Understanding Pharmacy Terms

There are times when medications are available in different dosage forms but the differences are not really understood. So here are the definitions of certain terms commonly used in pharmacy.

Chewable tablet (Chew tab) - a tablet that should be chewed, not swallowed whole.

Tablet - a medicine taken by mouth that is swallowed whole.

Caplet - a tablet that must be swallowed whole, but it's oblong shaped for ease of swallowing.

Softgel -a gelatin capsule usually containing a liquid.

Sprinkle Capsule - a capsule that is meant to be opened and sprinkled on food.

Scored - the tablet (or chew tab) can be split in half.

Double scored - the tablet can be split into quarters.

Suspension - a liquid that must be shaken well prior to use.

E.R. (ER) - Extended Release

Otic - for the EAR

Ophthalmic (Ophth.) - for the EYE

Topical - applied to the skin

Let me know if I can help with any other terms.

Setting the record straight

PetMed Express, Inc., d/b/a 1-800-PetMeds (PetMeds) is a mail order pharmacy licensed or authorized to dispense prescription medications to all 50 states and the District of Columbia. Like many retailers, PetMeds maintains a web site (http://www.1800petmeds.com/) which allows consumers the opportunity to order products from the convenience of their home and have the order shipped directly to them, which is especially convenient in this time of rising gas prices.

PetMeds sells two types of product:
1. Over-the-counter (OTC) which requires no prescription from a veterinarian, and
2. Prescription medication (Rx) that does require a prescription from a veterinarian.

OTC items include, but are not limited to Frontline and Frontline Plus, Advantage, K-9 Advantix, Cosequin, Synovi, and GlycoFlex.

Prescription medications include, but are not limited to Heartgard Plus, Interceptor, Iverhart Plus, Advantage Multi, Rimadyl, and Deramaxx.

Prescription medications will only be sent to a consumer if PetMeds receives a prescription from a veterinarian with whom there is a Veterinarian-Client-Patient relationship (typically meaning the pet has been examined within the previous year). Our pharmacists can get this prescription by calling the veterinarians office, by the veterinarian faxing a prescription to PetMeds, or by having the client mail the written prescription received from their veterinarian to us.

PetMeds has a 100% satisfaction product guarantee and all of our products are the same exact medications sold by veterinarians.

Pet Nutrition

The results of a recent survey by Nestle Purina PetCare Co. were published in the magazine, PetAge.

According to this survey, 90% of pet owners always try to purchase foods with the most health benefits for themselves. 82% look for foods with the most wholesome ingredients for their pets.
Antioxidants and omega-3 fatty acids are the leading nutrients pet owners want for themselves and for their pets.

To quote the article:

• High Quality Protein. While 83% of respondents buy foods with high quality protein for themselves, 91% rank protein as the most important nutrient to consider when buying pet food.
• Omega-3 fatty acids. More than 80 percent believe omega-3 fatty acids are among the most essential nutrients in food for themselves and their pets.
• Antioxidants. Ninety percent always look for foods rich in antioxidants for themselves and their pets.
• Vitamin A. A total of 79% said Vitamin A, which promotes good vision, is an important nutrient in their food, and 74% said it was important in their pets' food.

Some additional data from the article includes:

• More than 75% of respondents consider natural ingredients important in their food, and more than 65% search for natural ingredients in pet food.
• Thirty-one percent said natural ingredients dictate what they buy for their families, and 38% said the same for the food they buy their pets.

1-800-PetMeds has a food called 1-800-PetMeds Eat Great. Be Well. Dog Food. How does this product measure up to what these consumers want in a pet food?:

• High Quality Protein: The main ingredient in 1-800-PetMeds Eat Great. Be Well. Dog Food is chicken.
• Omega-3 fatty acids: Natural ingredients as a source of Glucosamine and Omega-3 fatty acids.
• Antioxidants: Natural ingredients including Vitamin E.
• Vitamin A: Contains Vitamin A

1-800-PetMeds Eat Great. Be Well. Dog Food is 100% nutritious with no artifical ingredients or fillers. It is NOT made from wheat or corn. 1-800-PetMeds Eat Great. Be Well. Dog food is formulated to meet the nutritional levels established by the AAFCO dog food nutrient profiles for all life stages.

