Small Animal Clinical Pharmacology - CYF MEDICAL DISTRIBUTION

CHAPTER 1 PRINCIPLES OF CLINICAL PHARMACOLOGY
● Disposal of medicines. Knowledge of prevailing
legislation is essential and must be observed during
disposal.
● First aid and antidotes. It is prudent to be familiar
with the adverse consequences of either human or
animal exposure to drugs stored on site and to have
the appropriate first aid materials and antidotes
readily available.
● Extra-label (off-label) use of drugs
– This refers to use of a drug in an animal that is
not in accordance with the approved labeling.
This includes use in species not listed in the labeling,
use for indications not listed in the labeling,
use at dosage levels, frequencies or routes of
administration not listed in the labeling. Extralabel
use may arise from use of an animal drug,
a drug approved for use in humans or extemporaneous
preparations.
– Generally, extra-label use is limited to situations
when the health of an animal is threatened or
suffering or death may result from failure to treat
and no approved animal drug is available that is
considered likely to be effective.
The collection of responsibilities described above is
especially relevant to extra-label drug use, in particular
the need for a minimum base of drug knowledge, a
reasonable expectation that the selected drug may be
effective in the prevailing circumstances, combined with
client consent.
Veterinary prescriptions
To preclude errors and avoid ambiguity, prescriptions
should be written legibly and indelibly. The form and
content of a prescription are usually subject to rules and
regulations prevailing in the prescriber’s jurisdiction
and must be observed. However, the content of the
prescription usually includes:
● name, address and telephone number of the
prescriber
● date of prescription issue
● name and address of client
● identification (name and species) of the animal(s) to
be treated
● name and strength of the drug(s) to be dispensed (e.g.
amoxicillin 100 mg): the name may be the proprietary
name if a specific product is required or the
nonproprietary name if a choice of available products
can be made by the pharmacist who dispenses
the prescription – for extemporaneous products, full
details of preparation should be provided
● dosage form and total amount to be dispensed
(e.g. 25 tablets)
● information for the package label: this usually
includes directions for use (route, amount and frequency
of administration), special instructions (e.g.
‘give with food’) and warnings; in addition, some
jurisdictions require the statements ‘For Animal
Treatment Only’ and ‘Keep Out of the Reach of
Children’, unless already on the printed label of the
product being dispensed
● signature and qualifications of the prescriber.
CONCLUSION
Veterinarians are in a unique position to improve the
health and wellbeing of their companion animal patients.
A number of responsibilities accompany the practice of
veterinary medicine, particularly relating to the use of
drugs. Of high importance is the application of clinical
pharmacology to the judicious development of individualized
therapeutic plans. There are many factors that
lead to variations in the expected clinical outcome of
treatment. An accurate diagnosis and thorough understanding
of the patient’s disease or disorder, age and
physiological state, combined with knowledge of the
pharmacology, efficacy and safety of the selected drug,
permit a therapeutic plan to be prepared. Implementation
of the plan and measures to increase compliance
while minimizing errors, combined with subsequent
reassessment and plan refinements if necessary, provide
the best opportunity for a successful outcome.
FURTHER READING
Barach P, Small D 2000 Reporting and preventing medical mistakes:
lessons from non-medical near miss reporting systems. Br Med J
320:759-763
Baxter K (ed) 2006 Stockley’s drug interactions: a source
book of interactions, their mechanisms, clinical
importance and management, 7th edn. Pharmaceutical Press,
London
Brunton LL (ed) 2005 Goodman and Gilman’s the pharmacological
basis of therapeutics, 11th edn. McGraw-Hill, New York
Dean B, Schachter M, Vincent C, Barber N 2002 Causes of prescribing
errors in hospital inpatients: a prospective study. Lancet
359:1373-1378
Gibaldi M (ed) 1991 Biopharmaceutics and clinical pharmacokinetics,
4th edn. Lea and Febiger, Philadelphia, PA
Hardee GE, Baggot JD (eds) 1998 Development and formulation of
veterinary dosage forms, 2nd edn. Marcel Dekker, New York
Weingart SN, Wilson RML, Gibberd RW, Harrison B 2000
Epidemiology of medical error. Br Med J 320:774-777
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