Terry J. Crowder, RPh, MBA, PhD. Veterinary Pharmacy Issues: Identifying Illegal Practices and Distinguishing Supply Chain Variations

Transcription

1 Terry J. Crowder, RPh, MBA, PhD Veterinary Pharmacy Issues: Identifying Illegal Practices and Distinguishing Supply Chain Variations

2 Learning Objectives Illustrate why pharmacists who dispense veterinary medicines should possess particular skills. Describe the additional training necessary for pharmacists to practice veterinary pharmacy.

3 Self-Assessment Questions T/F - It s OK to give cats acetaminophen. T/F - Dogs shouldn t eat onions or raisins. T/F - Ibuprofen is OK to use in humans so it must be OK to give to dogs and cats. T/F - All insulin products are U-100.

4 Why Should Pharmacists Know About Veterinary Medications? There are 72 million dogs, 88 million cats, about 7 million horses, and many more pets that walk, crawl, slither, fly, and hop. 62% of all households in the U.S. have a pet Pharmacists should be knowledgeable about anything they dispense. Veterinarians have concerns regarding current dispensing practices.

5 Surveys from Idaho, Oregon, Iowa, S. Cal, Washington State VMAs 1. Pharmacist changed dosage or medication without your authorization? Yes: 23.9%; 35%; 20%; 32%; 38% 2. Related adverse event? Yes: 8.7%; 16.5%; 9.5%; 8.7%, 10% 3. Contacted about concerns with an Rx? No: 58.7%; 43%; 59.3%; 39.8%; 34%

6 Recurring Issues in the Surveys Caused by a Pharmacist Knowledge Gap? Switched insulin and syringes (Vetsulin, Prozinc ) Changed thyroid medication strength Dispensed Vicodin instead of Hycodan Changed vet strength to human drug strength Changed vet formulation to human Changed frequency of dosing Provided wrong counseling information Dispensed items with xylitol to dogs

7 Current Pharmacist Education Virtually nothing included in Pharm D. curriculums Vast majority of current CE used for community practice is... Written by people without proper credentials or experience Focuses on medications only Limited coverage of laws Written from the human perspective (example: calculating ibuprofen dosing for a dog)

8 What Needs to be Done? First - Adopt this Philosophy

9 Additional Pharmacist Training In the Classroom and Community Begins in the classroom, residency, and rotations Expand all classroom / CE education to include: Pharmacotherapy (more than medications): Metabolic variations within and across major species Toxicology (no xylitol for dogs, no APAP for cats) Anatomy (one stomach versus many, feathers versus skin, etc.) standard vital signs Psychosocial aspects of pet ownership Socioeconomic aspects of pet ownership Appreciation for Veterinarian versus Human practice Expand knowledge and applicability of veterinary laws Include AMDUCA, ELDU, EPA, FARAD, USDA, CPGs, etc.)

10 With the Additional Training What Can Pharmacists Do?

11 With Correct Knowledge and Attitude Pharmacists will... Form beneficial working relationships with veterinarians and owners Provide supportive and correct counseling Reinforce the veterinarian s message Provide objective monitoring parameters Help with dosing and cost issues Provide correct information on OTCs Know when to refer

12 Along with... Discuss poison control issues Human meds #1 call to animal poison control Have pet poison number handy - not all free! Educate about toxic human foods (no onions, raisins, grapes, or macadamia nuts for dogs) Educate about toxic potential of all items in store (garden bulbs, cleaners, rodent poisons, etc.) Be ready to discuss Pet foods, vitamins, pet treats, grooming products, OTCs, etc.

13 Also... Pharmacists need to protect all patients Separate inventory and counting trays Don t use the same pill splitters Consider if animal needs sulfonamide and owner is allergic Protect children from toxic animal products Proper disposal of pesticides, chemotherapy, etc.

14 And NEVER Forget...

15 How Can BOPs Help? Warner brothers

16 BOP Specifics... Reach out to VMBs - get ahead of issues Enforce all laws Ensure same standard of care for humans and animals Include animals in patient safety initiatives Regulate on-line vet suppliers Educate the public about counterfeits, illegal compounds, buying on-line Add traditional vet medications to your PDMP programs

17 Also... Warn veterinarians and pharmacists about owners abusing human meds intended for pets Encourage your state s pharmacy schools and colleges to provide students with necessary education Work with state VMBs to encourage veterinary and pharmacy schools to exchange rotations Mandate veterinary references in community pharmacies

18 And Finally Help place questions regarding veterinary pharmacology, medications, socioeconomics, psychosocial aspects, toxicology, veterinary practice, etc., on the... NAPLEX

19 thanks T anks u

20 Self-Assessment Questions T/F - It s OK to give cats acetaminophen. T/F - Dogs shouldn t eat onions or raisins. T/F - Ibuprofen is OK to use in humans so it must be OK to give to dogs and cats. T/F - All insulin products are U-100.