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Pharmacy Procedures
Michael Lavoie
6/13/12
Veterinary Assistant Program
Middlesex Community College
Reading a Prescription
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Often abbreviated Rx
The prescription is the type of
medication, amount of medication, and
directions of use for the medication
Prescription is determined by the
veterinarian, and we are there to put
the prescription together.
Several parts to a prescription
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Medication name
Medication strength
Method of administration
Amount to be administered
Frequency of the medication
Length of use
Amount to be dispensed
Special instructions
Number of refills
Veterinarian name
Labeling a Prescription
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Purpose is to indicate to the owner how
to properly give the medication and
identify the medication in the container
When a label is prepared it should be
legible if handwritten, clean and
understandable
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The following information should be on
a label:
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Veterinary facility name, address and
phone number
Name of the prescribing veterinarian
Client name
Client address, if it is a controlled
substance
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Patient name or ID number
Medication name
Medication strength
Quantity dispensed
Expiration date of the medication
Number of refills
Amount per treatment or use
Route of use
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Frequency of treatments
Length or duration of use
Special instructions
Additional labeling can use used, such as
warning labels in sticker form.
Some stickers you may use
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“keep refrigerated”
“give with food”
“for the eye”
“for the ear”
“shake well before using”
“give by mouth only”
Labeling
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Each container should be labeled for
veterinary use only
When labeling directions for medication use
regular wording for the clients
Medical abbreviations should be avoided
Recheck the label for accuracy, and go over
with the client, so they understand the
directions as well
Dispensing medications
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Every medication
needs to have a
childproof container
Only exception is for
clients who ask for
one that isn’t due to
medical reasons
making it difficult to
open the lid
Dispensing medications
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It is important to explain that there is
always the possibility of children or pets
getting into a non child proof container
Be sure to mark in the medical record
that the owner requested a non child
proof cap
Medication Containers
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Plastic vials and bottles are commonly
used with a twist off or snap off lid
Size of the container is measured in
drams
Proper sized vial should be used to hold
the amount of medication dispensed
Vials are usually amber colored
Medication containers
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The reason is to keep the medication
for degrading in sunlight
Vials are used for pills and capsules
Bottles are used for liquid medications
Drug Identification
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Proper dosage and strength are
selected by veterinarians.
We need to make sure that the drug we
are dispensing is correct
A patients condition may worsen or not
improve if the wrong drug, or
concentration is given
Drug Identification
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Many drugs have similar names
Compare the spelling of the drug with the
drug on the drug label
Also drugs come in different concentrations
so always make sure you have the right
concentration
Drug strengths can be written in milligrams
(mg), millimeters (ml), cubic centimeters (cc),
or grains (gr).
Drug Identification
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Never dispense a drug that is expired.
Can find the expiration date on the bottle or
lid of the drug bottle
Check these for accuracy:
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Right
Right
Right
Right
Right
patient
drug
strength
quanitity
frequency
Amount to be Dispensed
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May be listed on the prescription or
may need to be calculated by the
veterinary assistant
Requires a knowledge of pharmacy
abbreviations and basic math
Lets work on an example
Amoxicillin 250 mg PO BID X
14
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Determine how often the drug is given
Determine how long the drug is to be
given
Multiply the number of doses per day
by the duration of treatment
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Locate the strength of the drug as
closely as possible to the prescription
Determine how many units per dose are
needed
Multiply the number of tablets per dose
by number of doses
Pill counting tray
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Is a device that has
a flat area for
medicine to be
placed and a
channel or funnel
like area to place
medication that has
been counted
Types of medication
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Divided into three categories
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Over the counter medications: can be
purchased by any one at a human
pharmacy
Prescription drugs: ordered or scripted by
veterinarians
Controlled substances: prescription drugs
that can have the potential for addiction or
abuse
Types of medications
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Controlled drugs are regulated by the
DEA
Have specific regulations and guidelines
for ordering, storing, and dispensing
Veterinarian must have a controlled
substance license
Controlled Substances
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Only person who can order and
prescribe controlled drugs are licensed
veterinarians
Licenses are issued by the DEA and
renewed every three years
Must legally be stored behind 2 locks
Access to the controlled substances are
limited to one or two people on shift
Controlled Substances
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Must be logged in the controlled
substance log
Written entries are required for every
substance dispensed by the facility
Must be recorded in blue or black ink
and records need to be kept for 2 years
Varies from state to state
Information for Controlled
Substances
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Name of controlled substance
Drug strength
Drug form (tablet, capsule, liquid, injection, etc.)
