Drug Compounding for Veterinary Professionals

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Drug Compounding for Veterinary Professionals

Drug Compounding For Veterinary Professionals

By Lauren R. Eichstadt Forsythe and Alexandria E. Gochenauer

Drug Compounding for Veterinary Professionals PDF provides an accessible, easy-to-use guide to all aspects of prescribing individualized mixtures of medications in veterinary practice. Its emphasis on practical knowledge and its discussion of both in-house and external options make it a comprehensive introduction to using compounded medications in animals. It guides practitioners through every step of the process, from formulating a compound to working with outside pharmacists.

The book presents guidance on how to get more information on current regulations, consider the risks and benefits, develop formulations, and more. Drug Compounding for Veterinary Professionals readers will also find:

  • Figures and line drawings illustrating effective compounding techniques and concepts
  • An emphasis on practical knowledge for clinical use
  • Answers to frequently asked questions about drug compounding

Drug Compounding for Veterinary Professionals is essential for any veterinary practitioner, veterinary pharmacologist, or student looking to understand this crucial component of patient care.

Table of Contents

 

1 Compounding Regulations 

Organizations and Regulatory Agencies Involved with Compounding

Food and Drug Administration

United States Pharmacopeia

Drug Enforcement Administration

State Boards of Pharmacy

State Veterinary Boards

Compliance Policy Guides and Guidance for Industry Documents

What Is Compounding?

The Food, Drug, and Cosmetic Act

Animal Medicinal Drug Use Clarification Act

Preparing Compounds from an Approved Product or a Pure Drug Powder

Federal Versus State Law

Office Use Compounding

Drug Quality and Security Act

Finding Additional Information

2 Risk–Benefit Analysis of Compounded Medications 

Benefits of Compounded Products

Dosage Form

Flavoring

Dosage Strength

Eliminating Ingredients

Availability Issues

Appropriate Use of Compounded Medications

FDA-Approved Drugs

Compounded Medication Risks

Compounded (USP) Versus Manufactured (cGMP)

Risks Associated with Compounded Medications – A Look at the Literature

Studies Showing Incorrect Potency

Studies Showing Lack of Stability

Studies Showing Lack of Efficacy

Risks Associated with Specific Types of Compounds

Active Ingredient Source Decisions

Patient-Specific Compounding Versus Office Use Compounding

Adverse Event Reporting

Identifying Potential Formulation Issues

Drug Recalls

Selecting a Compounding Pharmacy

Client Education

Reducing Risk in Practice

Conclusion

3 Beyond-Use Dating 

Factors Considered When Assigning BUDs and Expiration Dates

USP Default BUDs

Stability Studies

Evaluating Stability Studies

Determining BUDs for In-House Formulations

BUD Considerations When Prescribing Compounded Medications

Conclusion

4 Identifying High-Quality Compounding Pharmacies 

Case Study 1

Case Study 2

What to Evaluate

General Practices

Staff Skill Level

Familiarity with Veterinary Medicine

Pharmacy Culture

Ways to Evaluate Compounding Pharmacies

Looking Beyond the Pharmacy’s Website

What to Look for on a Tour

Questions to Ask the Pharmacist in Charge

Conclusion

5 Formulation Development 

Dosage Forms

Oral Administration

Oral Solutions

Oral Suspensions

Oral Syrups

Oral Capsules

Oral Tablets

Oral Treats

Oral Emulsions

Oral Pastes

Oral Powders

Transdermal Administration

Topical Administration

Topical Solutions

Topical Ointments

Topical Shampoos

Topical Mousses

Topical Emulsions

Topical Creams

Topical Gels

Otic Administration

Otic Solutions

Otic Suspensions

Otic Ointments

Other Routes of Administration

Rectal Solutions

Intranasal Solutions

Injectable Preparations

Ophthalmic Preparations

Ingredients

Ingredient Selection

Solubility

Partition Coefficient

Density

Water Activity

pH

Chelators

Antioxidants

Preservatives

Flavors, Coating Agents, and Sweeteners

Coloring Agents

Salt Forms

Organic Salts

Inorganic Salts

Common Excipients by Dosage Form

Oral Liquid Medications

Oral Solid Medications

Emulsions

Transdermal Medications

Cream, Gel, and Ointment Medications

Hazardous Drugs

Beyond-Use Dates

Formulation Resources

Calculations

Measurements Used in Compounding

Displacement Factor

Capsules: Packing Statistics

Packing Statistic of Drug

Average Weight of Ingredients

Percentage of Drug per Capsule Using Bulk Powder

Percentage of Drug per Capsule Using Manufactured Tablets

Percentage/Amount of Filler per Capsule

Conversion to Grams

Compounding Formulations to Avoid

Formulation Development Process

Developing a Compounding Formula: Example 1 (USP Compounding Compendium)

Developing a Compounding Formula: Example 2 (Stability-Indicating Assay)

Compounding Formulation Assessment

6 Compounding in House 

Documentation

Master Formulation Record

Compounding Record

Formulation Record Components

Quality Assurance and Quality Control

Labeling

Packaging and Storage

Compounding Techniques

Trituration

Sifting

Geometric Dilution

Wetting

Colored Tracers

Equipment

Mortars and Pestles

Glassware

Containers

Scales

Spatulas and Measuring Devices

Equipment Cleaning

Training

Formulation Instructions

Species-Specific Information

Flavoring

Toxicities

Potency Designations

Feasibility for a Veterinary Clinic

Index

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