Pharmacy Flashcards
what is the generic name of a drug?
its chemical or actual drug name (e.g. paracetamol)
what is the proprietary name of a drug?
the brand name (e.g. calpol)
which drug name is likely to change?
proprietary
what sort of drug is maropitant?
antiemetic
what are the 2 ways drugs are classified?
they way they bring about their effect on the body/mode of action
the body system they affect
what does SID/UID/q24h mean?
once a day - injected/administered every 24 hours
what does BID/BD/q12h mean?
twice a day - injected/administered every 12 hours
what does TID/TD/q8h mean?
three times a day - injected/administered every 8 hours
what does QID/QD/q6h mean?
four times a day - injected/administered every 6 hours
what does PO mean in terms of drugs?
oral drugs
what does IM mean in terms of drugs?
intramuscular
what does SC mean in terms of drugs?
subcutaneous
what does IP mean in terms of drugs?
intraperitoneal
what are the routes of administration of drugs?
oral intravenous (IV) intramuscular (IM) subcutaneous (SC) cutaneous (for topical or systemic effect) transdermal (through a patch) ocular (through the eye) otic (ear) intrathecally (into the space around the spinal cord) sublingually (under the tongue) buccally (between the gums and cheek) rectally vaginally inhalation (through the mouth) nebulisation (mouth and nose) intraosseus (directly into bone marrow) intraperitoneal (within or through peritoneum)
where is a subcutaneous injection usually given?
scruff of the neck
why is the scruff often used to administer wide range of non-irritant medications?
poor supply of nerves and blood vessels
how long do subcutaneous injections take to work?
30-45 mins, due to the poor circulation in the area
how does preparation for subcutaneous injection differ if it is a vaccine?
site should not be swabbed as it can react with the contents of the vaccine
why should skin be prepped before all injections other than vaccines?
to ensure that no bacteria is introduced into the skin along with the needle
why can large volumes of fluid be given subcutaneous?
there is more room
when giving a subcutaneous injection how should the needle be angled?
45 degrees to the skin tent created by your other hand
what must you do before beginning to inject the medication?
pull back on syringe to check for blood
what are the main injection sites for IM muscles?
lumbo-dorsal (epaxial)
quadriceps
how long do IM injections take to work?
20-30 minutes
quicker than SC as there are more blood vessels in the muscle
slower than IV
how do you administer IM injection?
insert needle at 90 degrees
draw back (no blood)
administer injection slowly
massage area afterwards
which is usually the most painful injection type?
IM
what sort of drugs should be avoided IM?
when administering irritant drugs and large volumes
what is the maximum volume for dogs and cats that should be injected IM
5ml in dogs
2ml in cats
what are the 2 most common sites of IV injection?
cephallic and saphenous veins
how long do IV injections take to work?
0-3 minutes
How should the patient be prepared for IV injection?
hair should be clipped, clean/swab skin, vein should be raised by assistant/tourniquet
How may medication be administered IV?
a bolus, slowly over several seconds, or as an infusion (within a bag of fluids)
what is often given IV?
drugs that are irritant or of large volumes
what should be monitored during/after IV injection?
vein ‘blowing’ as medication not entering the vein any more (moving perivascularly)
side effects as IV is rapid onset
where are the cephallic and saphenous veins located?
cephallic: dorsal aspect of forelimb, proximal to elbow
saphenous: dorsal transverse aspect of hindlimb, proximal to hock (tarsus)
what is the rate of effect of oral medication?
variable but usually less than 20 mins
how should tablets be administered to cats?
tilt head back as far as possible (without causing pain/discomfort)
allow head to drop to normal position once tablet is administered (but do not let go) to allow cat to swallow
can stroke throat and syringe small volume of water into mouth to encourage swallowing
how should tablets be administered to dogs?
tilt head back slightly and ensure dogs lips aren’t stuck in it’s teeth
administer tablet and stroke throat/syringe small volume of water into mouth to encourage swallowing
how should liquids be administered orally?
tilt head back slightly, locate gap between canine teeth and insert dropper or syringe. Administer small amounts and allow patient to swallow
stop immediately if coughing occurs
How should aural medication be administered?
hold ear close to the base, gently lift pinna. Insert nozzle, apply correct number of drops. Let go of pinna and gently massage around outside base of vertical canal
How should occular medication be administered?
