Veterinary Medicines

Question 1

Where can you buy vet meds?

Answer 1

• Veterinary practice
• Pharmacy
• Feed merchant
• Supermarket
• Pet stores

Question 2

What legislation governs veterinary

medicines?

Answer 2

• The Veterinary Medicines Regulations 2013
• Legislation made and enforced by Veterinary
Medicines Directorate (VMD)
• Veterinary Medicines Framework- EMA

Question 3

People who can supply vet products

Answer 3

• Vets – may supply all vet meds
• RQP – registered qualified people
• those who are entitled to supply vet pharmacy
products due to their professional qualification
• pharmacists
• SQP – suitably qualified people
• may supply particular products once they have
undertaken accredited SQP training

Question 4

Four classes of drug

Answer 4

• Prescription only medicine – veterinarian (POM-V)
• Includes medicated feedstuffs
6
• Prescription only medicine – veterinarian, pharmacist,
suitably qualified person (POM-VPS)
• Non-food producing animal – veterinarian, pharmacist,
suitably qualified person (NFA-VPS)
• Authorised veterinary medicine – general sales list
(AVM-GSL)

Question 5

Supply

Answer 5

• POM-V, POM-VPS & NFA-VPS can be supplied from
a registered pharmacy
• Or, POM-VPS and NFA-VPS, can be supplied from
registered premises such as saddlers and
agricultural merchants
• AVM-GSL – can be supplied by any retailer, thereare no restrictions on supply

Question 6

POM-V

Answer 6

• POM-V – vet needs to have undertaken a clinical
assessment to prescribe
• POM-V due to:
• New active ingredient
• Strict limitations needed for use due to safety
• Required specialist veterinary knowledge for use
• Narrow safety margin
• High level of professional control demanded by
Government

Question 7

POM-VPS

Answer 7

• POM-VPS – no clinical assessment required
• Usually for reducing/preventing endemic diseases
• Its use implies a risk for user, animal etc., but user can
be made aware of simple counter measures through
simple advice
• A professional user can be given adequate training in
its regular use

Question 8

NFA-VPS

Answer 8

• NFA-VPS – no clinical assessment required
• Usually only for use in non food animals
• Routinely used to prevent/limit endemic diseases in non food animals
• Use may carry risks but suitable countermeasures can be taken
• Animal keeper can be given sufficient practical advice to permit effective/safe usage

Question 9

AVM-GSL

Answer 9

• Wide margin of safety
• Used to alleviate, prevent the symptoms or support the
treatment of common ailments
• Special advice is not required to permit safe/effective use

Question 10

Small Animal Exemption Scheme

SAES

Answer 10

• SAES allows products to be available for small

animals without the need for full testing

Question 11

Prescriptions

Answer 11

• Needed for POM-V and POM-VPS
• May be oral or written
• Must be written when person prescribing is not
person who supplies medicine

Question 12

Prescriptions need…

Answer 12

• Name and address of prescriber
• Qualifications that allow them to prescribe (e.g. MRCVS)
• Telephone number of prescriber
• Date (Valid for 6 months for non-CD, 28days for Schedule 2,3,4 CD )
• Name and address of the owner of the animal (and where the
animal is kept if this is different)
• Signature
• Identification of the animal(s), including species
• Name and quantity of product
• Dosage and administration instructions
• Withdrawal period, if relevant
• Any necessary warnings
• If necessary, a declaration that it is
“for administration under the cascade”
• If schedule 2 or 3 CD, a declaration that “the item has been prescribed under the
care of the veterinarian’
• If the prescription is repeatable, the number of times it may be repeated

Question 13

Directions on a vet Rx

Answer 13

• VMD state that
“as directed” is not acceptable
• Need to be clear for owner – label as
“Give” not “Take”!
• “Repeat” means dispense twice

Question 14

Additional requirements for controlled drug prescriptions

Answer 14

• Valid for 28 days
• NO repeats allowed
• Must have total quantity in words & figures
• Also needs to state that these items are
“prescribed for the treatment of an animal or herd under his/her care.”
• include MRCVS registration number of vet

Question 15

The prescribing cascade

Answer 15

• Is where veterinary surgeons exercise their clinical
judgment to prevent an animal from suffering. This situation arises when there is no product authorised in
the UK for a diagnosed condition in a particular species.
As a result there are three main options available to the
vet:
1) Off-label use – using a medication for the same condition in
another species
2) Use of human authorised medicine
3) Veterinary special – made on a one-off basis

Question 16

“Administration under the cascade”

