Drugs and Pharmaceuticals

Dosage Ex. Salt is used as treatment in animals, but giving too much can cause swelling in the brain and even death Drugs is all about quantity

• Biologicals • Antimicrobials • Other Pharmaceuticals (many exist)

Products (usually proteins) that are typically synthesized by a living organism Examples * Vaccines (traditional vaccines) (killed or inactivated pathogens) (attenuation, “breeding” viruses to be useless) * Antibody preparations, blood or blood products, cells or tissues * Often very expensive, but very effective * Some hormones and growth factors * Insulin * Antibody/immunoglobulin products * Colostrum sourced from other animals * Probiotics

Broad term for any natural or synthetic compound that kills microorganisms or suppresses their growth * Includes antibiotics, ionophores, antiseptics, disinfectants Antibiotics - Specifically a drug (which may be derived from a substance produced by a microorganism, eg. penicillin) * Can be made synthetically * If it ends with “mycin” it typically came from a mold

Parasiticides Fungicides Tranquillisers and anesthetics Anaesic (pain) medications Hormones Cardiovascular drugs Chemotherapy drugs Vitamins, minerals MORE

Food animals have less treatments available to them then companion animals, because you have to consider that someone is going to eat that animals * We’re worried about passing on resistant bacteria

Should be in the right context * Don’t give animals drugs when they don’t need them * Drug supply is gate kept by veterinarians and pharmacists Animals should be given preventative care (or herd health) Diagnosis should be made before prescribing drugs * There should be a treatment plan Management changes * Sometimes you just need to move the animals * Sometimes you need to vaccinate them more often * Change biosecurity policies

Biological (pathogenic bacteria) Chemical (drug residues, pesticide residues) Physical (Needles in meat, flies or straw in milk)

Therapeutic * Treatment for infection, parasites, pain, inflammation etc. * Nutrients to treat deficiencies * Reproductive management (reproductive hormones) Preventive * Vaccines to prevent infection * Nutrients to prevent malnutrition Growth Promotion * Antibiotics * Creates the risk of antibiotic resistance * Most antibiotics used in animals are not used for humans to mitigate the risk of antibiotic resistance * Hormones * We do not use hormones in pigs, chickens, and turkeys * In most cases there are nano levels of hormones added * Hormones are added very early in the animal’s lifespan

Drugs are used as often are they are used in human medicine Includes many classes of drugs seldom or never used in food animals They are treated for things not treated for in food animals * Cancers * Immune diseases * Organ failures We don’t need to worry about the animal residues, but some drug residues might need to be avoided * Animal drugs have effects on humans too

What is the specific process you want to alter? Is it absolutely necessary to use the drug? * Bacterial infection? - Use the Specific antibiotic for they bacteria * Heart Disease? - May choose a drug that will decrease blood pressure, or increase heart contractility

Which route can the chosen drug be given? * IV, IM, Subcut, Oral, Topical, etc. Which do you use? An what basis do you make these choices Advantages or disadvantages Can the owner or caretaker do it?

What dose to choose within the range for this drug? What interval * Once a day, twice a day, constant infusion? What duration How do these factors fit the particular animal

Cost per treatment * Remember to count how long the animal will be taking it Cost compared to the value of animal and budget of owner Cost appropriate to disease? Include related expenses * Must the drug be administered in the clinic? * By IV line? * By a technician or vet? * Cost of syringes or other administration devices

Any special considerations based on this animal? * its age * other health conditions * its use * its strain * breed or species What contraindications for this drug? * When should it not be used (is it a food animal?) What adverse reactions might be expected? * How do we monitor this * What do we do if detected

How do we tell if the drug is working, or has worked? * Physical response? * Blood tests? What follow up procedures do we need? * Re-examination? * Diagnostics

• Delay in diagnosis • Failure to properly treat life-threatening but curable disease • Prolonged disease state • Toxicity • Development of disorder to which patient would not otherwise be subject • Drug residues in food or antibiotic resistance in bacteria • Treatment failures • Increased costs

Wrong diagnosis * Viral infection misdiagnosed as bacterial Multiple problems nat all recognized Right diagnosis but very virulent pathogen Late initiation of treatment Inaccessible infection (brain, joints, scar tissue, abscess) Resistant bacteria * Do culture/sensitivity testing of bacteria first Ineffective medicine or use of medicine * Choice of product * Dose or duration inadequate * Other concurrent meds interfering * Expired or degraded product * Resistant bacteria

Any noxious change in a patient’s condition which a physician/veterinarian believes to be caused by a drug * Intrisic drug reaction * Idiosyncratic drug reaction * Allergic response

Expected side effects of the drug * Dose related

Not predictable, peculiar to the individual * Usually not dose related * Occurs in a small proportion of exposed animals * Associated with drug specific, patient-specific characteristics or environmental factors * Can be related to enzyme deficiencies in the individual, or may be immune-mediated (still not allergies)

• Not usually dose related • Unrelated to pharmacological effects • Can be severe • May require treatment • May be minimalized with other drugs **Nature of reaction depends on organ specificity and Ag-Ab reaction ** * Immediate reaction (anaphylactic) * Immune Complex reactions (rashes) * Drug fever

Regulates the veterinary profession, confers self-governing status Defines qualification and requirements for registration of veterinarians, scope of practice (what is veterinary medicine), who can perform vet medicine, and gives authority to prescribe and dispense drugs for animals * This creates a potential conflict of interest where the vet overcharges for medicine to make more profit Prescription (Pr) Drugs for Veterinary Use (Under the CANADA Food and Drug Act)

The relationship and responsibilities of the vet, client, and animal Under bylaws of the Alberta Vet Med Assoc. Vet: ◦ Vet is responsible for clinical judgments re animal’s health and treatment and Client agrees to follow vet instructions ◦ Vet has sufficient knowledge of animals to have general Dx of condition ◦ Vet has recently seen animal, personally acquainted with circumstances ◦ Vet is available for followup and emergencies Client: * The client agrees to follow the vet’s recommendations and prescription