Vet Meds for Human Use?

[akfanatic]

Wondering if anyone has any info on the use of veterinary medications in humans?
By this I mean concentration, dosages etc…

I have not been able to find any good info floating around but with the cost of meds being what they are and the availability of vet meds and pricing…

Here is a good example…
http://www.1800petmeds.com/pdetail.asp?SK=10246&SP=dog&MG=25&PT=4

100x 25mg for 6bucks!! :eek:


I’m thinking more along the lines of anti-inflammatory, antibiotics etc…

Any input?

[Dr. X]

I learned about this when I worked at the Humane Society. The manager was always giving us anti-inflammatorys, antibiotics, etc., from the stock used for the animals. According to her the ingredients are the same as the ones used for humans, the big difference is the cost. The antibiotics I used killed an abcessed tooth infection without having to visit the dentist, and I could tell no difference...:cool:

as ever,
Dr. X

[HottAK47]

I was planning to raise this same topic myself. I am a Blacksmith/Farrier that has been involved in the horse business for over 40 years and I have used and seen used a BUNCH of animal medicine. How dangerous it is I dont know. But I aint dead yet. I would love to have some input on this subject from some of our members with a more formal medical education.

Will post more experiences and anecdotes on this subject when I have more time but for the mean time will post this link:

http://aquaticpath.umd.edu/news/#anchor14215930

[DrBaboon]

I have heard 3 factors that make veterinary medications attractive for consideration:

1) An assumption that animal medicines are cheaper.

2) Perceived or actual ease of getting them.

3) Coming across a supply of veterinary medicines when you don't have human medicines available.

Leaving aside safety questions - at least for now...

And leaving aside 2) and 3) for now - let's consider 1)

The PetMed site that was originally linked goes to the page for veterinary diphenhydramine 25mg 100 minitabs, with a price of $5.99.

I made a couple "secret shopper" stops today, just for fun.

A nearby Walgreen's had their house brand/generic diphenhydramine 25mg at $5.99 for 48, but $12.99 for 200.

At those prices, the PetMed price is a little lower (by about $0.50 per 100) than the Walgreen's price, but you still have to pay shipping, which will cost more than 50 cents.

Since Jonas Parker has been posting about Walmart's EQUATE house brand, I checked Walmart, too.

The EQUATE prices were $2.74 for 24 doses, but $3.44 for 100 doses.

These are all the same 25mg doses, so we're comparing the same dose size, whether at PetMed, Walgreen's or Walmart.

So EQUATE beat the PetMed price by $2.55 per 100, and you don't need to pay for shipping.

I didn't go wild looking for other veterinary medicine sites, so feel free to comparison shop.

Maybe veterinary meds are *sufficiently* cheaper some of the time, but that's going to be on a case by case basis, depending on the medication.

FWIW -- I didn't take notes, but a good many of the prices for other drugs on the PetMed site seemed to be similar to the retail prices of human medications.

My impression is that that veterinary medications have become their own revenue source, and it's not possible to assume they are automatically cheaper.

How much cheaper do they have to be?

That's for the buyer to decide (assuming cost is the only consideration).

In my book, if you don't save enough money in one purchase to buy a pizza, you really haven't saved much money.

So far, I haven't seen pizza-sized-price differences in what I've looked at.

Maybe there are some meds or some circumstances where it's a large price difference, I just haven't seen it yet.


Question B -- if we keep the discussion to diphenhydramine, do you really need diphenhydramine, or do you want loratidine?

EQUATE loratidine 10mg goes for: 30 tabs @ $6.27 or 60 tabs for $11.44.

3 or 4 25mg diphenhydramine tabs/caps is one day's dose. 10mg loratidine is one day's dose.

My point is that 10mg loratidine is not *that* much more expensive than a comparable amount of diphenhydramine.

Are there some uses of diphenhydramine for which you wouldn't use loratidine? Sure.

OTOH - if you don't want to impair people with the sedating properties of diphenhydramine, would loratidine be a reasonable choice?

[DrBaboon]

BTW, Walmart's recent pharmaceutical marketing splash is now up to the 4th page of medications:

http://i.walmart.com/i/if/hmp/fusion/genericdruglist.pdf

They are marketing a 30 day supply (or in some cases, a shorter course of medication where it normally is some set period of time) for $4.

