Pharmacy and Compounding Flashcards
4 categories of veterinary medications
-Drugs; veterinary drugs directorate
-Pesticides
-Biologics
-VHP (veterinary health products…. not a drug)
What is required for a vet to dispense/prescribe medication
Valid vet client patient relationship
What are drugs categorized based on?
-Safety concerns
-Abuse potential
-Ability of a lay person to understand and execute directions for their use
What does scheduling of drugs/products dictate?
-How drug is ordered for dispensing from a clinic
-How drug it to be stored
-How drug is obtained by the client
What are the requirements for NAPRA I drug schedules? What are included in this category?
-Prescription needed for sale by pharmacist
-May be stocked and dispensed by rDVM at clinic
-Things like narcotics, controlled drugs, and targeted substances
What is NAPRA II?
A classification where a prescription is not required, but the medication must be dispensed by a pharmacist (behind the counter).
What is NAPRA III?
A classification that allows clients to obtain medications at a pharmacy without needing a pharmacist’s intervention.
What does “unscheduled” mean in the context of NAPRA III?
It refers to medications that can be obtained at retail stores without any specific scheduling or prescription requirements
What is required for all prescription medications (NAPRA I) in terms of labeling?
-They must include the name, strength, and quantity of the drug
-Date drug is dispensed
-Expiration date
-Name of the owner
-Drug identification number (DIN)
-Name and address of the dispensing veterinarian
-Identity of the animal(s)
-Directions for use
-Storage precautions and other warnings
What is an exception to labeling requirements for non-PDL medications?
Non-PDL medications that are veterinary-approved, in their original packaging, and state “veterinary use only” do not require a veterinary label.
What must be done if a drug is dispensed and used in an extra-label manner
It must be labeled with new directions for use.
What is required of veterinarians who dispense drugs?
They must create a written record (patient record) of the dispensed medications.
What is the veterinarian’s responsibility regarding medication use?
To communicate effectively with the client about medication use.
What factors can lead to client noncompliance with medications? (4)
-Health beliefs/disbeliefs
-Communication problems
-Skills and experience
-Dosage regimen
-Challenging patient behavior
What communication strategies are most effective for client compliance?
Combination of written and verbal
What types of materials can help with client communication?
Manufacturers’ materials and client handouts.
What is compounding in veterinary practice?
It is the combining or mixing of two or more ingredients (at least one being a drug) to create a final drug in an appropriate dosage form that does not comply with the approved label directions.
What can compounding involve?
-Alteration of the form or strength of commercially available formulations
-Use of raw bulk chemicals (active pharmaceutical ingredients, API)
What are some examples of compounding? (5)
- Combining/mixing 2 or more drugs to create a new drug
- Diluting a drug other than according to label
- Mixing to administer by a different route than on the label
- Converting an approved medication into a differing form eg.
tablet to liquid, splitting one capsule into two capsules - Adding an unapproved non-drug substance eg flavouring
agent
What does the client need to know to ensure informed consent expectations are met?
-Drug has not been approved by the VDD of Health Canada
-Efficacy of the drug may not be known; drug not rigorously tested
-Any potential ADRs that may be incurred with the compounded product
-Not required for routinely utilized compounded drugs analgesic and anesthetic
drugs (eg ketamine /valium in same syringe, dilution of narcotics)
When is a compounded product considered a controlled substance?
If any of its ingredients contain a controlled substance.
Can veterinarians re-dispense compounded products?
Yes, veterinarians can compound or obtain a compounded product from a pharmacist for use in their accredited veterinary facility, labeling it for “in clinic use.”
Under what conditions can compounded products be re-dispensed to animals?
They can be re-dispensed to individual animals or groups where a valid veterinarian-client-patient relationship (VCPR) exists, provided records show the original pharmacy that made the product.
Should veterinarians report adverse drug reactions (ADRs) when using compounded products?
Yes, while reporting ADRs associated with compounded products to the VDD of Health Canada is voluntary, it is encouraged.
