Small test 1 Flashcards
What are the types of the cascade
- Non-food producing animals
- Food producing terrestrial animal species
- Food producing aquatic animal species
Which schedule is not used therapeutically
Schedule 1
Which schedule needs a special locker receptacle
Schedule 2 and Buprenorphine
WP of meat when using human authorized medicine
28 days
What are the purposes of the application of medicine
Therapy Prophylaxis - Prevention Metaphylaxis Diagnosis Growth Euthanasia
What is POM-VPQ? Explain
Prescription-only-medicine - Veterinarian, pharmasist, Suitable qualified person
Room temperature for medicines
15-25 degrees
Which schedules are not used for therapeutical use in animals
Schedule 1
What drugs need recording
All veterinary treatment need recording, except homeopathic treatments.
Schedule 1-5
Drug usage
1. Therapy
Who is treated?
• Individual therapy
o Typically pets
• Mass medication
o Typically production animals
Drug usage
1. Therapy
What is treated?
1• Causative treatment
o Treating cause, not just symptoms
o E.g., Antibiotics, antiviral, antifungal
2• Symptomatic (palliative) treatment
o Treating the symptoms that occur during disease (such as fever), but not the cause of the diseases E.g., Painkillers, anti-inflammatory, mucolytic
3• Substitution therapy
o If the body lacks some kind of substance
(such as a hormone), it can be added to achieve a normal body
function.
o E.g., Levothyroxin to treat hypothyroidism (Bingo!), insulin, glucocorticoids to treat Addison’s disease
Drug usage
Types
- Therapy
- Prevention (Prophylaxis)
- Metaphylaxis
- Growth promotion
- Diagnosis ex juvantibus
Drug usage
Types of therapy
- Causative
- Symptomatic (palliative) treatment
- Substitution therapy
Drug usage
What is 1. Causative therapy
Causative treatment
o Treating cause, not just symptoms
o E.g., Antibiotics, antiviral, antifungal
Drug usage
What is 2. Symptomatic (palliative) treatment
Symptomatic (palliative) treatment
o Treating the symptoms that occur during disease (such as fever), but not the cause of the diseases
E.g., Painkillers, anti-inflammatory, mucolytic
Drug usage
What is 3. Substitution therapy
Substitution therapy
o If the body lacks some kind of substance (such as a hormone), it can be added to achieve normal body
function.
o E.g., Levothyroxin to treat hypothyroidism (Bingo!), insulin, glucocorticoids to treat Addison’s disease
Drug usage
2. Prevention (Prophylaxis)
Examples: • Antibiotics are given prior to surgery to avoid infection. • Vaccines! • Repellents: o Selamectin against flees (and more) o Imidacloprid (insect repellent)
Drug usage
3. Metaphylaxis
Applying medication to ALL animals in a herd, when only a few are sick. It is a type of preventative treatment and is
used in production animals mainly that can easily infect each other.
Drug usage
4. Growth promotion
Illegal (EU) growth promotion
Illegal (EU) growth promotion
• Growth hormone
• Β2-agonists (reduce lipid content in meat)
• Antibiotics
Drug usage
4. Growth promotion
Legal growth promotion
• Probiotics o Beneficial bacteria in the stomach • Prebiotics o Oligosaccharides • Symbiotic o When pro-and prebiotics are applied together
Drug usage
5. Diagnosis ex juvantibus
“Guess” the disease and give treatment for that disease.
→ If the problem is solved, then the guess was correct
Typical for skin problems
Sources of drugs
Drug cascade rule
Drug cascade rule
When applying treatment/medication to an animal we need to follow the drug cascade rule. There are 5 types of
treatments listed from 1-5, and we need should always try to use medication that is from the lowest numbered group
first!!
Sources of drugs
Drug cascade rule
The order
• (1) Veterinary authorized medicines (AVM)
o Non-immunological drugs
o Immunologicals
▪ Vaccines (active)
▪ Serums (passive)
▪ Diagnostics
• (2) Human authorised medicines
o Some of them are off-limits!