This may also change the discussion of some medication costs beyond the veterinary medication question.

It also leaves open discussion of a wider variety of antibiotics.

[akfanatic]

Wondering if anyone has any info on the use of veterinary medications in humans?
By this I mean concentration, dosages etc…

I have not been able to find any good info floating around but with the cost of meds being what they are and the availability of vet meds and pricing…

Here is a good example…
http://www.1800petmeds.com/pdetail.asp?SK=10246&SP=dog&MG=25&PT=4

100x 25mg for 6bucks!! :eek:


I’m thinking more along the lines of anti-inflammatory, antibiotics etc…

Any input?

OK. Perhaps diphenhydramine was a BAD EXAMPLE as it has gotten us off the original intent of the thread (thanks for the input though...) which was dosing etc...

[DrBaboon]

the original intent of the thread (thanks for the input though...) which was dosing etc...

Do you have a particular drug in mind (by name)? Or perhaps a few drugs?

Dosing is still going to be done by the same measurements. 25mg of a product is still going to be 25mg of that generic medication. A gram of a parenteral antibiotic is still going to be a gram of that drug.

IOW - the diphenhydramine products above all came in 25mg unit doses, but the PetMed site indicated the veterinary dose:

"The usual dose in dogs and cats is 0.5-2mg/pound by mouth every 8 to 12 hours."

That's really on the high side for adult people. Adult dosing is typically 25-50mg 3-4 times per day. Pediatric dosing is given here:

http://www.rxlist.com/cgi/generic/dihydram_ids.htm

But it's still not a challenge to dose it as you would for people, as the product comes in the same size pill.


TRIVIA QUESTION: Why would the adult human dose appear to be lower than the veterinary or pediatric doses?


So if you're asking if the correct dose for people would change just because it's a different product but the same generic, probably not. If you're asking if human doses might differ from animal doses, they might, depending on the product.

Rather than try to come up with a list of human doses here, it's already widely available. PDR or other sources, printed on paper or on-line.

Everyone has a medication reference available, don't you?



The bigger *theoretical* problem would possibly come up if you had in mind to use a veterinary medication that is not used as a human medication. IOW - there would not already be human dosing available.

Realistically, that's not going to happen in every day patient care, and I don't have an easy example to give you. Obviously, I don't go out of my way to try out veterinary medications on my patients. My sense is that there are far more anit-parasite and anti-worm medications used in animals than there are for humans, and that would be the area I would assume someone might encounter a veterinary medication without an established human dose.



Why don't you mention which anti-inflammatories or antibiotics you had in mind.


If you're looking for NSAIDs - they're readily available, often OTC, at bulk prices.

If you are thinking of oral or topical corticosteroids, topical hydrocortisone is readily available OTC, and prednisone is dirt cheap even if it's Rx.



I share the same concerns about veterinary antibiotic use leading to more widespread bacterial resistance as was mentioned in the article HottAK47 provided.

IOW - if a veterinary antibiotic is in widespread use in your area, you might not have as much of a chance of successfully treating infections with that same antibiotic as you might have had if it were not in widespread use. The same often goes for classes of antibiotics - even more so with quinolones.

You would need more information - such as the antibiogram that I mentioned in another thread - in order to have an idea of whether you would have much likelyhood of success with using a particular antibiotic or class on particular human infections.



Again - we've set aside safety discussions - so far.

Why might there be safety concerns in human use with the same veterinary generic drug?

The obvious answer is that there are sometimes different additives or ingredients to make it into a pill.

For example - at least one of the antibiotics on the PetMed site is dyed brown and has flavoring to make it taste like meat.


We already have some situations with human medications where people have allergic reactions or other problems with dyes or additives or preservatives in medications.

So without testing and data gathering, it would be unknown territory to give people veterinary products.


Is it still worth giving humans veterinary products? That's for you to decide. It's a risk-benefit consideration, as is everything else in patient care.

[Jonas Parker]

Seems to me the best source for a stash of prescription antibiotics is my friendly family doctor. I've never had a problem yet in getting a prescription for antibiotics. The doctor knows that those drugs are to be used in emergencies, and has even suggested which drugs to stock.

