You are dosing tramadol and levothyroxine too high

pharmacist

Respectfully submitted by: Sarah Iannacone Third year pharmacy student working with Dr. Drew Olson at Essential Pharmacy Compounding (EPC).

One of the great things about being part of Essential Pharmacy Compounding is that we are also part of the retail pharmacy chain, Kohll’s Pharmacy and Homecare, consisting of 9 locations spanning two states. We learn from our retail pharmacists what questions they have regarding veterinarian prescriptions so we can help educate the entire team on those concerns.

Recently, Dr. Olson and I visited all of our retail locations educating them on veterinary medicine and resources to use. During our visits to the retail stores we brought with us to show the pharmacists Plumb’s Veterinary Drug Handbook. Most pharmacists have never seen or heard of this book before. One question that was brought up quite frequently was the dosing of tramadol and levothyroxine in dogs. Most pharmacists are alarmed by the high dosing that is required for dogs with these two medications, some will call the veterinarian office to confirm the dose.

Our visits were very educational not only for our pharmacists but also for Dr. Olson and I to see where the confusion lies. When working with retail pharmacies it is important to remember that not everyone has heard of Plumb’s or is comfortable with dispensing medications for animal patients. Here at EPC we work with all of our locations to ensure everyone is comfortable and educated in our vet team resources. We know your time is valuable and we want to ensure the most quality care for our patients.

Intimidation of Chemotherapy drugs

Respectfully submitted by: Sarah Iannacone Third-year pharmacy student working with Dr. Drew Olson at Essential Pharmacy Compounding (EPC).

Chemotherapy drugs can be intimidating. Here at EPC we make it easy for you to help administer those drugs to your patients. Many veterinary clinics do not have the necessary biological safety cabinets to prepare chemotherapy drugs safely. When it comes to drug preparation, chemotherapy drugs should not be split and capsules should not be opened. If a specified dose is needed for your patient a licensed compounding pharmacy can do this for you in a safe environment. At EPC, we prepare your chemotherapy medications and provide you with the necessary personal protective equipment to safely administer them at your clinic. Our Chemotherapeutic Infusion Pack includes the chemo drug in a syringe or AccuFlo™, personal protective equipment for the veterinarian and technician (gown, gloves, mask), disposable preparation mat, cytotoxic agent disposal bag, and a chemotherapy sharps container.

To keep accidental administration of a chemotherapy agent low, it is wise to keep these hazardous drugs in a separate area or bin from your other medications. When it comes to safely disposing of the chemotherapy agents and waste your clinic needs to be contracted with a licensed hazardous waste handler to be compliant with state and federal laws. Federal requirements come from OSHA, EPA, and DOT; state requirements are from the office of the Inspector General. Be sure to talk with owners that for the next 72 hours their pet’s waste may be hazardous and they should handle any feces, urine, or vomit with gloves and cleaning any areas with detergent and water.

Compounding Compliance Monitoring Can Help

Veterinarians overwhelmingly agree that compounding compliance monitoring has a positive impact on their practices.

Veterinary compounding can be of great assistance in this area. Compounding is designed to take into account the special needs and circumstances of individual pets. Compounding is flexible in concentrations and can help fine-tune dosages. And it can make administering medications much easier than usual.

Essential Pharmacy Compounding (EPC) is your premier source for small animal formulations. EPC is accredited by the Pharmacy Compounding Accreditation Board (PCAB) in non-sterile and sterile compounding. EPC delivers medication to patients in all 50 states including controlled and chemotherapy medication.

When Triamcinolone Tablets Are Not the Answer

Triamcinoloneis a powerful anti-inflammatory and anti-itch agent that is effective in treating some small-animal skin, ear, eye and mouth infections. It is sold in tablet form.

Compounded ointments containing Triamcinolone can make administering the drug easier. For instance, dogs often resist having drops placed in their ears. A one-time treatment – packing the infected ear with ointment – is much more convenient.

Injectable suspensions containing Triamcinolone also are available.

Compounding Animal Drugs from Bulk Drug Substances

The FDA recently released potential guidance which specifically includes veterinarians. The guidance document is being distributed for comment and the comment period ends in 90 days.

