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PHARMACEUTICAL PHACTS
published in the Northeast Times
Most readers of this paper who have pets have prescription medications for their pets at home in the cabinet right now. In fact, nearly every patient that walks into my office is going to leave with a prescription for something. It?s the nature of what we do. Therapeutic medications are the backbone of modern Western medicine. Even well-pet annual exams routinely involve dispensing medications in the form of heartworm, flea, tick, and other parasite prevention medications. Because of this, it is important that everyone have an understanding of what kinds of medications we use for their pets, how they work, and how to use them safely. All the legal requirements, regulation, recordkeeping, and instructions are with a single thing in mind: Safe use of an effective therapeutic medication.
What is a prescription medication?
The Food and Drug Administration (FDA) is in charge of ensuring that drugs on the market are safe and effective. A prescription medication is one that the FDA has included on the list of medications or legend drugs that require a doctor?s direct care and doctor?s prescription to purchase. Over the counter (OTC) medications are those which have been deemed safe to use without the direct care of a physician and can be sold without a prescription. The important point here is the use of a prescription medication is intended to be by or on the order of a veterinarian, physician, PA, RNP, etc. To make it more confusing, some medications exist in both OTC and Rx only forms! Ibuprofen, for instance, is OTC at one strength, but requires a prescription to purchase the higher strength tablets.
Time and time again I hear frustration from owners that they have to ?come in for an appointment? just to get a prescription. The reason lies in the paragraph above. In order to be given a prescription medication, the patient must be under the care of the doctor. Therefore, we must have a current veterinarian-client-patient-relationship (VCPR) in order for the doctor to even prescribe the medication legally. The veterinarian can actually loose their license if there is not the required physical examinations and paperwork associated with that prescription! It may seem cumbersome at times, but the reality is that it is intended to make SAFETY the number one priority.
Common prescription medications dispensed at your veterinarian?s office:
In my approximation, the most common types of prescription medications I use each day are non-steroidal anti-inflammatory drugs (NSAIDs), steroids, antibiotics, certain flea and tick preventatives, heartworm preventative, and anesthetics. Did you notice I said certain flea and tick preventatives? Several flea and tick preventatives are actually OTC, some are by prescription. It all depends on the type of medication or chemical involved. For instance Frontline (Merial) is OTC. Revolution (Pfizer), on the other hand is by prescription only. That doesn?t mean one is more effective or even safer than the other. Rather, they are just treated differently by the FDA because of how they are classified.
A few examples:
NSAIDs used in veterinary medicine include drugs such as Rimadyl, Metacam, Previcox, Deramaxx, and Zubrin as well as many others. NSAIDs are fantastic medications that have changed the lives of many, many pets and people. They are generally thought of as safe, but they are a medication that must be taken carefully. Especially in pets, NSAIDs require careful thought regarding their use. Human OTC NSAIDS should never be used without first consulting with your veterinarian. Tummy upset, diarrhea, liver, and kidney problems are the main complications with this type of drug. Because of these concerns, when a patient is on a medication long-term it is terribly important that we do regular physical exams and check blood to ensure the medication is still safe to take.
Steroid medications are also anti-inflammatory and are used in a whole host of conditions. Anyone who has ever suffered with their pet through allergy season has probably seen the beneficial effects of intelligent steroid use. Short-term use is common and generally safe; long-term use of steroid medications can be quite dangerous and must be done under strict supervision of your veterinarian. Routine monitoring and examination is very important. NSAID and steroid medications should never be taken together!
Heartworm preventatives have saved millions of lives. They are extremely effective when used properly. However, when the wrong medication is used in a pet who is carrying a heartworm burden, the results can be lethal. This is why heartworm preventatives are Rx only and require a veterinarian?s care to prescribe. Annual heartworm testing is recommended by the American Heartworm Society to make sure we do not have failures or preventative and to ensure that our preventatives are being used safely in our patients.
Internet Pharmacy:
The FDA estimates that upwards of 40% of all medications dispensed through on-line pharmacies is counterfeit or impure. This is a staggering number! Imagine the number of illness and deaths associated with this. Because of the concern with on-line pharmacies dispensing medications without a proper prescription and concerns over drug safety and purity, many veterinarians have chosen to avoid writing prescriptions out to be filled by an on-line source. In fact, the FDA has issued warnings to pet owners to beware of on-line pharmacy. It is important to point out that the decision to decline prescriptions to internet pharmacies is not an economic one, but one of safety. Our first concern is the health of your pet and that means ensuring the accuracy and safety of what we are prescribing.
Another important point is that the manufactures of medications like Frontline, Advantage, and Revolution do not sell directly to on-line drug stores. In fact, these companies do not warrantee product purchased from an internet pharmacy because of concerns over re-importation, improper labeling, and counterfeit drug. Warrantees only apply when the medication is purchased through your veterinarian.
The moral of the story:
Speak with your veterinarian. Speak with your physician. Know that we have your safety and your pet?s safety in mind. Find out the safest and most effective way to use the medications we have at our disposal to help keep your pet (and you) healthy.
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