take care not to touch the surface of the eye or to contaminate bottle/tube. Gently hold lower lid down and upper lid upwards. Apply and gently open and close eyelid to encourage distribution
What are other types of topical mediactions?
shampoo - not commonly used, check label and wear correct PPE
Creams
Lotions
Patches
what should you be careful of when applying topical treatments?
absorption of product doesn’t happen through your skin - gloves should be worn
what are 10 requirements for drug storage in a veterinary practice?
separate room in the practice not accessible by public no eating or drinking in pharmacy must be kept in a orderly manner and drugs should be stored in logical order clean and tidy with good stock rotation labeling of shelves follow manufacturers guidelines in the fridge (if needed) check expiration dates regularly use 'dummy packs' in public areas
what do all medicines sold or supplied in the UK need to have?
a product licence
when is a product licence awarded to the drug manufacturer?
only when certain criteria have been met on the safety and efficacy of the product, quality control measures are in place during production and drug trials have been carried out
what does the veterinary medicinal products directive (2001) control?
manufacture, authorisation, marketing, distribution, and post-authorisation of veterinary medicine in all EU member states
what does the veterinary medicinal products directive (2001) provide the basis for?
controls on veterinary medicines set out in the 2013 veterinary medicine regulations
do clients have to purchase their prescriptions from their practice?
no - should be made aware of other options although vet will need to examine the pet in order to prescribe most drugs
under veterinary medicines regulations who can prescribe or supply certain categories of authorised veterinary medicines?
RQP: vets, pharmacists and SQPs
what does SQP stand for?
suitably qualified person
what are the 3 different types of RQP?
registered veterinary surgeon
registered pharmacist
registered SQP
who must the SQP receive training from in order to be registered?
AMTRA: animal medicines training regulatory authority
what medicinal products can SQPs dispense?
POM-VPS
NFA-VPS
what does POM-V stand for?
prescription only medicine - veterinary surgeon
what must happen before a POM-V medicine is dispensed
vet must carry out a clinical assessment of the animal under their care and then prescribe the drug and write out the prescription
who can POM-V drugs be supplied/dispensed by?
any vet or pharmacist provided they receive a valid written prescription by the vet that assessed the animal
what does POM-VPS stand for?
prescription only medicine - vet, pharmacist or SQP
who can POM-VPS drugs be supplied by?
a vet, pharmacist or SQP when presented with a prescription from anyone of these people
does the animal receiving a POM-VPS drug need to be seen prior to prescription?
no
what does NFA-VPS stand for?
non-food animal - vet, pharmacist or SQP
who can supply NFA-VPS drugs?
non-food animal - vet, pharmacist or SQP
can NFA-VPS drugs be supplied without a prescription?
yes
what is classed as a non-food animal in the UK?
domestic pets
what does AVM-GSL stand for?
authorised veterinary medicine - general sales
are there restrictions on the sale of AVM-GSL?
no restriction on this catergory as they have a wide safety margin
who can supply AVM-GSL?
any retailer by an staff
how must AVM-GSL drugs be labelled?
to show that they are medicines
what prescription category do controlled drugs fall into?
POM-V
what does the misuse of drugs regulations (2001) control?
production, supply, possession, storage and dispensing of drugs where there is potential for abuse of this drug by humans
How many schedules are there for controlled drugs?
5
what drugs are in schedule 1?
addictive drugs e.g. LSD, cannabis
can vets prescribe schedule 1 drugs?
no authority to possess or prescribe schedule 1 drugs as they have no medicinal use
what drugs are in schedule 2?
opiate analgesics (e.g. morphine, ketamine, methadone)
which controlled drugs schedule has stringent rules applied?
schedule 2
what drugs are in schedule 3?
barbiturates - used to induce apathy and sleep (e.g. tramadol, phenetobarbitone)
do schedule 3 drugs need to be kept in a locked cabinet?
advised and buprenorphine must be kept locked away
what drugs are in schedule 4?
benzodiazepines (e.g. valium, diazepam)
do schedule 4 drugs require control within a veterinary practice?
no restrictions
what drugs are in schedule 5?
low strength preparations of paracetamol, codeine and morphine
are there any restrictions on drugs in schedule 5?