Quantity dispensed
Quantity on hand
Date dispensed
Time dispensed
Client name and address
Patient name
Animal breed/species
Initials of person dispensing
Educating Clients on
Medication Use
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The veterinary assistant should be able
to review all medication instructions
before the client and patient leave the
facility
Should be urged to call with any
questions
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Some clients will receive a handout
about how to give the medication with
examples or diagrams on how to give
It is important for the veterinary
assistant to be able to review or show
the client how to give the medication
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Why the medication is administered
How the medication is to be administered
How much is to be administered
When the medication is to be administered
Administering Oral
Medications
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Administered by mouth
Can be tablets, capsules, or liquids
Small animals like dogs and cats require
the mouth to be opened and medication
to be placed in the back of the mouth
Larger animals like live stock may
require more power to hold and give
medications to
Instrument use
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Some animals may require pet pillers or
other medication aids
A pet piller is a small device, usually
made of plastic, that has a long thin
handle with a plunger on the end
The plunger holds the medication and
the handle is used to throw the
medication to the back of the mouth
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Large animals may require a balling gun
which is a metal device that has a long
handle and a plunger at the base
Disposition of the animal also plays a
part in how the medications are
delivered.
When administering medication it is
important to consider the drug used
Tablets and capsules can be given in
peanut butter or a bit of cheese
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Also, a product called pill pockets can be used
in dogs and cats that have various flavors
that appeal to the animal.
Tablets and capsules can be crushed into a
powder and administered in water using an
oral dosing syringe
A mortar and pestle can be used to grind
down the medication into a fine powder
Pastes can also be made to administer
medication (usually done at a compounding
pharmacy
Administering Oral
Medications in Dogs
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Apply gloves
Elevate head upward
Open mouth at side by pressing
between the upper and lower jaw joint
by cheek
Place medicine between index finger
and thumb of free hand
Administering Oral
Medications in Dogs
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place middle finger of same hand at
front of mouth and apply pressure to
open mouth wide
Drop the tablet or capsule at the back
of the throat
If safely able to use index finger of
free hand, push the medication deeply
into the throat
Administering Oral
Medications in Dogs
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Close the mouth and hold until patient
swallows
Gently blow on face or rub throat to
stimulate swallowing
Monitor for any signs of the
medication not being ingested
Administering oral medications
in cats
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Apply gloves
Have someone hold front feet and
body while pilling
Elevate the head upward
Open mouth by pressing at the side
between the upper jaw and lower jaw
joint by cheek
Administering Oral Medication
in Cats
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Place medicine between index finger
and thumb of free hand
Place middle finger of the same hand
at front of mouth and apply pressure
to open mouth wide
Drop the tablet or capsule at the back
of the throat
Administering Oral Medication
to a Cat
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If safely able to use index finger of free
hand, push the medicine deeply into the
throat
Close the mouth and hold until the patient
swallows
Gently blow on face or rub throat to
stimulate swallowing
Monitor for any signs of the medication not
being ingested
Using a Pet Piller or Balling
Gun
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Apply gloves
Place pill in the end of the plunger of
the pet piller or balling gun
Apply the end of the piller or balling
gun into the side of the mouth
between the upper and lower teeth
Once in the mouth, push plunger to
release medicine to back of the throat
Using a Pet Piller or Balling
Gun
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Remove the balling gun or pet piller
and immediately elevate head upward
Blow on nose or rub neck to stimulate
swallowing
Check to make sure the medicine was
swallowed
Disinfect items and put away
Administering liquids and
pastes
1.
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4.
Apply gloves
Elevate head upwards
Insert syringe or paste tube in side of
the mouth between the upper and
lower teeth
Press the plunger to the desired
amount into the back of the throat
Administering liquids and
pastes
5.
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Remove syringe or tube and
continuing elevating the head upwards
Blow on nose or rub throat to
stimulate swallowing
Keep mouth held shut until swallowing
occurs
Disinfect any tools and put away
Administering Aural
Medications
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Are placed in the ear and may be used
for ear infections, ear cleaners or ear
mites
The opening of the ear canal includes
the tragus
Area located caudally and with no har is
the pinna
Aural Medications
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Internal ear canal is L-shaped
Ear canal is made of cartilage
Treated for many reasons, most
common is ear infections
Long eared dogs have ears that do not
allow for good ventilation and moisture
and bacteria may easily build up in the
canal
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Some dog breeds such as poodles and
bichons have hair that grows in the
canal which may prevent proper
ventilation from occurring
All animals are susceptible to ear mites
Flies and mosquitoes may bite the ear
flaps such as in large animals which can
cause crusting and bleeding on the ear
edges
Wax and other debris can be lodged in
the are causing trauma and irritation
Hematomas
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Hematomas can be made by damage to
the ear or excessive head shaking
When an animal shakes its head
severely it may cause blood vessel to
rupture and the pinna to fill with blood
Aural Medications
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Are usually in liquid form
Can be either a drop or ointment
Some medications can be packaged in
bottles or tubes
Many tubes are meant for multiple uses
Often ears need to be cleaned before
applying medications
Aural Medications
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The veterinary assistant can be asked
to show the clients how to properly
apply ear medications at home
Gloves should be worn to prevent
contamination
Also tops to ear medications should be
cleaned between ears to prevent
contamination
Administering Aural
Medications
1.