For information about the products 1-800-PetMeds carries, visit the 1-800-PetMeds website. Follow this link for a complete list of ingredients, for 1-800-PetMeds Eat Great. Be Well. Dog Food.

Newly Released Medications - 2

In my previous blog regarding new products, I discussed a product called Reconcile and today I want to discuss another new medication called Vetmedin.

Vetmedin (pimobendan) is a medication that is used in dogs for the management of the signs of mild, moderate or severe congestive heart failure due to conditions called atrioventricular valvular insufficiency and dilated cardiomyopathy. Vetmedin treats these conditions by increasing the heart's ability to pump blood. Vetmedin works by opening the blood vessels that take blood away from the heart thereby reducing the work the heart does to pump blood. Vetmedin also opens the blood vessels that return blood to the heart thereby reducing pressure on the heart.

Vetmedin is available in 1.25 and 5mg scored chewable tablets and is FDA approved for use only in dogs 6 months of age or older. It should not be used in humans. The total daily dose should be divided into two portions. The portions should be given 12 hours apart.

Vetmedin does have the potential for side effects such as: loss of appetite, tiredness, diarrhea, labored breathing, weakness, and incoordination. In some cases the pet may develop an allergic reaction with symptoms including facial swelling, hives, scratching, sudden onset of diarrhea, vomiting, shock or seizures. If an allergic reaction should occur, contact your veterinarian immediately.

Vetmedin does interract with other medications and you should consult your veterinarian before using Vetmedin with verapamil, propranolol, theophylline and pentoxyfiline.

There is more information regarding Vetmedin on the 1-800-PetMeds website and the pharmacists on staff areavailable to answer questions as well.

Why Do I Need a Prescription for My Pet's Medication?

Like any other pharmacy, 1-800-PetMeds sells pet supplies and medications that can be either over the counter (OTC), where NO prescription is required or prescription (Rx) where a prescription from the veterinarian IS required.

Examples of OTC medications include flea and tick products such as K-9 Advantix, Frontline TopSpot, Frontline Plus, and Advantage.

Examples of medications that require a prescription include heartworm medications such as Heartgard Plus, Iverhart Plus, Revolution, Interceptor and Sentinel, pain relievers such as Rimadyl, Deramaxx, Previcox and Metacam and medications such as Soloxine, methimazole and antibiotics.

I'm often asked the question - "Why do I need a prescription if my vet gives it to me without a prescription?" That's an excellent question and is best answered by comparing the situation to human medications.

When we need to see a doctor, and the doctor determines that we need a medication, a prescription is given to us. We then go to our local drug store and the pharmacist fills the prescription for us. Or, we use a mail order pharmacy, so we mail the prescription away to the mail order pharmacy and a pharmacist fills the prescription and mails it to us.

However, there are doctors that sell prescription medications in their offices. They are allowed to do so because their doctors license allows them to. So instead of giving you a piece of paper (the prescription), you get the medication itself.

The same situation exists in veterinarians offices with the exception that while doctors are used to giving prescriptions to patients to be filled at the drug store, veterinarians are used to having their customers buy from them.

When a vet examines a pet and makes the determination that a prescription medication is necessary to either prevent a disease (such as heartworm medication), treat a condition (such as thyroid medication) or cure a disease (such as antibiotics), the pet owner has the right to fill that prescription at the pharmacy of their choice. They do not have to buy the medication from the veterinarian.

What is meant by "the prescription"? Prescriptions can be written on paper. Prescriptions can be given over the telephone from the vets office to the pharmacy and prescriptions can be transmitted by fax from the vets office to the pharmacy. So when I say the vet should give you a prescription, it can be by either of those means. If you are at the vets office, ask for a written prescription. You can then mail it to us and our pharmacists will process it. Otherwise, we will gladly call or fax your vet in order to fill your prescription need.

Newly Released Medications - 1

The FDA has recently approved two new prescription medications for use in dogs. These products are Reconcile (fluoxetine) and Vetmedin (pimobendan). Let me discuss Reconcile today and I'll discuss Vetmedin next time.

