Errors in Veterinary Medications

The Center for Veterinary Medicine (CVM) recently released an updated report on medication errors for veterinary patients. Of course, that includes our horses. Medication errors can come about in a number of ways and cover a number of potential problems. 

The error might be that the wrong medication was dispensed. Illegible writing (no joke – it happens and that is why many veterinarians have now gone to digitally printed labels and prescriptions!), a tired pharmacist reading the form, two medications with similar names, etc. These are all potential accidents waiting to happen. Perhaps the correct medication is dispensed but at the wrong dosage. An overdose could lead to toxicity while an under dosing might render the medication ineffective.

The CVM tries to prevent some of these mistakes before they happen. Similar drug names may require a change to better differentiate drugs. A bottle of tablets must contain certain information even if the intent is to dispense portions at a time. That information includes strength, number of pills or capsules, expiration date, etc. Additional information is supplied on the container and the package insert. 

The insert might mention a method of administering the medication, potential side effects, antidotes if needed and situations where the drug would be appropriate to treat an animal. Medication labels need to be easy to read in both font, legibility and coloring. If you are purchasing a medication in bulk, the exact packaging may vary from brand to brand or with a generic vs a brand name version. The same information should be available however.

Luckily, medication errors in equine drugs aren’t too common. Compounding a drug (see Compounding Pharmacies, recent news) can add another layer of potential for mistakes (remember the polo ponies with a decimal point change in their selenium supplement that led to many deaths) but most horses get the proper medication at the proper dose. 

If you choose to use a human pharmacy, you will still need a veterinary prescription for your horse. By so doing, you are placing your trust in the hands of someone who may or may not be familiar with horses and veterinary health care. That puts more responsibility on YOU to be sure the medication, dosing, etc are correct. In general, we believe you are better off using an equine pharamcy or your own veterinarian’s pharmacy.

Your responsibility as an owner is to be sure you clearly understand:

  1. Why your horse is taking a certain medication, 
  2. Exactly how to dose it,
  3. Possible side effects, 
  4. And to dispense the full dose for the full length of time specified.

Sometimes directions are confusing. Should this pill be given at a dose of one pill twice a day or two pills once a day? Don’t guess. Ask your veterinarian so you give the correct amount at the correct time interval. Ask how to store a medication. If it says to refrigerate, be careful not to leave it out in a warm tack room.

For example, many probiotics left in a warm room become ineffective. Some liquid medications will settle out or become ineffective if they freeze, while others can be safely frozen. Vaccines need to be kept at the proper temperature or they lose their ability to create an immune response.

In addition, you should remember to:

1. Verify if a medication should be given with meals or in between.

2. Check expiration dates. If you use a medication past its expiration date you have no recourse if your horse has a reaction or if the medication does not work properly.

With a little care and some effort on your part, medication errors for your horse can be avoided.

Article by Debra M. Eldredge, DVM, Contributing Veterinary Editor.

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