Protecting animal health and welfare. It’s a key phrase in the veterinary oath, one that veterinary students make upon graduation and both new and experienced veterinarians carry with them throughout their careers. From routine check ups to complex care, ensuring the health and welfare of animal patients is top on the list of priorities. Often, ensuring that health and welfare requires prescribing medications, an area where pet owners place high value on veterinarians. In fact, pet owners consider veterinarians to be the most trusted provider of medications, a trust that can erode if they aren’t dispensed and administered safely. It’s one reason why medication and pharmacy labels are so important. They play a critical role in preventing medication errors, ensuring compliance with regulatory standards, and streamlining pharmacy operations.

Understanding the Importance of Medication and Pharmacy Labels

How many different pieces of information can you juggle in your mind at the same time? Numerous studies suggest that it’s no more than seven. It’s well known that Steve Jobs was so obsessed with his focus on only the most important topics, he became famous for always wearing the same black turtleneck each day. Why? It reduced his decision fatigue.

If you are filling a vial and treating a single pet, you might get by without labeling a syringe or vial. But working memory can only take you so far. A label eliminates decision fatigue and provides the details necessary for administering medications effectively. For veterinary practices, accurate labeling is crucial for patient safety, regulatory compliance, and an efficient operation. Veterinary pharmacy labels provide vital information that ensures medications are used correctly and safely.

Further, veterinary practices face unique challenges when managing pet medications. One significant issue is the potential for confusion between human and pet medications. Many drugs are used in both fields but require different dosages and handling instructions. Proper labeling helps mitigate these risks by providing clear, specific information tailored to veterinary needs.

Why Medication Labels Matter in Veterinary Practices

“What we have here is a failure to communicate.” That’s a line from the movie Cool Hand Luke and is considered one of the best movie quotes of all time. It reflects a breakdown in communication and the inability to effectively convey messages or intentions, leading to misunderstandings. Although Cool Hand Luke is about interactions between a prisoner and the prison warden, it’s not the only setting where breakdowns occur. In fact, communication breakdowns are the most common cause of medication errors in veterinary practices. Dosing mistakes, administration of the wrong drug and administration at the wrong time are the most common problems².

Labels play a vital role in ensuring clear and accurate communication within a veterinary practice.

Patient Safety

Proper labeling is a frontline defense against dosing errors. Surprisingly, illegible handwritten prescriptions are still a widely recognized cause. This includes insufficient or missing information about co-prescribed medications, past dose-response relationships, laboratory values and allergic sensitivities. With clear, precise labels, veterinary staff can ensure that the correct medication is administered to the right patient at the appropriate dosage.

In addition, although look-alike, sound-alike drugs are widely publicized, their similarities still contribute to error rates. Using labels that clearly mark the drug name and alert the staff to those that look or sound similar is one way to minimize this problem.

Compliance with Regulations

Labels also help veterinary practices comply with various regulatory requirements. These include guidelines related to drug storage, handling, and dispensing. Adhering to these regulations is critical for maintaining the practice’s license, avoiding legal issues and enhancing medication safety in veterinary practices.

Streamlining Pharmacy Operations

Well-designed labels can significantly improve workflow efficiency. They reduce the time spent on medication management by making it easier to identify and handle drugs. This not only decreases the likelihood of errors but also enhances overall operational efficiency.

Challenges With Pet and Human Medications in Veterinary Pharmacies

Prescribing drugs and pet medication management has its complexities. Here are a few of the challenges:

Dispensing Challenges

National Provider Identifier (NPI) standards is a unique identifier number for healthcare providers that enables quicker and more effective electronic transmission of health information. Unfortunately, quick and more effective doesn’t apply to the veterinary side of the equation. Veterinarians don’t have NPI numbers which can create issues with pharmacy computer systems designed to work best with NPI/DEA numbers. Veterinary practices that prescribe controlled substances do have a DEA number which streamlines the process, but it’s unlikely for practices that don’t prescribe controlled substances to retain a DEA number because of the high costs.

The lack of integration between veterinary practice management systems and DEA-compliant electronic prescribing systems can complicate the dispensing process.

Medication Differences

Another challenge for veterinary pharmacies is the difference between human and pet medications. Some human medications contain inactive ingredients that can be toxic to animals. For example, xylazine is toxic to dogs, and benzyl alcohol can be harmful to cats, even though small amounts might be safe. Dosing differences are also notable. For instance, the doses of levothyroxine, phenobarbital, and terbinafine used in dogs are much larger than standard human doses.

Discrepancies like these highlight the importance of pharmacists verifying veterinary-specific doses to ensure accurate medication administration.

Collaboration and Staff Education

Some medications prescribed for pets and ordered through a retail pharmacy aren’t covered in pharmacy school and may not have comparable human versions. This makes collaboration between veterinarians and veterinary pharmacists essential to ensure accurate dosing, prevent adverse reactions, and maintain compliance with prescribed treatment regimens. This partnership helps tailor medications to the specific needs of animal patients, enhancing safety and efficacy.