• (3) Official and Prepared medicines
o Pharmacopoeias: reference work for the quality control of medicines (book)
• (4) Biocides
o Disinfectants, insecticides, rodenticides
• (5) Complementary products
o Vitamins, minerals, natural, herbal etc.
Sources of drugs
Drug cascade rule
• (1) Veterinary authorized medicines (AVM)
o Non-immunological drugs
o Immunologicals
▪ Vaccines (active)
▪ Serums (passive)
▪ Diagnostics
Sources of drugs
Drug cascade rule
• (2) Human authorized medicines
o Some of them are off-limits!
Sources of drugs
Drug cascade rule
• (3) Official and Prepared medicines
o Pharmacopoeias: reference work for the quality control of medicines (book)
Sources of drugs
Drug cascade rule
• (4) Biocides
o Disinfectants, insecticides, rodenticides
Sources of drugs
Drug cascade rule
• (5) Complementary products
o Vitamins, minerals, natural, herbal etc.
Veterinary authorised medicines (AVM)
How to apply
When using AVMs the drugs are “easier” to use the specific drugs (unique name, dose form, package) is developed and tested for a specific target animal species
(which is indicated on the package).
Efficacy and safety are already worked out for the specific target animal.
What is SPC
SPC (Summary of product characteristics)
→ Legal document containing information
about a medicinal product, based on data generated during the development of the
product.
What is the Withdrawal period (WP) and what is is characteristic for
- The minimum time period between the last administration of a veterinary medicine product to an animal and the production of foodstuffs (e.g. milking, slaughter) from that animal.
- Only for production animals
What is the • Major Food producing animals
o Cattle – meat, milk o Sheep – meat o Chicken – meat, egg o Pig – meat o Salmonidae (fish)
What is the • Minor Food producing animals
o Other ruminants – meat, milk o Other avian species (turkey, goose, duck, pigeon, quail) o Rabbit o Equidae – meat milk o Bees o Other fin fishes
Why is the drug cascade so importaint
The drug cascade is important when prescribing drugs, and it is also regulations regarding what kind of drugs can be given to animals depending on their function (production or non-production animals)
How does the drug cascade apply to non-food producing animals
Non-food-producing animals
- Authorized Veterinary Medicine (AVM) authorized for the treated species
- AVM authorized for another species or indication (off-label)
- Human authorized medicine
- Official or occasionally prepared medicine
- Equidae must be stated in horse passport if they belong to this category
What is the WD for food-producing terrestrial animal species when AVM authorized for the treated species is applied
(used according to the SPC)
What is WD for meat, milk and egg producers?
- AVM authorized for another food-producing species or off-label use
At least 1.5xLWP
LWP=Longest withdrawal period
What is WD for meat producers?
3. AVM authorized for another non-food-producing
species
At least 28 days
What is WD for milk producers?
3. AVM authorized for another non-food-producing
species
At least 7 days
What is WD for egg producers?
3. AVM authorized for another non-food-producing
species
At least 10 days
What is WD for egg producers?
4. Human authorized medicine
At least 10 days
What is WD for milk producers?
4. Human authorized medicine
At least 7 days
What is WD for meat producers?
4. Human authorized medicine
At least 28 days
What is WD for meat producers?
5. Official or occasionally prepared medicine
At least 28 days
What is WD for milk producers?
5. Official or occasionally prepared medicine
At least 7 days
What is WD for egg producers?
