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Chapter 13 Pharmacy Skills 245

• Schedule III: moderately addictive The second challenge arises from the use of abbrevia-
potential – recording amounts dispensed are tions in a prescription. Remember from Chapter 1 that
required in the drug log by law (e.g., acetaminophen abbreviations are a combination of Latin and English.
with codeine, ketamine, anabolic steroids). Limited to There are standard abbreviations recognized within the
five refills in 6 months. profession. Some abbreviations have several meanings
• Schedule II: potential for severe dependence – depending on the context in which they are used. To
recording amounts dispensed are required in the add further confusion, some veterinarians or practices
drug log by law (e.g., oxymorphone, morphine, have their own abbreviations. You need to memorize both
pentobarbital injectable, fentanyl). No refills. the standard abbreviations and the ones used within
• Schedule I: no medical use. These are not found in a your practice. If you are struggling with the abbrevia-
veterinary facility. Their use is limited to research tions it is a good idea to include them in a pocket refer-
facilities only. ence book for a quick review. When you encounter
non‐standard abbreviations, make a note of these in your
Clients may not receive more than a 30‐day supply
of a controlled substance. Refills depend on drug book. Never use these abbreviations on labels or when
speaking to a client. It is necessary to translate the abbre-
classification. Also, beware of clients, particularly those viations on the prescription to standardized English. For
that seem to frequent multiple veterinary clinics, request- example, most clients don’t know what “bid” means.
ing medications for their pets or seeking constant refills.
It is not uncommon to find unscrupulous owners who are
taking their pet’s medication for their own personal use.
Accuracy and safety are vital factors when filling a Review
prescription or administering medications. The patient
and client have the right to know that veterinary profes- What do the abbreviations; qd, bid, tid, RX, PO,
sionals are following certain standards of practice by and q8h mean?
ensuring they are getting the correct prescription.
Clients can also be reassured that the facility is practicing
the best standard of care. When filling a prescription, A third challenge encountered when filling a
preparing a label, or giving a medication to a patient prescription is drug identification. There are brand
always double check these against the “Patient’s Rights” names for medicines for example, Tylenol® is a brand
in Chapter 11. By keeping them in mind we can achieve name of acetaminophen which is the generic name or
the goal of best standard of care.
formulation name. There are many companies that
package acetaminophen under their own label and may
simply label it as “pain care.” This is the same with
Review prescription strength medications. Be aware that one
veterinarian in the practice may use the brand name but
Jot down the “Patient’s Rights” discussed in only the generic formula is in the pharmacy. Usually, this
Chapter 11 and reflect on how you can best keep is out of habit. Think of it this way, when you ask for
these rights in mind as you assist in the pharmacy. something for a headache do you say, “Does anyone have
any acetaminophen?” or do you say, “Does anyone have
any Tylenol?”
Medications are made in different concentrations per
Reading a Prescription unit and are packaged similarly, the only difference is
the strength. Using our acetaminophen example, they
The veterinarian may ask an assistant to fill a prescription, come in 200 or 500 mg tablets. The 500 mg tablets may
label the secondary container, and explain to the client say something like “extra strength” on the front of the
how to administer it to their pet. Let’s being with the label as your only clue that they may be of a different
prescription. Filling a prescription presents some major strength. Reading the label carefully for strength is very
challenges regarding accuracy. The first concern is cor- important when filling a prescription.
rectly reading the veterinarian’s handwriting. Legibility Some manufactures will have a “brand” packaging.
with handwriting can range from good to indecipher- For example, all their products have a red and white
able with anybody, not just veterinary professionals. label. This comes into play when drug names are similar,
Learning the scrawl of each veterinarian in a practice such as amoxicillin and ampicillin. In this case they are
takes time. In the beginning, ask an experienced team similar antibiotics but work a bit differently and so one
member to help you. If there is any doubt, it is wiser to may be selected by the veterinarian over another. So, it is
ask the veterinarian for clarification than to risk filling a very easy to grab the wrong bottle because we went for
prescription incorrectly. Don’t ever assume. the color pattern and something that started with an