (Controlled Drugs)
controlled drugs are …
POM-V
Potential for abuse
Five schedules
Determines requirements for requisition, storage, record-keeping, prescribing, supply and disposal
May only be prescribed by VS and supplied by VS or pharmacist
what are schedule 1 drugs and can vets possess or prescribe them?
Vets not generally authorised to possess or prescribe
Research purposes
Special licence must be obtained
Highly addictive substances with no therapeutic indication in vet practice
LSD, Cannabis, Raw Opium
Legal possession and supply of Schedule 1 CDs requires Home Office authority
give examples of Schedule 1 drugs?
LSD, Cannabis, Raw Opium
What are Schedule 2 drugs and how can they be obtained?
Can only be obtained with written requisition signed by VS
All purchases and each individual supply must be recorded within 24 hours in a bound CD register
eg. Ketamine Morphine Methadone Fentanyl Secobarbital
Give some examples of Schedule 2 drugs?
Ketamine Morphine Methadone Fentanyl Secobarbital
What are the requirements for the drug register and the storage of schedule 2 drugs?
Indelible ink Chronological order Separate section for each drug running total for each drug mistakes should not be written over register must be kept for 2 years all entry's should be signed by a veterinary surgeon
All drugs should be kept in a locked receptacle which can only be opened by a VS or a person authorised by them to do so. The key should not be communal or kept in a drawer.
how should schedule 2 drugs be destroyed and why?
Destruction must take place in presence of a person authorised by Secretary of State
Significant potential for abuse but have therapeutic indication in vet practice
-Opiate analgesics
Schedule 3 drugs
what are the prescription and requisition requirements ?
Same prescription and requisition requirements as S2
can only be obtained with a written requisition signed by VS . All requisitions recorded in bound register.
Administration and dispensing does not have to be recorded in CD register
Most not subject to special storage requirements
Buprenorphine must be kept in locked receptacle
Recommended that all are locked away
food producing animals
drugs should have withdrawal period specified. for how long the animal must be off the drugs before they can be used.
records must be kept for 5 years
7 days for eggs and milk
28 days for meat
500 days for fish
the cascade system
1- always prescribe a veterinary medicine that has obtained a marketing authorisation for that species and condition
2- where such product doesn’t exist, select a product that is authorised for treatment of that condition in another species , or for another condition in the same species
3- if there isn’t one , select a product that is authorised for human use or a veterinary product authorised in an EU member state but not the UK.
4- if there isn’t one its acceptable to use a product prepared by an authorised person, special order products
recommendations for cascade use?
keep records of all unauthorised and off label use of drugs, inform the client, obtain written consent, must be administered by VS or someone under the direction of VS to animals under the VS responsibility
avoid causing unacceptable suffering to the animal
small animal exemption scheme ?
certain veterinary medicines can be imported, marketed and supplied in the uk without a marketing authorisation if they are for aquarium fish, cagebirds, homing pigeons, small rodents , ferrets and rabbits .
antibiotics, narcotics and psychotropic agents are not included in this scheme. as well as products intended for parental, ophthalmic or aural administration might not be included. must all be clearly ladled as included in scheme
What can drugs that effect the Gastrointestinal system be used to do?
they can be used to increase appetite , control nausea, inhibit or induce vomiting, control diarrhoea, treat colitis
what are some drugs that act on the gastrointestinal tract?- appetite stimulant
appetite stimulants - Diazepam - acts on the brain to stimulate appetite
what are some drugs that act on the gastrointestinal tract?- emetic
Emetics - Apomorphine- stimulated vomiting after eating toxin
what are some drugs that act on the gastrointestinal tract?-h2 agonist
Ranitidine- reduces gastric acid
what are some drugs that act on the gastrointestinal tract?- Prokinetics
Ranitidine- increases movement of ingested material through GI tract
what are some drugs that act on the gastrointestinal tract?-Antidiarrheal
Loperamide- increases intestinal transit time and reduces gut peristalsis
what are some drugs that act on the gastrointestinal tract?-laxative
stimulant laxatives Bisacodyl - increases mobility of the intestine
drugs used on the respiratory system - antitussives
Butorphanol/codeine - Supresses the cough centre of the brain
drugs used on the respiratory system - Bronchodilators
anticholinergics - block cholinergic stimulation to prevent bronchoconstriction
drugs used on respiratory system - corticosteroids
fluticasone - reduces inflammation of the airways
drugs that are used on the respiratory system - respiratory stimulants
Doxapram- acts on the respiratory centre of the brain to stimulate respiration
Drugs that effect the cardiovascular system - used for congestive heart failure
Digoxin - cardiac glycoside
Pimobendan - Phosphodiestrase inhibitors
Benazepril - ACE inhibitors
Glyceryl trinitrate - Nitroglycerides
Diuretics like hydrochlorothiazide can be used to help with congestive heart failure by increasing urine output
drugs used to treat Cushing’s disease/ hypoadrenocorticism
Trilostane - acts on over producing adrenal gland reducing adrenocorticotropic hormone
drug for diabetes mellitus
insulin
what is the most commonly used antiepileptic medication ?
Phenobarbital - enzyme influencer
potassium bromide can also be used but not in animals with renal failure
some common behaviour modifying drugs
clomipramine
selegiline
fluoxetine
which drugs act on the central nervous system?
local and general anaesthetics
eg of a schedule 5 drug
codeine
eg of a schedule 4 drug?
Diazepam
eg of a schedule 3 drug?
Buprenorphine
eg of a schedule 2 drug?
Morphine
eg of a schedule 1 drug?
Cannabis
RAMIPRIL
its an ACE inhibitor meaning it binds and blocks active sites, it is converted to ramiprilat in the liver and the kidneys . it lowers the blood pressure causing renin to be released.
Loperamide
is an opioid receptor agonist which attaches to the receptors in the large intestine and means that substances will stay there for longer reducing the amount of water in them.
Butorphanol
is a synthetic opioid agonist - antagonist - analgesic . it bypasses the gi tract and blocks pain impulses at specific cites in the brain and spinal chord
metoclopramide
relives symptoms of nausea by having effects on the brain and it increases gastric emptying by decreasing pressure in the lower oesophageal sphincter
Furosernide
it manages hypertension and edema. acts directly on cells of the nephron and increases urine output.