Prescription requirements from a veterinarian to a state-licensed pharmacy may include verbiage similar to “This patient is not a food-producing animal” and “Compounded drug X would produce a clinical difference for the individually identified animal patient because the approved drug is too large a dose for the animal and cannot be divided or diluted into the small dose required.”

According to the Guidance for Industry document, FDA regulations define “bulk drug substance” as “any substance that is represented for use in a drug and that when used in the manufacturing, processing, or packaging of a drug, becomes an active ingredient or a finished dosage form of the drug, but the term does not include intermediates used in the synthesis of such substances.”

CLICK HERE TO READ: COMPOUNDING ANIMAL DRUGS FROM BULK DRUG SUBSTANCES, DRAFT GUIDANCE

Essential Pharmacy Compounding strives to keep veterinarians up-to-date on compounding animal drugs.Watch Full Movie Online Streaming Online and Download

“I believe veterinarians should discuss with their state organization possible comments and suggestions for the draft document before the 90 day comment period runs out.” Dr Olson

Researchers Find Voriconazole Among Most Effective Equine Eye Antifungals

Compounded voriconazole is one of the most effective topical treatments for equine keratomycosis, according to a study presented at the 60th Annual Convention of the American Association of Equine Practitioners (AAEP).

The report on the study notes that because limited topical ophthalmic antifungals are available, compounding is necessary to ensure the most effective treatment. The study surveys a number of topical treatments, and says of voriconazole:

“With excellent penetration and good efficacy against yeast and hyphae, voriconazole has emerged as a good option for antifungal therapy. . . . Voriconazole was found to outperform natamycin, fluconazole, itraconazole, ketoconazole, and micronazole against in vitro isolates in a study by Pearce et al.”

Essential Pharmacy Compounding (EPC) is your premier source for voriconazole and other equine formulations. Click Here To Contact Us Now

Confusion Clears on Compounded Veterinary Medications

Two recent developments clear up the recent confusion concerning the use of compounded medications by veterinarians.

The Nebraska Pharmacy Board says that compounded emergency veterinary medications may be provided to prescribers labeled “office use” for companion animals.
The federal Drug Quality and Security Act (DQSA) does not apply to veterinary compounded medications, the Food and Drug Administration (FDA) has confirmed.

The clarification from the Nebraska Pharmacy Board came about because Drew Olson DVM, of Essential Pharmacy Compounding, raised the issue. Dr. Olson made presentations on the issue to the Nebraska Veterinary Medicine Association, the Nebraska Board of Veterinary Medicine as well as the Nebraska Pharmacy Board.

The Board confirmed that “office use” compounded medications may be prescribed by veterinarians when used for emergencies or immunizations. The Board added:

“The Pharmacy Practice Act does not define ‘emergency.’ Deciding what constitutes an ‘emergency’ is left to each practitioner to decide on a case by case basis, recognizing that qualified professionals have considerable discretion in making that judgment.”

Regarding the DQSA, the FDA confirms that it applies to “human drug compounding” only, and veterinary compounded medications are regulated by state pharmacy authorities. For more detail on this topic, read this alert from the Duane Morris LLP law firm.

Essential Pharmacy Compounding (EPC) is your premier source for all animal formulations. EPC is accredited by the Pharmacy Compounding Accreditation Board (PCAB) in sterile, non-sterile, controlled and chemotherapy medication. EPC leads the nation with the capability to provide medication to any patient anywhere within all 50 states.

Your Go-to Info Source on Compounded Medications

We would like to share with you our new newsletter with you! The Compounding Chronicle, will be a monthly email containing curated content from the professional blog of Drew Olson DVM, of Essential Pharmacy Compounding (EPC). His mission is to be your go-to resource for the latest information on the compounded medications you need in order to provide world-class veterinary services.trevordiy.wordpress.com

He will provide new content every week that is useful to veterinarians, practice managers and veterinary technicians. We welcome your comments, so please be sure to let us know about the topics that are of special interest to you.

Essential Pharmacy Compounding