Pharmacy

1. Pharmacy Michael Lavoie 6/18/12Middlesex Community College Veterinary Assistant Program

2. Types of Drugs • Chemical Name • Provides scientific and technical information • Is a precise description of the substance • Geriatric (nonproprietary) name: • Official identifying name of the drug • Describes the active drug (i.e. famotidine) • Written using lowercase letters

3. Types of Drugs • Brand (trade, proprietary) name: • Establishes legal proprietary recognition for the corporation that developed the drug • Is registered with the U.S. patent office and is used only by the company that has registered the drugs • Is written in capital letters or begins with a capital letter and has a superscript R by its name • Example: Pepcid AC

4. Sources of Drug Information • Package insert • Provided with drugs to reach regulatory requirements • Registered trade name, generic name, controlled substance notation if warranted • Description or composition statement • Clinical pharmacology, actions or mode of action • Contradictions • Warnings • Adverse reactions or side effects • Overdosage information • Dosage administration • Storage • How supplied

5. Sources of Drug Information • Drug References • Bound book of information on package inserts • Physician’s Desk Reference (PDR): human approved drugs • Veterinary Pharmaceuticals and Biologicals (VPB) • Compendium of Veterinary Products (CVP)

6. Expiration Dates • Expiration dates is the date before which a drug meets all specifications and which the drug can no longer be used • Expiration dates are assigned based on the stability of or experience with the drug • Expiration dates with drugs that are mixed at the clinic may vary depending on the reconstitution and refrigeration status of the drug

7. Drugs used in the Veterinary Clinic • Veterinary drugs are those approved only for use in animals • Human drugs are approved by the FDA and guidelines for their use in food-producing animals is provided in the Compliance Policy Guide • A veterinary/client/patient relationship must be established before any medication is prescribed for an animal

8. System of Measurement in the Veterinary Field • House hold system: Lacks stardardization; not accurate for measuring medicine. • Metric system: developed in the 18th century to standardize measurement for European countries • Prefixes denote increases or decreases in size of unit • Apothecary system: system of liquid units of measure used chiefly by pharmacists

9. Metric System • Units are based on factors of 10 • Base units are meter (length), liter (volume), and grams (weight) • Prefixes commonly used: • Micro= one millionth of a unit= 0.000001 • Milli-= one thousandth of a unit= 0.001 • Centi-= one hundredth of unit= 0.01 • Kilo-= one thousand units= 1,000

10. Conversion • Move decimal point appropriate direction based on units • Examples: • -kg to g= move decimal point 3 places to the right • - g to kg= move decimal point 3 places to the left • l to ml= move decimal point 3 places to the right • ml to l= move decimal point 3 places to the left

11. Remember… • When converting from larger units to smaller units the quantity gets larger • When converting from smaller units to larger units the quantity gets smaller

12. Temperature Conversions • In the Fahrenheit system, water freezes at 32 degrees: water boils at 212 degrees • In the Celsius system, water freezes at 0 degrees; and water boils at 100 degrees • Comparison • C= F - 32/1.8 • F=1.8C + 32

13. Dose Calculations • Must know the correct amount of drug to administer to a patient • Must be in a system of measurement • Weight conversion factor: 2.2 lbs = 1 kg • Remember that drugs can be measured in mcg, mg, g, ml, l, units • Remember that drugs can be dispensed or administered in tablets, ml, l and capsules.

14. Skin anatomy and physiology • The skin is made up of three layers: • Epidermis: (the most superficial layer that contains cells but not blood vessels • Dermis: middle layer that is composed of blood and lymph tissues, nerve tissues, and accessory organs of skin such as glands and hair follicles • Subcutaneous: deepest layer that is composed of connective tissue

16. Drugs Used for Treating Skin Disorders • Topical treatments consist of agents applied to the surface; they affect the area in which they are applied • Systematic treatments consist of drugs that are given systematically that affect many areas of the body

17. Drugs Used in Treating Pruritus • Topical antipruritics provide moderate relief of itching (may be used with systemic medication) • Topical nonsteroidal antipruritics • Local anesthetics such as lidocaine, tetracaine, benzocaine, and pramoxine • Soothing agents • Oatmeal has soothing and anti-inflammatory effects • Antihistamines • Products containing diphenhydramine calm pain and itching due to allergic reactions and sensitive skin • Topical corticosteroids • Variety of products such as hydrocortisone

18. Drugs Used in Treating Seborrhea • Seborrhea is characterized by abnormal flaking or scaling of the epidermis and may be accompanied by increased oil production (seborrhea oleasa) or not (seborrhea sicca) • Keratolytics are an important group of antiseborrheics • Keratolytics remove excess keratin and promote loosening of the outer layers of the epidermis • Keratolytics break down the protein structure of the keratin layer, permitting easier removal of this material