5. Official or occasionally prepared medicine
At least 10 days
How do you determine the WD in Food-producing aquatic species
Withdrawal period is measured in:
- Degree days
(cumulative sum of daily water temperature)
- Metabolism is higher in warm water → shorter WP
- SPC (Summary of Product Characteristics)
Dispensation of drugs
Considerations before prescriptions:
• Toxicity, the therapeutic index
o LD50/ED50
o Safe if the therapeutic index is high
• Global impact (e.g. antibiotics)
• Hazard of abuse or addiction
o Controlled drugs (e.g., ketamine)
Dispensation of drugs
Responsibility of the veterinarian:
- “Animal under his/her care”
- The vet must see the animal or herd
- The vet must acquire an accurate picture of the health state of the animal or herd
Classification of veterinary medical products
- POM – Prescription only medicine
- P – Pharmacy medicine
- GSL – General sales list
Stability of drugs
Drug sensitivity
• Vitamin C
o Sensitive to: Temperature, metal ions, light, pH
Stability of drugs
Drug sensitivity
• Vitamin B1
o Sensitive to: Temperature, pH
Stability of drugs
Drug sensitivity
• Vitamin B2
o Light
Stability of drugs
Drug sensitivity
• Clavulanic acid
o Sensitive to: Humidity, metal ion, pH, water
o If clavulanic acid is added to Amoxycillin (antibiotics), the effect can get enhanced
Stability of drugs
Drug sensitivity
Degradation
• Some drugs should be stored as a powder because they degrade quicker when in contact with water
• If a drug starts degrading, the toxicity of it can increase:
o Tetracyclines → anhydrotetracycline
o Diazinon → diazoxon (antiparasitic agent, sheep)
o Rifampicin (antibiotic) → potential allergic reaction (e.g., eyedrop should be stored at -15°C, 1 month)
Temperature requirements
Category Temperature
Room temperature
15-25°C
Temperature requirements
Category Temperature
Cold or cool
8-15°C
Temperature requirements
Category Temperature
Refrigerator
2-8°C
Temperature requirements
Category Temperature
Deep freeze
< -15°C
Temperature requirements
Category Temperature
Room temp Cold or cool Refridgerator Deep freeze Do not freeze
What happen upon the expiration date of a drug
Expiration
• At the expiration date – 95% of the active ingredients is still guaranteed
If the expiration date says: month/year
→ drug can be used until the last day of that month
Expiration
Normal durability:
o Authorized veterinary/human medicine:
usually 2-5 years
▪ Except for immunological products, eyedrops – shorter
Expiration
o Prepared medicine:
days – months
Expiration
For products that have multiple dose injections (eye drops, eye ointments):
▪ Should be thrown out max. 28 days after opening
Expiration
o Some drugs should also be thrown away immediately after usage
▪ E.g. propofol (anesthesia) – has active ingredients that can cause bacterial growth.
What is a Prescription
Prescription writing
A prescription is a written order of a practitioner (physician, vet, dentist) for one or more drugs to be dispensed by a pharmacist to owner/farmer
Requirements for the prescription wrighting
• Should either be written with (blue) ink (non-erasable) or electronically
o Corrections can be done for non-controlled drugs, but it must be validated with a signature to avoid that the patient/owner does any corrections.
o If a mistake is made on a controlled drug, then the entire prescription must be redone.
• Date:
o Prescriptions are only valid for a certain amount of time
• Signature and stamp proving the validity
• Name of the drug should be written clearly and not abbreviated
• Amount:
o 1 gram or more → g
o Micrograms/nanograms or “units” should not be abbreviated
Important Latin abbreviations:
• S.i.d. (semel in die) → once daily
• B.i.d (bis in die) → twice daily
• T.i.d. (ter in die) → three times daily
• Sig. (signature) → what the pharmacist should write on the label when handing out the drug
Validity of a prescription
In general
AB
CD
Prescriptions are only valid for a certain amount of time (UK: 6 months)
o Antibiotics: 5 days (usually)
o Controlled drugs: 28 days (usually)
• Signature and stamp proving validity
Parts of the prescription
The heading: The superscription: The inscription: The subscription: The signature (“S.” or “Sig.”) The veterinarian’s own signature (and title)
Parts of the prescription
The heading:
• Heading 1:
o Name, address, registration number of the practitioner (the person writing the prescription)
• Heading 2:
o Date
o Name and address of the owner
o Treated animal(s): species, name/ID number
Parts of the prescription
The superscription:
RX
Parts of the prescription
The inscription:
• Authorised: name (of drug), dosage form (tablet, ointment etc.) and the strength of medicine (grams)
• Official/Prepared: list of the ingredients and their amounts
o Ingredients: major ingredient/active substance, adjuvant, vehicle
Parts of the prescription
The subscription:
• Information for the pharmacist:
o Official/Prepared: What to prepare from the ingredients, total amount, and how to dispense
▪ E.g., “Send 10 tablets in a suitable package”
▪ E.g., “Prepare a suspension and send 100 ml in a suitable package”
o Authorised: Package size and original package quantity
▪ E.g., “Send one original package, 10 tablets”
Parts of the prescription The signature (“S.” or “Sig.”)