In addition, differences in terminology and common practices between human and veterinary medicine, such as the abbreviations for once-daily dosing (QD in human medicine vs. SID in veterinary medicine), can lead to confusion. Educating veterinary staff is crucial to address the unique characteristics of veterinary medication management.

Best Practices for Veterinary Medication Labeling

Although there are a number of different medication errors that can occur, as noted above, the most common are:

• Dosing mistakes
• Administering the wrong drug
• Administering a drug at the wrong time

These are steps you can take to minimize these issues.

Label Design and Information

Dosing mistakes often start with prescription labels. To prevent error, ensure the prescription label contains the necessary information that corresponds with the medication in the prescription bottle. Whether the information is preprinted or computer-generated, the label should contain seven distinct categories ranging from the veterinary practice name and contact info to directions on how to use the medication. It’s also important to apply medication instruction labels to the container. They emphasize important directions such as when to take the medication or precautions that need to be followed when using the medication.

In addition, anesthesias like Propofol, Alfaxalone, and Carprofen, which are commonly used in veterinary practices, should contain labels that provide an area for indicating quantity and volume. Plus, they should conform to the nationally recognized color coding ASTM standard. This labeling practice is especially important when look-alike, sound-alike drugs are involved.

Also, implement these design steps:

• Even though compliance standards mandate preprinted or computer-generated labels, poor writing is still a common cause of errors. Use desktop printers with label formats built for veterinary practices like DYMO or Zebra.
• Minimize the use of medical abbreviations. Although they may save time, abbreviations are a common driver of veterinary medication errors.
• Eliminate the use of leading and trailing zeros. Eliminating extra zeroes (like 5.0 mg) helps prevent pet owners from dispensing 5 mg of a medication incorrectly remembering it as "50 mg”.
• When calling in or writing out a human drug prescription for animals, verbally state or write out the entire prescription. This assists pharmacists who are unfamiliar with veterinary abbreviations.
• Difficult-to-read fill lines for syringes and other medication dispensing devices can elevate inaccuracies. Fill line labels aid in the accurate drawing of medications.

Integration of Digital Tools with Labeling Systems

Many veterinary practices use practice management software to automate various parts of their business including the pharmacy. These systems automate previously manual tasks including printing out a prescription. There are various prescription label formats you can select from that allow you to print the prescription label that best fits your needs.

In addition, an electronic system enables better pet medication management. It can house a complete list of a pet’s drugs and track all prescription information, including renewals and refills. Compiling this information in one system reduces the risk of drug interactions and helps to avoid an adverse drug event (ADE).

Regulatory Considerations and Label Compliance

Veterinary practices are governed by a number of different agencies. This includes the State Board of Pharmacy, State Board of Veterinary Medicine, applicable federal regulations including FDA's Extralabel Drug Use Rules, and more. Here are a few of the rules that veterinary pharmacy labels help practices adhere to.

Extralabel Drug Use Rules

An extralabel is required when an FDA-approved drug is used in a way that differs from the instructions on the label. These are the specific steps the FDA requires¹:

Any human or animal drug prescribed and dispensed for extralabel use by a veterinarian or dispensed by a pharmacist on the order of a veterinarian shall bear or be accompanied by labeling information adequate to assure the safe and proper use of the product. Such information shall include the following:

• The name and address of the prescribing veterinarian. If the drug is dispensed by a pharmacy on the order of a veterinarian, the labeling shall include the name of the prescribing veterinarian and the name and address of the dispensing pharmacy, and may include the address of the prescribing veterinarian;
• The established name of the drug or, if formulated from more than one active ingredient, the established name of each ingredient;
• Any directions for use specified by the veterinarian, including the class/species or identification of the animal or herd, flock, pen, lot, or other group of animals being treated, in which the drug is intended to be used; the dosage, frequency, and route of administration; and the duration of therapy;
• Any cautionary statements; and
• The veterinarian's specified withdrawal, withholding, or discard time for meat, milk, eggs, or any other food that might be derived from the treated animal or animals³.

AAHA Standards of Accreditation

In addition, AAHA-accredited veterinary practices have numerous standards that mandate the use of veterinary pharmacy labels. For example:

All medication containers utilized within the practice are labeled with:

• Name of medication
• Concentration
• Expiration date

All prefilled syringes utilized in the practice are labeled with the name of the medication.

When dispensing medication, each label

• Is computer printed or typed
• Is securely affixed to the container

Each label contains the following information:

• Client’s name
• Patient’s name
• Date
• Name of medication
• Strength of medication
• Route of administration such as by mouth, in the ears, etc.
• Dosage
• Quantity or volume dispensed

Medication containers include appropriate warning labels.

Partnering With United Ad Label

Medication and pharmacy labels play a critical role in veterinary practices. They ensure patient safety, regulatory compliance, and operational efficiency. By implementing best practices and partnering with experts like United Ad Label, veterinary practices can optimize their medication management and provide the highest level of care to their animal patients. Visit us online or contact us to learn more.