19. Other Agents Used toTreat Skin Disorders • Astringents are agents that constrict tissues • Antiseptics are substances that kill or inhibit the growth of microbes on living tissue • Soaks and dressings are substances applied to areas to draw out fluid or relieve itching

20. Ophthalmic Drugs • Things to consider when using topical ophthalmic drugs • They must be absorbed into the anterior chamber • They may be administered at different frequencies depending on whether they are in ointment or solution form • They must be relatively easy to administer so that client compliance occurs

21. Otic Medications • Many drug combinations are used in veterinary medicine to treat ear disease, including: • Antibiotics • Antiparasitics • Antifungals • Corticosteroids (in combination with anti-infectives) • Otic drying agents • Otic cleansing agents • Otic dewaxing agents

22. Inflammatory drugs • Inflammation is a useful and normal process that consists of a series of events, including vascular changes and release of chemicals that help destroy harmful agents at the injury site and repair damaged tissue • Vasodilation increases permeability of blood vessels in the early phase • Accumulation of leukocytes, reduced blood flow, chemical release (histamine, prostaglandin, and bradykinin) and tissue damage in cellular phase • Severe inflammation must be reduced to avoid additional damage to the body

23. Antibiotics • An antimicrobial is a chemical substance that has the capacity, in diluted solutions, to kill (biocidal activity) or inhibit the growth (biostatic activity) of microbes • The goal of antimicrobial treatment is to render the microbe helpless (either by killing them or inhibiting their replication) and not to hurt the animal being treated • Antimicrobials can be classified as: • Antibiotics • Antifungals • Antivirals • Antiprotozoals • Antiparasitics

24. Antibiotics • Antibiotics work only on bacteria and are described by their spectrum of action (range of bacteria for which the agent is effective) • Narrow-spectrum antibiotics work only on either gram-positive or gram-negative bacteria (not both) • Broad-spectrum antibiotics work on both gram-positive and gram-negative bacteria (but not necessarily all) • Antibiotics can be classified as bactericidal or bacteriostatic • Bactericidals kill the bacteria • Bacteriostatics inhibit the growth or replication of bacteria

25. Considerations When Using Antibiotics • Antibiotic resistance • Means that the bacteria survive and continue to multiply after administration of the antibiotic • Occurs when bacteria change in some way that reduces or eliminates the effectiveness of the agent used to cure or prevent the infection • Can develop through bacterial mutation, bacteria acquiring genes that code for resistance, or other means

26. Behavior Modification Drugs • The use of drugs to treat problem behaviors is only a small part of treating animal behavior problems • Must correctly diagnose the condition, examine the social conditions, and alter external stimuli • Potential side effects of long-term use • Liver, kidney, and cardiovascular problems • Used extra-label • Must have veterinarian/client/patient relationship

27. Classes of Behavior-Modifying Drugs • Anti-anxiety drugs: Attempt to decrease anxiety • Examples include diphenhydramine and hydroxzine • Antidepressants: are used to treat various mood changing disorders (such as aggression), and cognitive dysfunction in animals • Prozac, etc. • Hormones: Progestrins and estrogens have calming effects due to their suppression of male-like behaviors

28. Herbal Medicines • Alternative medicine refers to treatments or therapies that are outside accepted conventional medicine • Complementary medicine refers to the use of alternative therapies with or in addition to conventional treatment

29. Types of Alternative and Complementary Medicine • Veterinary acupuncture and acutherapy • Examination and stimulation of body points by use of acupuncture needles, injections, and other techniques for the diagnosis and treatment of conditions • Veterinary chiropractic • Examination, diagnosis, and treatment of animals through manipulation and adjustments • Veterinary physical therapy • Use of noninvasive techniques for rehabilitation • Veterinary homeopathy • Treatment by administration of substances that are capable of producing clinical signs in healthy animals

30. Types of Alternative and Complementary Medicine • Veterinary botanical medicine • Uses plants and plant derivatives as therapeutic agents • Nutraceutical medicine • Uses micronutrients, macronutrients, and other nutritional supplements as therapeutic agents • Holistic veterinary medicine • Comprehensive approach to health care using both alternative and conventional diagnostic techniques and therapeutic approaches

31. General Guidelines for Herbs • Ask all clients whether they give herbs or other supplements to their animals • Inform clients that herb-drug interactions exist • Encourage the use of standardized products from respected manufacturers • Use herbal therapies in recommended doses • Avoid herbs with known toxicities • Do not use herbs in pregnant or nursing animals, the very young, or the very old • Accurate diagnosis of the animal’s condition is essential to evaluate all therapeutic options • Document all herb or supplement use in the animal’s medical record