CONTROLLED SUBSTANCE RESTRICTIONS Regulated by the ___________. The original container must have a capital ___ and ___________________ indicating its schedule A veterinarian must be registered with the DEA to purchase, dispense, or prescribe controlled substances. Registration number must be on all controlled substance prescriptions and order forms. Registration is valid for three years Some states (Texas included) allows veterinarians without DEA numbers to administer or dispense controlled substances if they are employed by a registered veterinarian. However, they cannot purchase them or write a prescription for them. C-I drugs cannot be prescribed to animals C-II drugs must have written prescriptions and cannot be refilled Controlled substances must be dispensed in child-proof containers that read “Caution: Federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed.”

CONTROLLED SUBSTANCE RESTRICTIONS Must be stored in a __________________ _________________ of substantial construction Glass front, lightweight portable safes, and locked tackle boxes are not sufficient Farm-call vehicles may have a steel toolbox attached to the vehicle Log of ordering, receiving, and dispensing must be kept for ___ years (include stolen, spilled, lost) Bound pages that are sequentially numbered Write in ink Take inventory every two years. Computer records must not allow much editing CONTROLLED SUBSTANCE RESTRICTIONS

CYTOTOXIC AND HAZARDOUS DRUGS Cytotoxic drugs- drugs that are poisonous to mammalian cells Antineoplastic and antifungal agents Could potentially be teratogenic or carcinogenic _____________________/_____________________ agents- drugs that cause birth defects (not only in the patient, but also in the person dispensing the drug) ___________________________ agents- drugs that cause cancer or preneoplastic changes OSHA has guidelines for the safe use, storage, and disposal of these drugs

Cytotoxic drug exposure routes: Absorption through the skin when drug spills/drips Inhalation of aerosolized drug when needle is removed from pressurized bottle, when dug is being crushed/broken, or when ampules are broken. Ingestion of food contaminated with the drug REMEMBER: Store your lunch in a refrigerator that food is in! Don‘t place lunch on a counter where meds are placed. Wash your hands! Every hazardous material should have a MSDS, package insert, and a hospital policy procedure sheet for spills and disposal of equipment.

Cytotoxic drugs continued… Store cytotoxic drugs separately from other drugs and clearly label them. Prepare the drug just prior to administration in a low traffic, well-ventilated area. Wear protective gear: mask (not surgical), gloves (multiple pairs if latex), gown with long sleeves and cuffs, goggles. Use screw-on syringes and IV lines. Recheck calculations. Insure catheter placement is correct. Place all equipment in sealable plastic bags immediately after use and into a leak and puncture proof hazardous waste container. Clean up properly after use. Do not allow maintenance staff to handle cleaning Chemotherapy spill kits are available

COMPOUNDING DEFINITION: _________________________________________________________ ________________________________________________________________________ Examples: Flavoring to improve palatability Formulating drugs into different forms to ease administration NOTE: Diluting drugs with saline, crushing a tablet into a liquid, and mixing drugs together in a syringe or vial are all examples of compounding.

AMDUCA rules of compounding Must be made and dispensed by a veterinarian or pharmacist Unacceptable if causes drug residues in food animals or puts the general public at risk Cannot be made for anyone outside the practice A valid client patient relationship must exist The compounded drug must meet safety and efficacy standards Records must be maintained Drug must be labelled correctly