chpt 5

I. Drug Naming

• A. Chemical

  • Provides scientific and technical information

  • A precise description of the substance

• B. Generic (nonproprietary)

  • Official identifying name of the drug (assigned by the U.S. Adopted Names Council)

  • Describes the active drug

  • Written using lowercase letters

• C. Brand (proprietary)

  • Establishes legal proprietary recognition for the corporation that developed the drug

  • Registered with the U.S. Patent Office, used only by the company that registered the drug

  • Written in capital letters or begins with a capital letter and has a TM or ® by its name

• D. Other Comments

  • The first product to contain a new drug is known as the pioneer drug.

  • Once the patent for a drug expires, other companies can market the drug under their trademark as bioequivalent.

  • Generic drugs are cheaper as they did not pay for development and testing.

• E. Compounding Drugs

  • Occurs when health professionals prepare a specialized drug product for individual patient needs when an approved drug is unavailable.

  • Uses include:

    • Tailoring doses and strengths to meet a particular animal's weight and health status.

    • Creating alternative dose forms such as liquids, ointments, transdermal preparations, or chewable tablets.

    • Adding flavoring to unpalatable drugs to make them more appealing.

    • Customizing formulations that combine multiple drugs for one-dose administration.

    • Combining tranquilizers with analgesics to create anesthetic cocktails.

  • Concerns with Compounding

    • No adequate and controlled safety and effectiveness data.

    • Lack of oversight.

    • Unexpected reactions may occur.

    • Unknown withdrawal times and risk of drug residues in food-producing animals.

II. Getting Information

• A. United States Pharmacopeia (USP)

  • Legally recognized drug standard of the U.S.

  • Describes source, appearance, properties, standards of purity, and requirements of important pure drugs.

  • FDA Requirements:

    • All drugs must meet US standards of purity, quality, and uniformity.

    • All drug containers must be correctly labeled.

    • All advertising must be truthful and correct regarding indications, toxicity, and general usage.

• B. Drug Labels Must Contain:

  • Drug names: generic and trade.

  • Drug concentration and quantity.

  • Name and address of manufacturer.

  • Manufacturer's control or lot number.

  • Expiration date of drug.

  • Withdrawal time (if warranted).

  • Controlled substance status of drug (if warranted).

• C. Package Inserts

  • Included with drug packaging, containing all information needed by prescriber/user.

• D. Reference Materials

  • Compendium of Veterinary Products.

  • Plumb’s Veterinary Drug Handbook.

  • Saunders Handbook of Veterinary Drugs.

  • Prescriber’s Digital Reference.

  • Micromedex and others.

• E. The Internet

  • FDA’s Approved Animal Drug Products (Green Book).

  • CDER’s Center for Drug Evaluation and Research.

  • Beware!: Ensure source is official; complete insert often found on the manufacturer's website.

III. Dispensing vs Prescribing

• A. Dispensing

  • Drug is dispensed from the veterinary facility to the client.

• B. Prescribing

  • Veterinarian writes/phones/faxes prescription to another facility (such as a pharmacy).

  • AVMA Principles of Veterinary Medical Ethics require veterinarians to honor client requests to prescribe rather than dispense.

  • Guidelines:

    • Veterinary prescription drugs must be properly labeled.

    • Maintain dispensing and treatment records.

    • Drugs should be dispensed only in required quantities.

    • Prescription drugs may be dispensed by pharmacists or trained veterinary staff.

    • Labels may include cautionary information.

    • Veterinary staff cannot refill or dispense medications without veterinarian approval.

    • Medications must be dispensed in childproof containers.

• C. The Prescription

  • An order from a veterinarian to a pharmacist to prepare the prescribed medicine with specific directions.

  • Label Requirements:

    • Name and address of the dispenser.

    • Client's name (+/− address).

    • Animal's name and species.

    • Drug name, strength, and quantity.

    • Date of the order.

    • Directions for use and route of administration.

    • Any refill information (if warranted).

    • Withdrawal or withholding times.

IV. Pharmacy Economics

• Maintaining a pharmacy is a business that depends on charging and collecting fees for services to continue providing medical care.

• A. Inventory and Control Maintenance

  • Maintenance of appropriate stock levels benefits the business health of the veterinary practice.

  • Goal: Stock quantities low enough to reduce overhead and inventory costs but not too low to cause shortages.

  • Longer inventory sits on the shelf incurs hidden costs (storage, expiration, spoilage).

  • Excess inventory ties up money that could be invested.

• B. Inventory Purchasing

  • Direct Marketing:

    • Directly from manufacturers to veterinarians, no middleman (less expensive, larger quantities).

  • Distributors or Wholesalers:

    • Purchase from manufacturers then resell to veterinarians (middleman increases cost but may reduce inventory cost/time).

  • Other Sources:

    • Veterinary practices, buying groups, pharmacies.

• C. Inventory Management

  • Maintain adequate stock and organize for easy location.

  • Identify products that need reordering.

  • Maintain accurate purchasing and inventory records.

  • Ordering and receiving shipments.

  • Establish and update pricing for inventory.

  • Rotate stock and monitor expiration dates.

  • Assess new/updated products and consider specials.

• D. Establishing an Inventory System

  • Record keeping and day-to-day monitoring of drug depletion.

  • Determine reorder points, shipping/delivery times, individual inventory records, and master list.

• E. Pharmacy Organization

  • Inventory should be arranged alphabetically, by drug classification, numeric, or dose category.

  • Open drugs and those with near expiration dates should be accessible.

  • Easier dispensing when tablets, capsules, liquids, and injectables are organized by their use area.

  • Refrigeration and secure storage are necessary.

• F. Disposal of Unused or Unwanted Drugs

  • Proper disposal lowers contamination risk to people, animals, and the environment.

  • Strategies for minimizing pharmaceutical waste:

    • Monitor prescriptions to avoid expiration.

    • Incineration is the best disposal method (following state and federal guidelines).

    • If incineration is not feasible, send unused drugs to landfill.

    • Owners can use drug return programs for disposal.

    • Special disposal guidelines for antineoplastic drugs used in cancer chemotherapy.