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Equine Drugs and Medications November 28, 2011 (Equine Medications, Forney, 2001)

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Presentation on theme: "Equine Drugs and Medications November 28, 2011 (Equine Medications, Forney, 2001)"— Presentation transcript:

1 Equine Drugs and Medications November 28, 2011 (Equine Medications, Forney, 2001)

2 Useful References

3 The Veterinary-Client-Patient Relationship VCPR – what is it? Defined by the American Veterinary Medical Association (AVMA) –The veterinarian has assumed the responsibility for making medical judgments regarding the health of the animal(s) and the need for medical treatment, and the client has agreed to follow the instructions of the veterinarian

4 The Veterinary-Client-Patient Relationship Defined by the American Veterinary Medical Association (AVMA) –There is sufficient knowledge of the animal(s) by the veterinarian to initiate at least a general or preliminary diagnosis of the medical condition of the animal(s) Examination Visits to premesis

5 The Veterinary-Client-Patient Relationship Defined by the American Veterinary Medical Association (AVMA) –The practicing veterinarian is readily available for follow-up in case of adverse reactions or failure of the regimen of therapy. Veterinarian must maintain medical records

6 Medical Records Must comply with State and Federal Standards Property of the practice –Must be retained for period determined by statute Information is private and can’t be released without consent of client or by court order Vet is obligated to provide copies at request of client; client should supply written release Vet can’t remove or copy any part of the record without approval from practice owner

7 Dispensing Drugs In order to dispense medication, a VCPR must exist AAEP Guidelines: –Veterinarians should honor a client’s request for a prescription in lieu of dispensing. –Without a valid VCPR, veterinarians’ merchandising or use of veterinary prescription drugs or their extra-label use of any pharmaceutical is unethical and is illegal under federal law.

8 The Veterinary-Client-Patient Relationship Who may terminate a VCPR? –Veterinarian  must notify client and do so with tact and courtesy No ongoing medical condition If there is ongoing medical condition, veterinarian must provide a referral for continuing care –Clients may terminate relationship at any time

9 Safety (Equine Medications, Forney, 2001)

10 Measurement Conversion Table Conventional Measure Multiply By Metric Measure Ounce (oz) 28.35 0.035 Gram (g) Pound (lb) 0.45 2.21 Kilogram (kg) Grain 0.0154 64.8 Milligram (mg) Fluid ounce (fl oz) 29.57 0.03 Milliliters (ml)

11 Measurement Conversion Table Conventional Measure Multiply By Metric Measure Cup (c) 0.24 4.24 Liter (L) Pint (pt) 0.47 2.13 Liter (L) Quart (qt) 0.95 1.05 Liter (L) Gallon (gal) 3.78 0.26 Liter (L)

12 Extra-Label (Off-Label) Drug Use Using the drug in a manner other than that on the label –Guidance of a veterinarian –Valid VCPR Examples –Using a different dose –Using a different frequency or route of administration –Using a drug for longer than is directed on the label –Treating different diseases than those indicated on the label –Treating a different species of animal than those approved on the label.

13 Drug Compounding Any drug manipulated to produce a dosage form drug (other than that manipulation that is provided for in the directions for use on the labeling of the approved drug product). Can be done by pharmacies FDA in 2003: some compounded drugs are considered “new” and must go through approval process Gives vets an additional tool in fighting disease Legal vs illegal compounding

14 Drug Controls Federal Drug Administration (FDA) Maryland Board of Veterinary Medical Examiners Association of Racing Commissioners International (ARCI) Federation Equestre Internationale (FEI) United States Equestrian Federation (USEF) American Quarter Horse Association (AQHA)

15 Drug Approval Process FDA definition of “drug”  Any substance, food or nonfood that is used to treat, cure, mitigate, or prevent a disease  Any nonfood substance that is intended to affect the structure or function of an animal  Any substance administered by injection

16 Drug Approval Process New drugs must be tested through scientific process and shown to be effective and safe Effective = does what it claims consistently and uniformly Safe = safe to animals and people administering the drug; also must be safe to environment Good manufacturing practices

17 ARCI Lists drugs classified according to their abilities to influence performance –Highest Potential for abuse/effect on performance = Class 1 –Lowest potential for abuse/effect on performance = Class 5

18 ARCI Uniform Classification Guidelines for Foreign Substances Classes 1 and 2 –Potent stimulants or depressants –High potential to influence performance –Little-no therapeutic uses Class 3 –May or may not have accepted therapeutic use but have potential to affect performance Classes 4 and 5 –Therapeutic agents

19 FEI ZERO TOLERANCE POLICY!!! Chapter V, article 1013 of Veterinary Regulations: “…regulations...are intended to ensure that no samples taken from a horse during an event shall show the presences in the horse’s tissues, body fluids or excreta, of any substance which is a Prohibited Substance.” –Includes substance, metabolites of substances, isomers and metabolites of isomers of substance

20 What Happened at the 2008 Olympics?? 6 horses and riders disqualified for positive drug test results Tested positive for drug, felbinac –“Medication class A” prohibited substance applied topically for the relief of local pain and inflammation –Tested levels? "However, after doing more research on the drug and having a bio- chemist analyze the data, we learned that the trace amount found in Myth's system could occur from something as distant and arbitrary as a person using Felbinac on their knee then using a broom, then someone else uses the broom and shakes my groom's hand, and then my groom touches my horse. In the sampling, 14 nanograms per milliliter were found. It takes 7500 to 100,000 nanograms per milliliter to have an effect on a rat."

