Medicine Flashcards
Who inspects veterinary practice premises and how often?
Either VMD or RCVS every 4 years
Which governing body governs the use of veterinary medicines?
VMD- veterinary medicines directorate
What regulations control the use, manufacture, sale, supply etc of vet meds?
VMR - veterinary medicines regulations 2013
Which act and regulations aims to control harmful drugs with the potential to be abused?
Misuse of drugs act 1971
Misuse of drug regulations 2001
Name the 4 legal categories of vet meds
- POM-V
- POM-VPS
- NFA-VPS
- AVM-GSL
Who can prescribe and who can supply POM-Vs?
Prescribe- vets
Supply- any SQP
What category of meds can SQPs prescribe?
POM-VPS
NFA-VPS
AVM-GSL
Authorised veterinary medicines- general sales list
Low risk, wide safety margin
What is CASCADE used for?
Unlicensed products for animal use
Who can prescribe under CASCADE?
Vets only.
SQPs and nurses can dispense
How long must records for CASCADE drugs be kept for?
5 years
What are the steps of CASCADE?
- Off licence product for same species different condition or different species same condition
- Human use licensed in UK or vet med licensed in EU (special import certificate)
- Creating a drug compound
- Human medicine outside UK or vet med outside EU
What goes on a cascade label?
Name and address of O and practice
Vet name
Animal name and species
supply and expiry date
Med info and batch no
Special storage instructions, warnings, withdrawal period
Animal Tx
Keep out of kids reach
What classes require written prescriptions and who can prescribe?
POM-V (vet only)
POM-VPS (RQP)
How long are written prescriptions valid for?
6 months
28days for schedule 2&3
How long do you need to keep prescription records for?
5 years
What info is needed for a written prescription?
Name, address, practice, prescriber name and credentials (RCVS/SQP no)
Name, address O and animal kept
Name, breed of animal
Med info
Withdrawal period
Under cascade if needed
Date and signature
For animals under my care
Number of repeats
Batch no for food animals
Routes of administration
Enteral- GI tract
Oral, buccal, sublingual, rectal
Parenteral- outside GIT
IV, IM, SC, IO, IP, topical, inhalation
What laws govern CDs?
Misuse of drugs act 1971
Misuse of drug regulations 2001
Storage of CDs
Locked cabinet bolted to wall or floor
Separate key
Combo code changed regularly
Staff access only
Away from public
Store CDs only
Disposal of CDs
Schedule 2- denatured and witnessed
Schedule 3,4,5- denatured but not witnessed
Who can witness CD disposal?
CD Liaison officer
VMD/RCVS inspector
Vet from another practice not bribed
Police officer
5 schedules and examples
Schedule 1- high abuse, strictest control- LSD, CANNABIS
Schedule 2- therapeutic value but highly abused- methadone, ketamine, morphine. CD register, CD cabinet, witness destruction, keep invoice 2 years.
Schedule 3- therapeutic value but not as abused- buprenorphine, midazolam, phenobarbital, tramadol, gabapentin. Only bup CD cabinet, not witness destruction or register, invoice 2 years
Schedule 4- therapeutic value but less abused- diazepam. No safe storage, register or witness destruction, invoice 2 years.
Schedule 5- very low strength, not much abuse- codeine, pardale. No requirements, invoice 2 years, script 6m
How to order CD
Requisition form in written ink, RCVS number, stored upon receiving and recorded into register. Keep invoice for 2 years
What info does SPQ need?
No CE required
Condition - vet diagnosis
When and where previously supplied
Last vet visit
What is pharmacodynamics?
The effect of drug on the body
What is pharmacokinetics?
Effect of the body on the drug- ADME
1.absorption
2. Distribution
3. Metabolism
4. Excretion
Fastest to slowest absorption/onset of routes
Injections- IV, IM, SC
Mouth- buccal, sublingual, inhalation
Rectal
Oral
Transdermal
Factors affecting duration of Action
Age
Hydration
Condition/ illness
Route of administration
Storage of meds
Drug formulation
Which vaccines are live attenuated?
