Small Animal Clinical Pharmacology - CYF MEDICAL DISTRIBUTION

CHAPTER 1 PRINCIPLES OF CLINICAL PHARMACOLOGY
These obligations will encompass a broad range of
activities from authorization to practice veterinary medicine,
to hospital registration, to supply, use, storage,
prescription and disposal of drugs or veterinary medicines.
While recognizing the diversity of rules and
regulations that specify actual requirements in each
jurisdiction, general principles of good prescribing practice
are set out below and an example of the application
of these principles to the appropriate use of antimicrobial
agents is set out in Table 1.4.
● Veterinary medicines must be used only by or under
the supervision of a licensed veterinarian.
● Veterinarian–client–patient relationship (VCPR):
veterinary medicines must only be used in the context
of a valid VCPR, which exists if:
– the veterinarian has assumed the responsibility
for making clinical judgments regarding the health
of the patient and the need for medical treatment
and the client has agreed to follow the veterinarian’s
instructions
– there is sufficient knowledge of the animal by the
veterinarian to initiate at least a general or preliminary
diagnosis of the medical condition of the
animal
Table 1.4 Principles of appropriate drug use
Parameter
Professional intervention
Diagnosis
Therapeutic objective
Therapeutic plan
Drug treatment
Monitoring
Record keeping
Disease prevention
Example: antimicrobial therapy
Establish a veterinarian–client–patient relationship
Clinical diagnosis
History, physical examination, other assessments
Microbiological diagnosis
Sampling of appropriate fluids or tissues
Likely etiological agent identified (i.e. not normal flora)
Culture and susceptibility testing
Options include:
Eradication of infecting organism
Clinical improvement
Therapeutic choices (drug and non-drug therapy)
Supportive therapy (drainage, debridement, nutrition, management, etc.)
Host factors (concurrent illness, age, immunocompetence, pregnancy, lactation)
Selection of appropriate drug; considerations include:
Activity against infectious agent
Activity against nontarget agents
Factors influencing effective concentration at site of infection
Availability of approved product
Acceptable dosage form
Target animal and environmental safety
Public health implications (e.g. antimicrobial resistance transmission)
Cost
Dosage regimen:
PK-PD factors
Dose rate
Route of administration
Site of administration
Dosage interval
Duration
Institute plan to monitor response to treatment to enable ongoing reassessment of the objectives and plan and
identification of any significant adverse events
Date of examination
Diagnosis
Animal identification
Drugs used
Dosage regimen (including dose rate, route and duration)
Date(s) administered
Other treatment advice and measures implemented
Prevention plan (health program, including consideration of vaccination, hygiene, nutrition, environment, routine
monitoring)
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