Drug legislation and dispensing procedures

Responsibility of the RVT

• Know which drugs can be dispensed, to whom, and under what conditions

• Understand drug categories and associated regulations

• Read and fill prescriptions

• Label and dispense medications

Drug

Any substance or mixture of substances manufactured, sold, or represented for use in the diagnosis, treatment, mitigation, or prevention of disease, disorder, abnormal physical state, or symptoms thereof in humans or animals.

Practitioner

• A person authorized by the law of a Canadian province to treat patients with any drug listed or described in Schedule F.

• Specifically: a physician, dentist, or veterinarian licensed to practice in the province of their employment.

Prescription

A legal order by a practitioner (written or verbal) directing that a stated amount of any drug or mixture of drugs be dispensed for the specific patient named in that order.

Dispense

To provide a drug pursuant to a prescription; does not include the administration of the drug.

Food and Drug Act: Federal legislation

• Prohibits the sale of foods or drugs containing harmful substances, protecting public safety.

• Regulates all food, drugs, cosmetics, and devices marketed in Canada.

Bureau of Veterinary Drugs (BVD): Federal

• A branch of the Health Protection Branch dealing with all aspects pertaining to veterinary drugs.

• Made up of physicians, pharmacists, and veterinarians via the Canadian Veterinary Drug Advisory Committee.

• The Veterinary Drugs Directorate (VDD):

  • Regulates biologicals and vaccines

  • Dictates specific labelling requirements

Narcotic Control Act: Federal

• Applies to drugs with a potential for abuse and addiction.

• A separate federal control mechanism.

• Legislates the use and prescribing of narcotic drugs.

• Regulated by the Bureau of Dangerous Drugs.

Provincial Legislation: Pharmacy Acts

• Regulates the dispensing and distribution of drugs.

• Establishes standards for pharmacies and pharmacists.

provincial: veterinary Profession Act (VPA)

• Administered by the ABVMA (Alberta Veterinary Medical Association).

• Defines the requirements for a "registered Veterinarian."

• States that only a registered Veterinarian can engage in the practice of prescribing drugs.

Prescription Drugs (Schedule F — Part I)

• Must be identified by "Pr" on the label.

Required label information for veterinary prescriptions: 

• "Veterinary Use Only"

• Name of client

• Name and quantity of drug

• Name of facility and DVM

• Animal name/identification

• DIN (Drug Identification Number)

• Directions for use

• Withdrawal times (where applicable)

• Storage precautions (where applicable)

• Toxicity warnings (where applicable)

• Expiry date (where applicable)

Dispensing rules for F1 (Schedule F — Part I) medications:  Prescription

• Can only be dispensed by a licensed DVM or licensed RVT.

• A valid VCPR (Veterinarian-Client-Patient Relationship) is required.

• A medical record must be kept and maintained for each medication dispensed.

• The public cannot have access to medicines prior to dispensing.

• Drugs must be labelled as per PIPS bylaws. (practice inspection practise standards)

Non-Prescription Drugs (Schedule F — Part II)  OTC drugs

• Can be dispensed by a DVM, RVT, or layperson.

• Client must be advised of:

  • Withdrawal times (w/d)

  • Storage requirements

  • Expiry dates

  • Dose and route of administration

  • Any toxicities

Record keeping requirements:

• Must maintain accurate records including:

  • Date

  • Name and address of purchaser

  • Type of medication and quantity

  • Identification of animal

Controlled Drugs (Schedule G)

• Marked with "C" or "N" on the label. (controlled or narcotic)

Examples include: 

• Hydromorphone 

• Fentanyl

• Butorphanol

• Diazepam

• Ketamine

• Barbiturates (including Euthanyl)

• Anabolic steroids (stanozolol)

Controlled Drug Regulations

General rules:

• DVM must be licensed in the province.

• Animal must be a patient of the DVM.

• Drug must be required for the condition being treated.

• Veterinarians are the only practitioners with legislated authority to both prescribe and dispense narcotic and controlled substances.

• Mandatory to record everything.

Triplicate Prescription Program (TPP)

• Administered by the College of Physicians & Surgeons of Alberta (CPSA).

• Monitors prescribing and dispensing of TPP medications.

• Can trace all transactions involving these substances.

• Veterinarians in Alberta must register with the TPP.

• Uses a two-part prescription form.

• CPSA copy information is entered into a database where reports are analyzed and monitored.

TPP Forms & Pads:

• Each DVM has their own personalized TPP pad.

• Pads cannot be shared.

• Verbal prescriptions are not allowed for TPP medications.

• Pads must be kept in a locked area.

• Stolen pads must be reported to CPSA and RCMP immediately.

Pads must be returned when no longer needed.

Completing a TPP form:

• All fields must be filled out.

• Once complete: keep two copies (for the "pharmacist" and prescribing DVM); send one copy to CPSA.

• Prescriptions must be filled within 72 hours or they are void.

• CPSA copies should be sent in weekly.

• Clients are required to sign the form when medication is dispensed.

TPP forms are NOT required for:

• Medications used on animals in-clinic.

Medications dispensed from a veterinary clinic for a usage period of less than 96 hours.

ABVMA Restricted Medications: (Never aloud to leave the clinic)

ABVMA Restricted Medications: (Never aloud to leave the clinic)

• Ketamine

• Euthanasia solution

• Sodium pentobarbital

• General anesthetics (propofol, isoflurane)

Purchasing controlled drugs:

• Order must be written with the DVM's signature and license number.

• WDDC has a controlled drug ordering system with a separate, secure username and password.

• Sign and return form within 5 days.

• Controlled drugs are shipped separately from regular orders.

Purchase records must be maintained for a minimum of 2 years.

Storing controlled drugs:

• Must be kept in a locked cabinet, protected from theft or loss.

Theft or loss must be reported within 10 days to the RCMP and local narcotics inspector.

Disposal and recording:

• Must account for all C and N drugs per dose, whether administered or dispensed.

• Records must make it easy to track all drugs (date, patient identification, amount of drug).

• Reasonable discrepancies are acceptable.

• Disposal must be authorized and witnessed.

Records must be maintained for a minimum of 2 years.