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Apply gloves
Clean ears as recommended by the
veterinarian
Place medication into dropper or tip
deep inside the ear canal only to the
depth of the start of the vertical
portion of the L-shape
Administering Aural
Medications
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Apply the proper amount of
medication into the ear as noted by
the veterinarian. This is usually in
drops that are counted according to
the veterinarian’s label
Remove the medication dispenser
from the ear
Administering Aural
Medications
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Massage the base of the outside of the ear
canal. This will create a swishing sound
caused by the medication moving around
the ear canal
Wipe any solution that may have leaked
onto the outside of the ear flap of hair
Disinfect the medication dispenser with
alcohol and place in appropriate area
Administering Topical
Medications
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Topical medication is a substance
applied to the outside of the skin coat
on an external body surface
Topical medications may include
antiseptics, flea and tick medications, or
wound treatments
Topical medications
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Areas of wounds or abrasions should be
soaked prior to applying the medication
Can be done by soaking with warm
water or surgical scrub
Some topical medications can come in a
single use container or in a large
volume meant for multiple uses
Topical medications
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Flea and tick medications should be applied
according to label medications
Each product treats specific animals for
specific reasons
Some topicals treat fleas only, others ticks
Gloves should be worn when applying these
medications because of the various chemicals
in them
Administering Topical
Medications
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Apply gloves
Clean area as necessary
Use a tongue depressor to transfer an
amount of topical medication if the
container is for multiple uses
Apply to ointment onto the area in a circular
motion, starting at the center of the wound
and gently working outward
Administering Topical
Medication
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Do not contaminate the medication by
touching items that have touched the
animal. Flea and tick medications
should be applied as directed on the
instructions
Separate hair from skin and apply as
directed
Clean area and put items away
Ophthalmic medications
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Are ointments or solutions that are
applied to the eyes
May be used to treatment of an eye
condition or used prior to bathing or
grooming to protect the cornea from
damage
Avoid the contact of the applicator with
the eye
Ophthalmic ointment
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Touching the tip to the eye will not only
contaminate the medication but may
also cause trauma to the eye
Wear gloves when applying eye
medication
Eye will need to be held open for a
better view
Ophthalmic medications
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Eye drops can be dropped into the eye
by holding the bottle over the open eye
Ointments can be applied by a thin
layer over the lower eyelid and allow
the animal to blink several times to
move the substance throughout the eye
Administering Ophthalmic
Medication
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Apply gloves
Wipe any discharge from the patient’s
eye using a gauze sponge
Open the end of the ophthalmic
medicine and hold in one hand
Using the free hand, use the index
finger and thumb to pull the upper
and lower lids apart to see the eye
Administering Ophthalmic
Medication
5.
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The thumb pulls the lower lid down, the
index finger pulls the upper lid upwards
The other finger may rest on the head of
the animal
Gently tilt the head upwards
Apply the drops or ointment gently into the
eye, counting each drop and applying the
proper amount. Do not touch the surface of
the eye with the dispenser
Administering Ophthalmic
Medications
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Apply the ointment over a thin layer
on the lower lid. Do not touch the
surface of the eye with the dispenser
Release the eyelids
Allow the animal to blink to move the
medication through the eye
Clean the dispenser with a small
amount of alcohol on a gauze sponge
Medication Storage
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Medications have an expiration date
and should be monitored for proper
dating prior to dispensing
Medications in the pharmacy should be
stored with the oldest dates being used
first to use up the products that will
expire the fastest
Medication Storage
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Expiration date is located on the bottle
Must be included on the pharmacy label
when dispensing medication
All outdated medication should be
removed from the shelves
Drugs typically arrive with an insert
within the container that details the
actions and use of the drug
Medication Storage
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Storage information is also located on
the insert
Some items are stored at room
temperature, other may need
refrigeration
Biologicals, like vaccines, are stored
under refrigeration
Medication Storage
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Some drugs need to be stored in a dark
place and kept away from direct light
These drugs lose their efficacy when
exposed to light.
All drugs without information on
storage should be kept at room
temperature in a clean dry area.
Medication Storage
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Most veterinary pharmacies keep medications
stored on shelves in alphabetical order for
ease of locating
All controlled items are kept in the controlled
substance lock box
All items after being opened need to be
sealed tight and replaced in their proper
pharmacy location
Pharmacy shelves should be cleaned on a
regular basis to keep dust and debris from
bottles.
QUESTIONS?