• Information for the owner about the application of the drug
o E.g., “Give 2 tablets to the dog orally daily for 10 days”
• These should always be written:
- o “This animal is under my care” (or “these animals…”)
- o “For animal treatment only”
- o “This prescription is written under the drug cascade”
• Might need additional info:
o “For external use only” (ointments)
o “Shake well before use” (suspension)
o “Keep out of reach of children”
• In case of production animals:
o Withdrawal period (milk, eggs, meat)!!!!!
▪ Fish: degree days
Parts of the prescription
Then at the end:
• The veterinarian’s own signature (and title)
• The veterinarian’s own signature (and title)
• Number of repeats should be written at the bottom of the prescription:
o “No repeats”, “1 repeat”, “2 repeats”
o Using only the word “repeat” without number allows for 2 supplies only
Record keeping
requirements
• Handbook/computer database
• Necessary for all veterinary treatments
(except homeopathic medicine)
• Records:
o Date
o Precise identity of the medicinal product
(including batch no.)
o Dosage administered, duration of treatment
o Name and address of farmer/owner
o Name and address of the veterinarian
o Withdrawal period
(for food-producing animals, must be observed)
o Records should be made within 48 hours of the transaction and kept for a period of at least 5 years
Record keeping
Deadline for recording
within 48 hours of the transaction
Record keeping
How long should you keep the recording
kept for a period of at least 5 yearsv
What is a CD
Controlled drugs
• 1-5 schedules: high potential for abuse and the potential to create severe psychological and/or physical dependence
Example of schedule 1 drug
• Schedule 1:
o Examples: cannabis, amphetamines, hallucinogenic drugs (e.g.,LSD)
Example of Schedule 2 drug:
o Examples: morphine, etorphine, fentanyl, ketamine
•Example of Schedule 3 drug:
o Examples:
buprenorphine,
pentobarbital
• •Example of Schedule 4 drug:
o Examples: benzodiazephines
• •Example of Schedule 5 drug:
o Certain preparations of
morphine,
cocaine and
codeine
that contains less than a specified amount of
the drug
Requirements for S2 and S3 CDs:
• The following must be included:
o The name, qualification, and address of the practitioner
o The date
o The purpose for which the drug is required
o The quality and quantity of the product
o Veterinarian’s own signature and qualification
• If the drug is not collected personally, an additional authorization must be included
• In an emergency situations, controlled drugs may be supplied to a practitioner without a requisition → if the vet
assumes an obligation to send a signed requisition within the following 24 hours.
Requirements for S2 and S3 CDs:
The register must
The register must:
o be either a computerized system or a bound book
o be separated into each class of drug
o have a separate page for each strength and form of that drug, with this record at the top of each
page
o have the entries in chronological order
o have the entries made in ink or in a computerized form in which every entry can be audited
o not have cancellations or alterations
o corrections: made by a signed and dated entry in the margin or at the bottom of the page
o be available for inspection at any time
o be kept for a minimum of two years
o running balance is recommended
• Controlled drugs should be kept in safe custody
Special formal requirements in the written prescription of Schedule 2 and 3 CDs:
Validation
• Special formal requirements in the written prescription of Schedule 2 and 3 CDs:
o Cannot be prescribed on repeat dispensing prescriptions
o No correction
o No abbreviation and Latin expression in the signature part
o Amounts should be written with numbers and words in the inscription and subscription part
Special prescription requirements of CDs that cannot be computer made
• all details except the signature can be computer-generated
Validation for • Prescriptions for Schedule 2, 3 and 4 CDs
only valid for 28 days
• Prescriptions for Schedule 5 CDs are valid for
• Prescriptions for Schedule 5 CDs are valid for 6 months