Reconcile is the first SSRI (selective serotonin reuptake inhibitor) approved by the FDA for the treatment of separation anxiety in dogs in conjunction with a behavior modification program. Reconcile is a chewable, flavored tablet that is given once a day and is available in four tablet sizes (8, 16, 32, and 64mg) for convenient dosing. Data show that 42% of dogs receiving Reconcile and behavior modification showed improvement within 1 week. Within 8 weeks, 73% of dogs showed significant improvement when combined with behavior modification.

Symptoms of separation anxiety often go unnoticed by the pet owner, or may be misunderstood as bad behavior. Separation anxiety causes distress for the pet as well as the pet owner. Symptoms that may be associated with separation anxiety include: destruction, inappropriate elimination, vocalization (both loud and/or soft), licking, salivation, anorexia, pacing, and withdrawal.

Factors that are associated with an increased risk of separation anxiety include: traumatic separation, previous inexperience with isolation, excessive greetings or prolonged owner departures, abrupt changes to the owner's routines, relocation to a new home, exposure to a new pet sitter, and death in the family.

Reconcile reduces inappropriate behaviors, minimizes the pet's distress and increases receptiveness of the at home behavior modification program. Because the medication is given once a day, treating the pet is easier, less time consuming, and increases patient compliance.

The most common side effects include calmness or lethargy, reduced appetite, vomiting, shaking, diarrhea, restlessness, excessive vocalization, aggression and in infrequent cases, seizures.

If your veterinarinarian prescribes Reconcile, make sure you discuss with your veterinarian or pharmacist any other medications your pet may be taking before starting your pet on this medication.

Tick Borne Diseases (4)

My last three entries have been related to zoonotic disease. In this entry, I want to discuss Lyme disease, the last of the four major diseases that can be spread from animal to man with the tick as the vector.

Lyme disease, also known as borreliosis, is transmitted to animals by the common deer tick on the east coast of the United States, and by a closely related tick on the west coast. Ticks become infected by feeding on an animal already infected with the disease causing organism (Borrelia) and when these ticks become attached to a non-infected pet and feed, the disease is passed into that animal. Humans cannot get Lyme disease directly from their pet. However, if the pet develops the disease a tick can feed on and then pass the disease from the pet to the human if the human gets a tick bite.

Symptoms that can occur in dogs that may be indicative of Lyme disease include: fever, lameness, swelling in the joints, lethargy, and loss of appetite. Unlike in humans, the appearance of a rash or circular ring of redness around the tick bite does not occur in dogs. It should be said that it can take from 2 to 5 months from the time a pet is bitten by an infected tick for symptoms of Lyme disease to show. In untreated pets, or pets who did not respond well to treatment, symptoms of arthritis can occur, and in rare instances, kidney disease and/or failure can occur. Blood tests are available to aid in the diagnosis of Lyme disease but the presence of clinical signs and a rapid response to antibiotic therapy is usually diagnostic of Lyme disease.

Lyme disease is treated most often with the antibiotics doxycycline or amoxicillin. These medications are usually given for at least 14 days, but 30 days is the recommended treatment duration and in some instances a longer duration may be needed. Pets that do not respond to antibiotic therapy within 48 hours should be brought back to the veterinarian for further diagnosis, since response to antibiotic treatment of Lyme disease is rapid.

Using a product such as K9-Advantix or Frontline Plus will help kill ticks, and even if the tick should attach to the pet, the tick will die within approximately 12 hours. In order for a tick to pass on Lyme disease, it must be attached to the pet for at least 48 hours. These products should be applied once a month. There are also vaccines available for preventing Lyme disease. However, veterinarians are divided as to whether these vaccines are or are not effective. If you live in a heavily tick infested area you can discuss this option with your veterinarian.

For the health of your pet, the pharmacy staff at 1-800-PetMeds recommends apply a flea and tick preventative once a month. Because ticks can survive indoors even in the winter, these products should be used year round.

For further information of tick borne disease visit the Tick FAQs site on PetHealth101