no
where must schedule 2 drugs be kept?
locked cupboard
what must vets do when schedule 2 drugs are withdrawn from the locked cupboard?
vets must withdraw drugs and sign controlled drugs register
how many people should have access to the schedule 2 drugs cupboard?
specific key holders only
What drug schedules must be kept in safe custody in a controlled drugs cabinet?
schedule 2 and 3
what schedule of drugs must have use recorded in controlled drugs register?
schedule 2 and good practice to record buprenorphine use in schedule 3
What drug schedules must only be destroyed in the presence of someone from outside the practice?
schedule 2
what should make up the controlled drugs register within a practice?
bound register or computerised system kept at the premises where controlled drugs are kept
within what time frame should purchase of schedule 2 drug be recorded?
within 24 hours of receipt
what should be recorded when a controlled drug is used?
patient details, amount given and VS signature
for how long after the controlled drugs record is completed must it be kept?
2 years
if a correction is made what must happen on the record?
must be signed
how soon after drug use must this be recorded?
up to 24 hours
under what conditions must controlled drugs be destroyed?
must be done in front of an appointed person using an approved commercially available kit, they cannot just be disposed of
when can veterinary medicine only be administered to an animal?
if that medicine has a product licence for the treatment of that particular condition in that particular species
what is the off label/cascade prescription of a drug?
using a drug outside the purpose for which it is authorised
what is the purpose of off label/cascade prescription of a drug?
to alleviate an unnecessary suffering
when may off label/cascade prescription of a drug be used?
if no drug is licensed for the condition in that species then another drug licensed in another species or for another condition may be used
what do vets need to do if using prescription cascade?
must justify their decision, record in clinical notes why and must obtain owner written consent
what can be used if a product licensed for the specific species and condition does not exist?
use another drug licensed for use in another species for that condition or for another condition in the same species
what can be done if there is not another drug licensed for use in another species for that condition or for another condition in the same species that is suitable?
use an authorised human medicine or use a veterinary product not licensed in the UK but is authorised by the EU
authorise the preparation of a product in accordance with vet prescription
what does the veterinary surgeons act 1966 state in regards to VN prescribing and dispensing medication>
diagnosing and prescribing in light of diagnosis is not in the realms of the VN.
VN is involved in dispensing under the supervision of VS
what are the legal requirements of what must be contained in a written prescription?
written in indelible ink
name, address and telephone number of person prescribing the product
qualifications of the person prescribing the product
name and address of owner
species, identification and number of animals
signature of authorisation of the person prescribing
the date of prescription issue
the name, amount and strength of product supplied
dosage and administration instructions
any necessary warnings
withdrawal period (if relevant)
directions for repeat prescriptions
if it is under cascade or not
within how much time after issue must a prescription be dispensed?
6 months
what does a controlled drug prescription require?
written in vets own handwriting
form, strength and quantity of drug written in numerals and letters
no repeats
within how much time after issue must a controlled drugs prescription be dispensed?
28 days
how much of a controlled drug should be dispensed at each time?
enough for 28 days (or less if prescribed less)
what is an animal suspected adverse reaction (SAR)?
a harmful and unintended reaction which may be due to exposure to a veterinary medicine administered to an animal at its normal dose
what is the suspected adverse reaction surveillance scheme (SARSS) run by?
VMD
how should hazardous drugs be handled?
warning should be printed on label
must only be used in a safe working environment
wear gloves
handle in a controlled environment
what are cytotoxic drugs?
treat neoplastic disease (cancer) and are very dangerous
what must be included on a drug label?
name and address of prescribing vet or pharmacy
name and address of owner
name of the animal
date of dispensing
the words ‘keep out of reach of children’
the words ‘for animal treatment only’ unless the package is too small for this to be practical
the words ‘for external use only’ on topical products
the name, amount and strength of product supplied
dosage and administration instructions
any necessary warnings for the user, target species, administration or disposal of the product
any special storage instructions
what containers should be used for drugs?
child proof containers
adjust for elderly
how can blister packs be dispensed?
card wallets
what sort of jars should be used for powders, creams etc?
wide mouth
how should light sensitive drugs be stored?
light sensitive
how can external liquids be stored?
in fluted bottles