Distemper, parvovirus
Calici and panleucopenia
myxomatosis
What vaccines are inactivated?
Lepto
Rabies
FelV
VHD 1&2
Examples of anti emetics and use
Maropitant- safe for FB obstruction, not liver issues
Metaclopromide- prokinetic, not for FB/obstruction
Ondanestron
H1 antihistamine vs H2 antihistamines
H1- antagonists, stops histamine release for allergy
Chlorphenamine, cetirizine
H2- antagonists (proton pump inhibitor) reduce stomach acid
Omeprazole, ranitidine, cimetidine
Anti epileptics
GABA agonists
Phenobarbital- contraindicated liver & renal failure, blood monitoring
Imepition- liver, renal, cardiac issues
Benzodiazepines
Diazepam- rectal, IV
Midazolam
Refractory
Levetiracetum
Propofol CRI
Gabapentin
Potassium bromide- replaces Cl- ions - renal failure as renal excretion
4 classes of sedatives
Phenothiazine
Benzodiazepines
Opioids and ketamine
Alpha 2 agonists
Phenothiazine examples
Acepromazine ACP
Alpha 1 antagonist, CNS depression
anti arrhythmic, anti emetic
Slow onset, long duration
Contraindication: peripheral vasodilation = hypothermia, cardiovascular disease
Benzodiazepines examples
Diazepam
Midazolam
GABA agonists
Safe for old, young, sick patients
Contraindications: healthy animals, liver disease, IV diazepam = thrombophlebitis
Opioids examples
Methadone- schedule 2, full agonist
Morphine, fentanyl- schedule 2
Buprenorphine- schedule 3, partial agonist
Butorphanol- schedule 4, mixed agonist/antagonist
Naloxone- antagonist reversal
Sedative & analgesia - can mix with benzos and ACP
Contraindications: morphine V+ in cats, bradycardia, bradypnoea, slows GIT
Alpha 2 agonist examples
Medetomidine, dexmedetomidine
Muscle relaxants and analgesic
Atipamezole- antagonist reversal
Contraindications: peripheral vasoconstriction, cardiovascular dx, liver dx, IOP/FB V+
Ketamine
Sedation can combine with others (benzodiazepines)
Analgesia
Contraindications: Renal or hepatic dx, hypertension, muscle rigidity if not combined
Diuretics and examples
Loop diuretics- frusomide
Ascending loop of Henle
Thiazides-
Distal convoluted tubule
Potassium sparing-
Distal convoluted tubule and collecting ducts
Contraindications: renal failure, Anuria, vasodilators will decrease BP
NSAIDs and examples
COX 1- prostaglandins in gastrointestinal
COX 1 inhibitor- Aspirin
COX 2- prostaglandins pain and inflammation
COX 2 inhibitor- Meloxicam, carprofen
Non-selective COX 2 inhibitors- ibuprofen, naproxen
Contraindications: steroids, GI issues or ulcers, D+, renal or hepatic issues, hypovolemia
Corticosteroids examples
Glucocorticoid agonist
Hydrocortisone, prednisolone, dexamethasone
Metabolic, catabolic, immuno and inflammation
Mineralcorticoid agonist
Fludrocortisone
Mineral/salt/fluid balance
Contraindications: NSAIDs, immunosuppressed, GI issues, hyperglycaemia
5 neoplastic/cytotoxic
Alkalyting agents
Anti tumor antibiotics
Mitotic inhibitors
Platinum compound
Anti metabolites
Excreted- urine, faeces, body fluids
Contraindications: pregnant, organ failure
Respiratory drugs
Bronchodilators- salbutamol, atropine
Anti-tissutives- codeine, butorphanol
Respiratory stimulants- Doproxam
Expectorants/mucolytics- bromhexine, bisolvin, guaifenesine
