Common Dispensing Errors: Practitioner Summary

Dispensing Errors in Veterinary Medicine

Therapeutic substitutions

Although switching from tablets to capsules or from brand to generic is perfectly acceptable (in some cases) in veterinary medicine, there are a few things to consider:
- Ensure that the substitution does not have an unintended impact on adherence and the human-animal bond. (ex., bigger size, inappropriate ingredient, bitter taste, etc)
- Ensure the prescribing veterinarian understands the allowance for substitution
Be aware of veterinary-only drugs of common drug classes in human medicine
- NSAIDS and fluroquinolones are commonly prescribed in both human and veterinary medicine but the drugs selected are completely different depending on the species.
- Example: carprofen should not be substituted for ibuprofen for a canine patient

Prescription Errors

Veterinary Terminology
- SID = once daily
- FS = female spayed
- MC = Male castrated
- Bolus = very large dose
Allometric dosing – weight based dosing (for the most part)

Medication	Error/Issues
Levothyroxine (most common medication error)	Dosed every 12 hours in veterinary medicine instead of every 24 hours Usually dosed in mg instead of mcg (canines have a much larger dose than humans)
Phenobarbital	Still see grain and gram errors “This dose is too high”
Trimethoprim/Sulfamethoxazole (Bactrim)	Referred to as “TMS” In veterinary medicine dose is based on combination strength
Amoxicillin/Clavulanate (Clavamox)	Dose is based on combination strength Clavamox: 4:1 ratio Augmentin shares a variety of ratios
Hydrocodone/Homatropine	May be written as just “Hydrocodone” Combination products with APAP may be dispensed instead which could cause toxicity issues
Insulin and Insulin Syringes	Inappropriate substitutions Serious and potentially life-threatening errors can occur if the wrong syringes are sold or dispensed with insulin (U-40 vs. U-100)

Common “look alike-sound alike” drugs in veterinary medicine