Cover Page

Pharmacotherapeutics for Veterinary Dispensing

Edited by


Katrina L. Mealey, BS (Pharm), DVM, PhD

Diplomate ACVIM, Diplomate ACVCP

Fellow, National Academy of Inventors

Professor and Ott Endowed Chair

College of Veterinary Medicine

Washington State University

Pullman, WA, USA






logo.gif


This book is dedicated to the two loves of my life: My husband, Bob, who shares my love of veterinary medicine and my son, Stephen, who shares my love of pharmacology.

List of Contributors

Terri L. Alessio, DVM, DACVO
Veterinary Medical Teaching Hospital College of Veterinary Medicine Washington State University, Pullman, WA, USA

Joe Bartges, DVM, PhD, DACVIM, DACVN
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA

Eden Bermingham, DVM, MS, DACVCP
Clinical Pharmacology Team, Division of Scientific Support, Office of New Animal Drug Evaluation, FDA Center for Veterinary Medicine, Rockville, MD, USA

Annie Chen‐Allen, DVM MS, DACVIM (Neurology)
Neurology and Neurosurgery, College of Veterinary Medicine, Washington State University, Pullman, WA, USA

Gigi Davidson, BSPharm, DICVP
Clinical Pharmacy Services, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA

Jennifer L. Davis, DVM, PhD, DACVIM (LA), DACVCP
Department of Biomedical Sciences and Pathobiology, Virginia‐Maryland (VA‐MD) College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA

Virginia R. Fajt, DVM, PhD, DACVCP
Veterinary Physiology and Pharmacology College of Veterinary Medicine & Biomedical Sciences, Texas A&M University College Station, TX, USA

Lauren Eichstadt Forsythe, PharmD, FSVHP
Veterinary Medical Teaching Hospital School of Veterinary Medicine, University of California, Davis, CA, USA

Alice M. Jeromin, RPh, DVM, DACVD
Private practice, Richfield, OH, USA

Margo J. Karriker, PharmD, FSVHP, DICVP
University of California Veterinary Medical Center–San Diego, UC Davis School of Veterinary Medicine, San Diego, CA, USA

Butch Kukanich, DVM, PhD, Diplomate ACVCP
Department of Anatomy and Physiology College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA

Sunshine M. Lahmers, DVM, PhD, DACVIM (Cardiology)
Department of Small Animal Clinical Sciences, Virginia‐Maryland (VA‐MD) College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA

Cory Langston, DVM, PhD, DACVCP
ORCID ID 0000‐0002‐4644‐1616
College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA

Stephen W. Mealey
Washington State University, Pullman, WA, USA

Katrina L. Mealey, BS (Pharm), DVM, PhD, Diplomate ACVIM, Diplomate ACVCP
College of Veterinary Medicine, Washington State University, Pullman, WA, USA

Karen L. Overall, MA, VMD, PhD, Diplomate ACVB
Department of Biology, University of Pennsylvania, Philadelphia, PA, USADepartment of Health Management Atlantic Veterinary College, UPEI Charlottetown, PE, Canada

Mark G. Papich, DVM, MS, Diplomate ACVCP
Clinical Pharmacology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA

Patricia A. Talcott, MS, DVM, PhD, Diplomate ABVT
Integrative Physiology and Neuroscience and Washington Animal Disease Diagnostic Laboratory, College of Veterinary Medicine Washington State University, Pullman, WA, USA

Andrea S. Varela‐Stokes, DVM, PhD
ORCID ID 0000‐0002‐3991‐9730
College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA

Katrina R. Viviano, DVM, PhD, DACVIM, DACVCP
Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, USA

Valerie J. Wiebe, PharmD, FSVHP, DICVP
Department of Medicine and Epidemiology, School of Veterinary Medicine, and Veterinary Medical Teaching Hospital University of California, Davis, CA, USA

Michael D. Willard, DVM, MS, DACVIM
Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA

Preface

The greatness of a nation and its moral progress can be judged by the way its animals are treated.

Mahatma Gandhi

A number of in‐depth veterinary pharmacology resources have been written that are aimed at the veterinary profession (veterinarians, veterinary students, and veterinary researchers). Similarly, there are a multitude of clinical pharmacology and pharmacotherapeutics resources available on the human side aimed at physicians and pharmacists. To our knowledge, this book represents the first effort to “marry” the disciplines of veterinary medicine and pharmacy.

Veterinary medicine, and veterinary pharmacotherapeutics in particular, are undergoing immense changes. No longer is veterinary pharmacology an inexact extension of human pharmacology. Veterinary pharmaceutical products are no longer discarded human drug candidates that are subsequently developed for animals. Targeted enzyme pathway inhibitors (tyrosine kinase and JAK kinase) and even species‐specific monoclonal antibody therapies have been developed by the veterinary pharmaceutical industry and are currently marketed for veterinary patients. The companion animal pharmaceutical market is a multibillion dollar per year industry. In an effort to gain part of this market share, corporate (traditionally “human”) pharmacies have actively lobbied to introduce legislation at both state and federal levels that requires veterinarians to provide prescriptions to pet owners rather than dispense drugs directly to pet owners. Veterinarians have independently started writing more outpatient prescriptions rather than dispensing drugs from their own formulary because (i) carrying a large drug inventory is expensive, and (ii) a number of human‐approved formulations are used off‐label for companion animal disorders.

Consequently, pharmacists are increasingly encountering pet owners in their pharmacies, dispensing drugs for veterinary patients, and being asked to provide counseling on veterinary pharmacotherapeutics. Unfortunately, most pharmacists are not adequately trained to provide these services for veterinary patients. The wealth of information pharmacists acquire in pharmacy school regarding “human” medicine, pharmacology, therapeutics, and so on is often not applicable to other species. Because the pharmacy oath is not limited to one species (i.e. human patients), all pharmacists have an obligation to gain the knowledge and skills necessary to assure optimal outcomes for all patients (human and animal).

The primary goal of this book, therefore, is to improve safety and efficacy of pharmacotherapeutics in veterinary patients – to minimize mistakes based on the presumption that human pharmacology applies to all species, and to maximize therapeutic efficacy by enabling pharmacists to be an integral member of the veterinary healthcare team. The book is not intended (nor is it possible) to include every drug and indication for each veterinary species. The book is not intended to rehash information that pharmacists and pharmacy students have already mastered (i.e. mechanisms of action of drugs used in humans). To emphasize important points, text boxes are used throughout the book. Yellow boxes indicate “Practiced but Not Proven” use of medications by veterinarians (common use of a particular drug without strong evidence supporting that use). Gray boxes indicate when there is a “Dramatic Difference” between species with respect to drug disposition, particularly between humans and animals. Pink boxes indicate “Mandatory Monitoring” for a particular drug, providing the reader with information that can be used to counsel pet owners.

Each contributor, whether a veterinarian, pharmacist, or both, is a recognized expert in his or her field, having received advanced training, achieving certification in their discipline, and most importantly having acquired extensive clinical experience. Collectively, we hope this text will enable more Schools of Pharmacy to provide courses in veterinary (or comparative) pharmacology and/or veterinary pharmacotherapeutics because it isn't enough to know that a dog is not a small person and a cat is not a small dog.