Listening to his anecdotes I feel that vet students are pretty much the same as medical students. They both need to learn pathophysiology of disease, diagnostics, and also the medicines to treat. They both have too much to learn, never enough time to do so thus leading to practically no social time left over. None the less, we try to make time to catch up and talk about random things.
One thing I learnt from him was that cats cannot tolerate paracetamol. This is because they lack an enzyme causing toxic metabolites of paracetamol to build up in their body!
Last exam period I saw him reading up on drugs and medicines. As a pharmacist (pronounced:drug nerd), I've spent the last four years of my degree touching nothing but drugs and their therapeutic usage. Surely I'd know a thing or two about medicines in animal use! I thought to myself. So I took a peak at his lecture notes, what the hell is this?
As you may know, Vets treat animals and doctors treat humans. Duh! However, both practitioners share common medicines that are used both in humans and animals alike. Products such as Proton Pump Inhibitors (PPIs) and antibiotics such as amoxicillin and doxycycline are medicines that are used by both practitioners. Because of that, we occasionally see patients bringing in scripts to the pharmacy that is for their dog.
What surprised me most when I looked at his notes was the different brand names vets use. Clavulox turned out to be Augmentin Duo Forte. Vibramycin was doxycycline. That was when I found out there are drug companies such as Zoetis specially make medicines designed for animals. Different branded products exist for animals even if there is the same product available for humans.
At work, I feel that a crucial role of a pharmacist is to be the gate keeper of medicine. It is our job to double check the doctor's work. All prescriptions go through a pharmacist to dispense, this allows us to ensure the doctor's choice of product and dosage is appropriate for the therapy. Using our knowledge, on occasion we would pick up the phone and call the doctor: "Doctor, I think this antibiotic dose for this kid is too low considering his weight. I'd recommend at least..."
On the other hand, when a vet script comes into the pharmacy, all this 'gate-keeper' duty goes out the window. I know nothing of therapeutic use of medicines in animals to 'double-check' the vet's choice of product. When it comes to a vet's script, I just put it through because I simply have no idea.
The following are some cases involving vet scripts that I've come across/ heard of in the pharmacy.
1) Patient comes in to request for 6 boxes of phenergan. As we usually limit 1 box per customer, we asked her for what it was for. She said it was for her horse as it is quite big it needs 5-6 tablets each time they feed it.
hmmm.... is it appropriate? (shrug) Sold!
2) My dog has conjunctivitis, it needs Chlorsig.
Do the usual WHAT STOP GO questions apply? (shrug) Sold!
3) Patient calls up to ask for Urocit-K (potassium citrate). This was prescribed for her dog and she requires it quite urgently. We did not hold any stock as this is an unusual product, so we tried to buy it through our suppliers. Unfortunately for her, it would take 2-3 weeks to get a hold of this item (it also costs around $150).
I thought of offering her an alternative products that contain potassium such as Duro-K. Sadly as I don't know the vet's intentions for choosing Urocit-K, I told her there was nothing we could do.
4) A vet clinic called to ask if we had Sporanox (itraconazole) 10mg/mL oral liquid available. As it also is a rare item, we did not have any stock on hand.
Why do vets prescribe the most weird and random medicines?
Another thing to keep in mind is that medicine prescribed by vets are not covered by the PBS. This means owners need to pay full cost price for the medication. For example, Sporanox costs about $210.40
There is still plenty for me to learn from my Vet friend. Maybe next time I see him I should ask him about Urocit-K.
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