EPISODE 5 | ALLERGIES
EPISODE 6 | PRESCRIPTION REFILL REQUEST
Practice Manager Holly walks us through the steps to follow when a customer requests that we fill a prescription.
Allergies in dogs manifest in different ways, the main way they manifest is through skin issues:
• Prednisone Vs Prednisolone: Cats: Typically like to treat them with Prednisolone. The reason being that there is a subset of cats that are unable to change Prednisone into its active form in the body called pregnisalin. Dogs: Can get either medication Please make sure to check the labels to make sure you are giving the correct medicine, especially to cats. These medicines cannot be stopped at anytime, you must wean off of them. • Apoquel and Cytopoint These medicines really changed the world of allergies for dogs. Important technology behind these medications found out is they are directed at a particular mediator of itch in the body called Interleukin-31. We know that causes itch in dog and is the main reason why dogs itch and lick with allergies. Apoquel: Pill and chewable form, dose it out as one pill 2X a day for about 2 weeks. Then go down to one pill once a day usually in the evening to help with nighttime itching. Minor side effects can be GI upset, but we rarely see that. It does have some immuno-suppressive effect, the reason we don’t like to stay on it at the higher dosing of twice a day is that long term, we could see immuno suppression. Apoquel can be stopped at anytime. Cytopoint is an injectable monoclonal antibody that is directed against Interleukin-31 which is the mediator of itch in the body. Very effective, a dose can last up to 6 weeks. Side effect profile on monoclonal antibodies is lower, the reason being is we are directing just against one element in the body. The reason you may give Apoquel more than Cytopoint is that Apoquel has more anti inflammatory characteristics so it brings down some of the inflammation, where Cytopoint would not. • Cefpodoxime is an antibiotic. A lot of dogs will get skin infections and allergies will be the underlying cause. So they get the allergy first, which causes inflammation, breaks the integrity of the skin, bacteria moves in, now they have a skin infection. If Apoquel or Cytopoint aren’t working there is a good chance there is an infection which needs to be treated with an antibiotic or an anti-yeast medication. Continue the full course of the antibiotic. • Ketoconazole is an anti-yeast medication. Yeast is also an infection that animals who have allergies may get. Many times yeast infections on the skin or in the ears are going to be secondary to the allergies. • Otomax is an ear medication. If a dog has chronic yeast infections or chronic ear infections, many times the underlying cause is allergies. The reason the ear infections keep coming back is the underlying cause is not being treated, which is the allergies. It is not because the medicine is not working. • Derm Complete is a food allergy prescription diet. If the animal has a food allergy, we are going to cure it by having them on a hypoallergenic diet. A hypoallergenic diet can come in different forms, sometimes it’s what’s called a hydrolyze diet, which means the molecules of the allergen are cut down into very small molecules and that the body can’t react to it. So you could have a dog who has a chicken allergy, but is on a diet with hydrolyzed chicken and they’re going to be fine. Then there are novel protein diets, meaning proteins they haven’t been exposed to before and doesn’t promote an allergy response. We carry Derm Complete, DD for both dogs and cats, ZD which is a hydrolyzed diet. These are called novel protein diets, we want them on the diet for about 6 to 8-weeks, not getting anything else except the diet.
Filling a prescription request
• Itching their skin • Licking their skin
• Pull up patient name on the Portal. Up in the corner across from their name is going to be a refill button. Click on Refill. If there are no refills: Make sure that you go to the doctor and make sure that refill _ is OK. A lot of the doctors will want to know who the patient is, why they are refilling, and was the medication they were on helping or not. If the doctor refills the prescription, he/she will put it in the Plan. • Go to the patient refills, click on the particular medication, then click on “Record and go to plan” This will put the refill into the plan for you. If they were here picking it up, you can put it in the cart and then print the label for the technicians in the back. • To send the prescription to the technicians in the pharmacy: Click on your medication and then click on the small printer icon (the one on the top). This will pull up an image of the label. Then you will print it from the printer icon in the upper right corner, use the printer drop down menu to make sure you are printing it to the DYMO LabelWriter. This will send the prescription label to the back so technicians can fill it for you.
80% of allergies are environmental, something in the air causing the allergies and triggering
an allergy in the dog 20% food allergies
Steroid medications are super effective anti-itch medications and anti- inflammatories so they are very effective against allergies. Side effects of steroids: • Drinking more water
• Urinating more • Panting more • Higher food drive
If you cannot find the prescription up front in the box
• Come back to the pharmacy. If the prescription is sitting here, you can take it as long as there are two initials on the label. • If there are not two initials , you’re going to find a technician and make sure that they check you and put those two initials on that label. Once the initials are on it you can take the prescription upfront to the owner. Controlled substances • Controlled substances are kept in the lock box. You will need to find Holly, Dr. Sam or any of the surgery technicians to come over to the lock box and put in the code. As they take the medication out of the lock box they will check it to make sure it is the correct medication being dispensed.
Steroids are the main medication to treat allergies in dogs. Cats can tolerate steroids better than dogs, so they do not suffer many of the side effects. Food Allergies The good news about a food allergy is that if a pet has it, it is something that can potentially cured because you can put them on Derm Complete and all of their allergy signs go away. Unfortunately 80% of the time there’s an environmental component.
Golden Paws Animal Hospital | Pharmacy Education
Golden Paws Animal Hospital | Pharmacy Education
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