Answer 16

• Vet product must be supplied IF IT EXISTS
• Can only supply a human medicine if Rx states that it is
“for use under the cascade”
• Medicines licensed for other species, a different clinical
condition, extemp product or a human medicine require
Rx to state “for administration under the cascade”

Question 17

Labelling requirements

• The following are needed when supplying for use ‘under the cascade”

Answer 17

• Name of the prescriber (the veterinary surgeon)
• Name and address of animal owner
• Name and address of the pharmacy
• Identification and species of animal
• Date of supply
• Expiry date of product
• The name or description of the product or its active ingredients and content
quantity
• Dosage and administration instructions
• If appropriate, special storage instructions
• Warnings for user
• Withdrawal period (if there is one)
• The words “For animal treatment only”
• The words “Keep out of reach of children”

• If not prescribed “under the cascade”, there is no legal obligation for a label
• However, RPS recommend pharmacists generate a
dispensing label for all vet medicines.

Question 18

Keeping records

Answer 18

• Records must be kept for receipts and supplies of POM-V and
POM-VPS products.
• Records must be kept for receipts and supplies and show:
• Name of medicine
• Date of receipt or supply
• Batch number
• Quantity
• Name and address of supplier or recipient
• Can either make a record in private Rx book or keep all
documents showing required info
• If there is a written prescription, it is good practice
also record the name and address of the prescriber
and to keep a copy of the prescription
• Records can be kept electronically
• Records and documents must be kept for 5 years
• Pharmacies that supply POM-V and POM-VPS
medicines must undertake an annual audit

Question 19

Advertising vet med products

Answer 19

• POM-V can only be advertised to vets and
pharmacists
• Only those carrying out supply may place advert
• Price lists are excluded
• No product must be promoted over another
• Brief description of product can be included
• Photographs of products may be included

Question 20

Sale of unauthorised veterinary medicines

Answer 20

It is unlawful to sell unauthorised veterinary
medicines (i.e. medicines not licenced as
veterinary medicines), including human
medicines such as GSL and P medicines, for an
animal unless this happens under the cascade.

Question 21

Sale of NFA-VPS and POM-VPS meds

Answer 21

• Legal requirement for pharmacists supplying
NFA-VPS and POM-VPS to: – Advise on how to use the product safely – Advise on any applicable warnings and
contraindications on the packaging or label – Be satisfied that recipient intends to use the
medicine correctly and is competent to do so – Prescribe the minimum quantity required for
treatment

Question 22

Physical presence of pharmacist in

supply

Answer 22

• Pharmacist must be physically present at the
supply of all POM-V, POM-VPS and NFA-VPS
medicines, unless:
– The transaction has been individually authorised
by a pharmacist AND
– The person handing out the medicine is judged to
be competent.

Question 23

Zoonotic disease

Answer 23

• Definition: Infectious diseases, the agents of
which are transmitted naturally between
animals and humans.
• Transmitted:
– Contact with contaminated food
– Direct contact via bites, scratches etc.
– Indirect contact with flies, flea, ticks etc.

Question 24

Example: Lyme Disease

Answer 24

• A bacterial infection spread by ticks
• Initial infection – circular rash called erythema
migrans that looks like a bulls eye on a dart
board; Flu-like symptoms
• Later infection – inflammatory arthritis,
numbness & pain in limbs, paralysis of facial
muscles, myocarditis, pericarditis, etc.
• Long term symptoms – resemble polymyalgia
or chronic fatigue syndrome.

Question 25

How can pharmacists get involved?

Answer 25

• Animals
– Must stay within The Veterinary Surgeons’ Act 1966
– Can respond to request to supply or prescribe POM-VPS or NFA-VPS products
– Can advise owner on what products are available to treat a particular condition and how should be used
– Must not diagnose or treat other than for some simple parasitic infestations

Question 26

lyme disease treatment

Answer 26

The usual adult doses of these antibiotics are:

doxycycline 100mg twice daily
amoxicillin 500mg three times daily
cefuroxime axetil 500mg twice daily.

Doxycycline use is contraindicated for children aged under 12 years and for pregnant and breastfeeding women.

Question 27

The existing distribution categories for veterinary medicines in the UK are: Prescription medicines

Answer 27

• POM-V: Prescription Only Medicine – Veterinarian
• POM-VPS: Prescription Only Medicine – Veterinarian,
  Pharmacist, Suitably Qualified Person

Question 28

The existing distribution categories for veterinary medicines in the UK are: NON - Prescription medicines

Answer 28

• NFA-VPS: Non-Food Animal – Veterinarian, Pharmacist,
  Suitably Qualified Person
• AVM-GSL: Authorised Veterinary Medicine – General Sales List