21 What is the FEI doing? November, 2008: Formed a commission on medication and doping –Examine current drug policy and testing procedures Make sure they conform to World Anti-Doping Agency (WADA) guidelines Establish single protocol –Protect the welfare of the horse –Overcome grey areas between doping and therapeutic medication Distinguish between acceptable and unacceptable practices New Equine Anti-Doping and Controlled Medication Regulations (EADCMRs) established and implemented in 2010

22 US Equestrian Federation Therapeutic Substance Provisions (Article 410) No foreign substance rule – includes reporting requirements for illness and injury –Horse may required to be withdrawn from competition for 24 hours following administration of drug Thousands of prohibited substances Special considerations for common drugs

23 FEI/USEF Prohibited Substances Substances acting on… 1.Nervous system 2.Cardiovascular system 3.Respiratory system 4.Digestive system 5.Urinary system 6.Reproductive system 7.Musculoskeletal system 8.Blood system 9.Skin (i.e. hypersensitizing agents) 10.Endocrine system, endocrine secretions and synthetic counterparts 11.Anti-infectious (including anti-parasitic) 12.Antipyretics, analgesics and anti-inflammatory 13.Cytotoxic substances

24 AQHA Drug-free policy –Any surgical procedure or injection of any foreign substance or drug which could affect a horse’s performance or alter its natural conformation or appearance is prohibited except during surgical procedures performed by a duly licensed veterinarian for the sole purpose of protecting the health of the horse. Uses ARCI classifications –No Class I or II drugs allowed under any circumstances

25 AQHA January 1, 1999 –Allowed use of certain medications under stringent guidelines: Be in the best interest of the horse Be more in line with AQHA's statement of position regarding the welfare and humane treatment of the horse Help owners and exhibitors avoid disciplinary action for inadvertently violating our previous "no presence" rule due to improved testing technology which allows detection of minute amounts of a drug in a horse's system even though those amounts can have no clinical effect on the horse

26 Drug Testing in Performance Horses Withdrawal time –Estimated time prior to competition that a drug should be withdrawn Detection time –Known period of time after drug administration when it can be detected in blood, urine or body fluid Clearance time –Time it takes the horse’s body to eliminate the drug completely

27 What is a “Positive” Chemical identification of a substance that violates the rules of competition 1.Screening and confirmatory tests must result in unequivocal chemical identification 2.Independent confirmation by a lab of trainer’s choice 3.For substances with threshold: drug and/or metabolites present above threshold level

28 Factors Affecting Withdrawal Time Dose Sensitivity of testing Local testing procedures pH of the urine of the horse post-race Route of administration Time of last meal Frequency of drug use Release time of drug preparation Drug formulation

29 Routes - IV (Equine Medications, Forney, 2001)

30 Routes - IM (Equine Medications, Forney, 2001)

31 Routes - PO (Equine Medications, Forney, 2001)

32 Categories of Medications Tranquilizers and sedatives Vitamins & minerals (covered in Equine Nutrition) Vaccinations Anthelmintics (deworming) Hormones and anabolic steroids Pain-controlling drugs ACTH and corticosteriods Antibiotics Performance drugs and medications/Doping

33 Actions of Drugs in Horses Indications –When is it ok to use a drug to treat a disease Contraindications –When should a drug NOT be used Possible side effects Interactions with other drugs

34 Tranquilizers/Sedatives 2 categories of use in horses: –Control of horses for surgical procedures –Control behavior

35 Tranquilizers – Rules of Use Always check with vet re: suitability for situation Know horses’ sensitivities to tranqs before need for use arises Avoid riding heavily tranq’ed horses Avoid use for training purposes Be aware of drug interactions Allow only vet to give tranqs to horses that are injured, ill or in shock Never give to very young (< 1 yr) or very old Dose given matches dose required

36 Pain-Controlling Drugs Pain does have benefits to the horse!! Analgesics vs. anesthetics –Analgesics block pain Narcotic – may be stimulatory in horses where sedative in humans Non-narcotic/Non-Steroidal Anti-inflammatory Drugs (NSAIDs) –Anesthetics block all sensations Should be used only be vet or vet technician

37 ACTH and Corticosteriods ACTH = adrenocorticotrophic hormone –Controls activity of the cortex and adrenal gland –Feedback loop –ACTH can stimulate the horse’s adrenal glands to produce natural corticosteriods to 10x normal level –Also used to test adrenal function Corticosteroids have an anti- inflammatory effect

38 Indications and Side Effects Indications: –Arthritis, bursitis, tendinitis –Skin conditions –Heaves –Spinal-cord injury or inflammation Side-effects: –Founder –Increased water intake  increased urine output –Sodium retention, increased excretion of K and Ca –Abnormally high blood glucose –Mood changes

39 Performance Drugs and Medications Magic pill to make horses perform better? Legality of use varies state to state Drugs that improve respiratory tract health: –Diuretics Salix/Lasix (furosemide) is perfect example –Bronchodialators Drugs that act on blood system –“Milkshakes” –Blood doping

40 What is ‘blood doping?’ Blood doping is the practice of boosting the number of red blood cells in circulation  enhance athletic performance –Can improve an athlete’s aerobic capacity (VO2 max) and endurance ARCI: The possession and/or use of blood doping agents, including but not limited to those listed below, on the premises of a facility under the jurisdiction of the Commission is forbidden: –Erythropoietin (“epo”) –Darbepoetin –Oxyglobin®

41 Performance Drugs and Medications Drugs that act on musculoskeletal system –Reduce pain from vigorous use –Phenylbutazone, other NSAIDs –Narcotics, stimulants, local anesthetics, anabolic steroids, corticosteriods Drugs that stimulate the CNS –Amphetamines –Cocaine

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