Pharmacy Procedures for Veterinary Technicians Notes

Learning Objectives
  • Understand the circumstances and components for writing prescriptions and drug labels, including legal terminology and regulatory requirements to ensure proper formatting and compliance with state laws.

  • Learn methods of calculating drug doses accurately, utilizing weight-based calculations for various species, and understanding different units of measurement.

  • Familiarize with procedures for handling and storing drugs, particularly focusing on storage conditions necessary to maintain drug efficacy and safety, including temperature and light controls.

  • Adhere to guidelines for drug compounding, emphasizing the importance of sterile techniques and the potential risks involved in compounding medications for veterinary use.

Clinic Pharmacies

Veterinary drug use is scrutinized by various agencies to ensure public safety and efficacy of veterinary drugs:

  • Drug Enforcement Administration (DEA): Monitors controlled substances and enforces their standards.

  • Food and Drug Administration (FDA): Regulates the approval and labeling of veterinary drugs.

  • U.S. Department of Agriculture (USDA): Oversees the safety of animal feed and veterinary biologics.

  • Environmental Protection Agency (EPA): Regulates the environmental risks associated with veterinary medications.

Essential protocols include:

  • Writing prescriptions versus drug orders

  • Calculating drug doses accurately and appropriately.

  • Handling, storing, and compounding drugs following established safety protocols to prevent medication errors.

Drug Orders vs. Prescriptions
Drug Order:
  • Request by a veterinarian to dispense/administer a drug within the hospital.

  • Can be documented in a patient’s medical record or communicated verbally, though written documentation is preferred to ensure clarity.

  • Example: Rx Amoxicillin 250 mg tab #14 sig 1 tab bid po for 1 week

Prescription:
  • A drug order sent from a veterinarian to a pharmacy for filling by a licensed pharmacist.

  • It is a legal document requiring compliance with state pharmacy law and pertinent federal regulations, including accurate patient information and medication details.

Guidelines for Writing Prescriptions or Drug Orders
  • Maintain a valid veterinarian-client-patient relationship to ensure ethical prescribing practices.

  • Ensure all drugs meet specific labeling requirements, including dosage forms and potential side effects.

  • Keep appropriate records to track prescriptions and ensure accountability.

  • Handle and store drugs safely and securely to prevent contamination or misuse.

Components of a Prescription

Example layout:

  • Practice Name & Address: Hometown Veterinary Associates, 200 West Chelsea Ave, Fort Collins, CO 80526

  • Date: November 22, 2004

  • Species: Canine

  • Patient Information: Name, owner, address

  • Rx: Amoxicillin tablets 100 mg #30 tabs

  • Sig: Give 1 tablet by mouth every 8 hours until gone

  • Refills: 0

  • Veterinarian’s Signature: Elizabeth N. Bauer, DVM

  • Include DEA registration # if applicable, particularly for controlled substances.

Dose vs. Dosage
Dose:
  • Specific number of dosage forms/mass administered at one time.

  • Example: 50 mg or 10 grams

Dosage:
  • Mass of drug needed per unit weight of the animal, crucial for calculating appropriate doses.

  • Example: 10 mg/kg or 2 mg/lb

Dose Form:
  • Physical form of the drug for administration, impacting absorption and effectiveness.

  • Example: one 50 mg tablet or 1 mL of a 50 mg/mL solution

Dosage Regimen

Encompasses:

  • Mass of drug

  • Route of administration (oral, injectable, topical, etc.)

  • Frequency of administration (every 8 hours, daily, etc.)

  • Duration of administration (for 1 week, as needed, etc.)

  • Example: For a dog weighing 10 kg: 5 mg/kg = 50 mg

Safety Practices
Drug Mistakes Can Be Fatal:
  • Always triple check:

    • Drug labels for correctness

    • Calculations for dosage

    • Dosages against known doses to minimize the risk of overdose or underdose.

Six Rights of Medication Administration
  1. Right Drug

  2. Right Dose

  3. Right Route

  4. Right Time

  5. Right Patient

  6. Right Documentation

Common Medication Errors

Avoid:

  • Using trailing zeros after decimal points to prevent misinterpretation.

  • Decimal numbers without a leading zero, as it could lead to incorrect dosing.

  • Using "cc"; prefer "mL" to ensure clarity.

  • Abbreviations for teaspoon or tablespoon, as they can be misunderstood.

  • Abbreviating grains as "gr," leading to potential errors in dosing.

  • Using the micron mu symbol instead of "mcg" for micrograms, as it is not universally understood.

Rounding Guidelines
  • Avoid rounding prematurely; round only the final answer to maintain accuracy.

  • Rounding conventions:

    • Nearest whole number: 79.5 rounds to 80; below 79.5 rounds to 79

    • Nearest tenth: 79.465938 rounds to 79.5; 0.432 rounds to 0.4

Common Prescription Abbreviations

Abbreviation

Meaning

b.i.d.

twice a day

q4h

every 4 hours

PO

by mouth

PRN

as needed

STAT

immediately

Poison Prevention Packaging Act
  • Implemented in 1970; mandates childproof packaging for potentially dangerous drugs to prevent accidental poisoning, particularly among children.

  • Applicable to manufacturers and pharmacists, but not directly to veterinarians, who must ensure the safety of their dispensed medications.

Dispensed Medication Label Requirements

Example contents:

  • Clinic name and address

  • Patient and owner details

  • Dosage instructions clearly stated

  • Drug name and quantity included

  • Dates, refills, and veterinarian's name must be prominent for reference

Storage and Handling Drugs
  • Follow medical and legal guidelines to ensure compliance and patient safety.

  • Store at proper temperatures, shield from light, and avoid using expired drugs to maintain drug integrity.

  • Always label syringes or vials clearly with the contents and date to prevent confusion.

Controlled Substances
  • Definition: Drugs with potential for addiction or abuse, requiring locked storage and proper logging of usage to prevent misuse.

  • Maintain a drug log for 2 years, including:

    • Date of usage

    • Purpose of the drug given

    • Amount used and wasted

    • Patient details for accountability

Controlled Substances Act of 1970
  • Enforced by DEA; governs prescriptions, handling, and storage of controlled substances to minimize diversion and misuse.

  • Classification of substances based on their potential for abuse, which affects their legal status (C-I to C-V).

Drug Log Components
  • Must include essential details for tracking:

    • Date of transaction

    • Purpose for usage

    • Amount used/wasted

    • Patient Name

    • Receipts for transactions to maintain a comprehensive record

Exposure to Toxic Drugs
  • Risk through skin absorption, inhalation, or ingestion of contaminated food necessitates awareness and adherence to safety protocols.

  • Essential to maintain hygiene in areas where drugs are processed and educate staff on proper handling techniques to minimize exposure risks.

Hospital Policy and Procedure Handbook
  • Must contain Material Safety Data Sheets (MSDS) for hazardous materials, detailing safety precautions and clean-up procedures necessary to ensure a safe working environment.

Drug Compounding
  • Combining drugs to form a new substance, subject to regulations for safety and legality.

  • It is essential for the comfort of animals but carries risks of adverse reactions and legal implications if public health risks are posed.

Common Drug Compounding Practices
  • Examples include anesthesia cocktails, dilutions, and suspensions of crushed tablets tailored to individual patient needs.

  • Important to prioritize animal benefit while minimizing health risks through careful formulation and adherence to safety guidelines.