ANSWERS

1. Prescription Only Medicines (POMs) are subject to strict regulations regarding their supply and storage. Who may supply POMs?
   • Veterinary surgeons.
   • Doctors.
   • Pharmacists against a prescription written and signed by a veterinary surgeon or doctor.
2. What are the 2 subgroups of the POM drug category?
   • Controlled Drugs (CDs) - further information on controlled drugs is provided in a later module).
   • General POM Drugs.
3. Pharmacy Only Medicines are less stringently regulated than POMs; list the 3 subgroups of this drug category and describe who may supply them.
   • General P Medicines - these may be sold over the counter by a pharmacist to the public or supplied by a veterinary surgeon to animals under his/her care.
   • Pharmacy Merchant's List Medicines (PMLs) - these may be sold by registered pharmacists, veterinary surgeons to animals under his/her care and agricultural merchants registered with the Royal Pharmaceutical Society to customers whose business involves animals.
   • Saddler's List Medicines (also PMLs) - anthelmintics (wormers) that may be sold by saddlers registered with the Royal Pharmaceutical Society to horse owners.
4. General Sales List Medicines (GSLs) may be sold by veterinary practices, pharmacies and pet shops without special regulation. Why?
   GSLs do not pose a significant health risk and therefore are not subject to such strict regulations regarding their sale.
5. A client asks you to supply a course of antibiotics for his cat who has a cut pad. The cat is registered with your practice but has never been prescribed antibiotics before. Describe your course of action.
   • Ask the client his name, address and cat's name.
   • Access the cat's medical history.
   • Explain that since antibiotics are Prescription Only Medicines it will be necessary (by law) for the veterinary surgeon to examine the cat and suggest that an appointment is made.
6. The client in Q5 is reluctant to bring the cat to the surgery. He asks what law governs the sale of antibiotics. What would you tell him?
   That the Medicines Act 1968 must be complied with, and that the purpose of this act is to prevent the sale of medicinal products to the public without sufficient professional advice.
7. The client in Q5 & 6 is still not convinced that an appointment is in either his or his cat's best interest! What other common sense advice regarding the dispensing of drugs could you proffer to win him round?
   • Advise that the vet would need to see the cat to obtain an accurate and up to date weight in order to calculate the drug dose.
   • Explain that there is a wide range of veterinary antibiotics available and the vet would only be able to supply the most appropriate medication having examined the extent of the injuries.
   • Warn the client that some antibiotics have been known to cause adverse reactions and that it would be negligent to supply them without adequate professional advice.
8. A client requests a repeat prescription of non-steroidal anti-inflammatory tablets for Gus, her dog with arthritis. The veterinary surgeon examined the dog only one month before and the medication is having the desired effect. The vet subsequently advises that you may dispense a further supply of tablets. However, when the client arrives to collect the medication, she is horrified to discover that the price has increased. She says "I can buy Ibuprofen at the chemist for half that price! Can't I use that instead?" What is your reply and why?
   You explain that the tablets provided by the veterinary surgeon are Prescription Only Medicine licensed for use in dogs. This means that the drug has been thoroughly tested and is safe and efficacious for use in canines. The human preparation will have been tested for safety in humans but not dogs and therefore could have side effects that may prove harmful to Gus. It would also be wise to mention that the therapeutic index in dogs (see Module 1) may be lower than in humans. In addition, accurate dosing instructions appropriate for dogs will not be known. The purchase of human drugs for pets falls foul of the Cascade System if veterinary brands are available, and indeed certain preparations containing Ibuprofen such as Nurofen can have fatal consequences if given to dogs.