Prescribing & Dispensing: The Prescribing Cascade Flashcards

1
Q

what does authorized vet meds mean

A

scientific assessment of quality, safety, and efficacy

potential risks to the environment, animals, operators and consumers

SPC of dose, route of admin, etc

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2
Q

what are problems with unauthorized medicines

A
  1. may not be of consistent quality
  2. may not be safe and effective
  3. may pose a risk to consumers if administered to a food producing species
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3
Q

what are exemptions to the cascade (3)

A
  1. products for research (ASPA)
  2. exceptional circumstances (disease outbreak)
  3. immunological products for imported or exported animals
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4
Q

what is the cascade

A

a mechanism to allow us to prescribe unauthorized medicines to our patients

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5
Q

when is the cascade legal

A
  1. three steps of the decision tree are followed
  2. justified with regard to the animal’s welfare
  3. not using the drug as a cost-saving exercise
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6
Q

who can prescribe and dispense under the cascade

A

only a vet can prescribe

a pharmacist may dispense an authorized VMP for use under the cascade, human medicines or extemporaneously prepared medicines against a prescription from a vet

an SQP may dispense an authorized VMP for use under the cascade against a prescription from a vet, provided they have the relevent qualification for that species

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7
Q

what is good practice before you prescribe a medicine under the cascade

A

get informed consent from the owner RCVS recommends

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8
Q

what is required for food animals

A

extra regulations to protect the consumer

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9
Q

what are the regulations to prescribing under the cascade in food animals (5)

A
  1. treatment restricted to a single holding
  2. if using an imported product, it must be authorized in a FP species in the other member state
  3. active substances must be listed in Table 1: allowed substances
  4. vet must specify appropriate withdrawal period
  5. vet must keep specified records
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10
Q

what is maximum residue limit (MRL)

A

max safe concentration of residue resulting from use of a vet medicinal product

expressed in mg/kg

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11
Q

what is a withdrawal period

A

period of time, following treatment of an animal with a veterinary medicine, in which the meat, milk, eggs or honey from the treated animals must not enter the food chain due to possible presence of residues from pharmacologically active substances

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12
Q

how do you set a withdrawal period

A

the vet does this

check the SPC –> if the species is different or dose is higher then the minimum statutory withdrawal period should be set

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13
Q

what records must be kept (10)

A
  1. date of exam
  2. name and address of owner
  3. animal ID and number treated
  4. result of clinical assessment
  5. trade name of product
  6. batch number
  7. name and quantity of active substance
  8. dose administered and/or supplied
  9. duration of treatment
  10. withdrawal period
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14
Q

how long do records need to be kept

A

5 years

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15
Q

what is step 1 in the prescribing cascade

A

a product authorized in the UK for use in another animal species (must be another food-producing species)

or a product authorized for another condition in the same speices

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16
Q

what is step 2 in the prescribing cascade

A

a human medicinal product authorized in the UK

OR

a veterinary medicinal product authorized in another EU member state for use in an animal species (in the case of a food-producing animal it must be a food-producing species)

17
Q

what is step 3 in the prescribing cascade

A

a medicinal product prescribed by the responsible VS and prepared extemporaneously by a pharmacist, a vet surgeon or a person holding a manufacturing authorization authorizing the manufacture of that type of product

OR

a medicine imported from third countries

18
Q

what are the tables

A

Table 1: allowed substances

Table 2: prohibited substances

19
Q

what is table 1

A

substances in which an MRL has been established, is being established or doesn’t need to be established

20
Q

what are table 2 substances

A

MRL cannot be established

any residue at any level, constitutes a hazard to human health

administration of substances listed to food-producing animals is prohibited

21
Q

what needs to be done before prescribing for a horse in the UK

A

check the passport

see if the horse is intended for human consumption

if not then treat as for any companion, non-food animal

follow normal cascade

22
Q

if the horses is intended for human consumption what should you do

A

follow the food animal cascade

23
Q

what is the essential substances list

A

additional substances that can be used in horses intended for consumption

BUT a minimum 6 month withdrawal period

24
Q

which medicines are not permitted in horses intended for human consumption

A

anything listed in table 2

and anything not listed in either

table 1 or essential list

25
Q

what if there is no horse passport

A

treat as intended for human consumption

26
Q

can phenylbutazone be used in horses intended for human consumption

A

no