[Jim West]

Interesting thread. Ive worked at veterinary clinic. Some of the medications were pediatric meds. Mostly antibotics. When I have to give oral antibiotics to my cats its always either bubble gum or tapioca flavored. Jim

[akfanatic]

Finally back online.
Lots of replies.

The problem with me is that most of the time I am online is the same time I SHOULD be sleeping (like right now...) so bare with me.

Many thanks to DrBaboon-

Do you have a particular drug in mind (by name)? Or perhaps a few drugs?
Not really; just wanted to rattle everyones collective cages and see what I could gather.

That's really on the high side for adult people. Adult dosing is typically 25-50mg 3-4 times per day. Pediatric dosing is given here:

http://www.rxlist.com/cgi/generic/dihydram_ids.htm
Good website...

TRIVIA QUESTION: Why would the adult human dose appear to be lower than the veterinary or pediatric doses?
Can you ask again after I've had a few shots of Vodka?

Why might there be safety concerns in human use with the same veterinary generic drug?
The obvious answer is that there are sometimes different additives or ingredients to make it into a pill.
For example - at least one of the antibiotics on the PetMed site is dyed brown and has flavoring to make it taste like meat.
We already have some situations with human medications where people have allergic reactions or other problems with dyes or additives or preservatives in medications.
This is one of the concerns I had that I was hoping someone would address...
What is commonly found in general use etc...

Here is the big one...
Coming across a supply of veterinary medicines when you don't have human medicines available.
I have never spent time at a vet office, pet supply shop or a feed store and so have little knowledge of what is commonly available or what the quality of the items are...

Interesting thread. Ive worked at veterinary clinic. Some of the medications were pediatric meds. Mostly antibotics. When I have to give oral antibiotics to my cats its always either bubble gum or tapioca flavored. Jim

I learned about this when I worked at the Humane Society. The manager was always giving us anti-inflammatorys, antibiotics, etc., from the stock used for the animals. According to her the ingredients are the same as the ones used for humans, the big difference is the cost. The antibiotics I used killed an abcessed tooth infection without having to visit the dentist, and I could tell no difference...

Has anyone else spent any time with our quadraped friends?

Thanks for all the input guys...

[HottAK47]

I have been shoeing horses for a living for 40 years so , yeah, you might say I got some experience with four leggers. We also have what our small spirited town councel choses to discribe as a "puppy mill" . It seems like I spend most of my time in feed stores and Vet offices and pet supply stores.

One drug I use and see commonly used is an antinflamitory called Banemine. It comes in injectable and powder form and it just flat ass works . Acording to the maker it has 10 times the anelgesic power of Codene with NO narcotic effects. In the words of a buddy of mine"Banemine will make even a dead horse feel better". I also have never found a better cure for a hangover.

Will post more later, I got to go wrestle horses for a while.

[DrBaboon]

It's important that members are able to follow along, particularly when some of the material involves details or technical material.

I'd like to encourage members to provide references/links where appropriate and if it's possible to do so:

The equine drug in question is banamine: http://sploughus.naccvp.com/view.php?prodnum=1047018&u=country&p=msds

Keep in mind that the pharmacokinetics and other information is species specific, so it may or may not be that close to human data if there were any.

I am sidestepping the question of whether this is a good idea for use in people, other than to ask if banamine is a Rx item (NSAID or COX-2), why not get injectable ketorolac as a Rx instead, which is used for humans, and is also a NSAID? The cost isn't significantly different, and each are Rx items anyhow.

There is some material that turns up searching on "flunixin human":

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8406686&dopt=Abstract

http://www.ams.usda.gov/nop/NationalList/TAPReviews/Flunixin.pdf

http://www.ams.usda.gov/nop/NationalList/Flunixinsupplement.pdf

BTW - it appears that most of the material I can find has to do with whether flunixin in meat is a problem for human consumption, vs. whether there's a problem with flunixin in cow milk that ends up consumed by people.

Anyone clear on the reasons why flunixin is approved for dairy cattle, but not dry dairy cows or veal calves? If the issue is milk, I would have thought it would have been the other way around?

[HottAK47]

Thanks for correcting my spelling, Doc, I knew Banamine didnt look right. I have been told (by a Vet who takes it himself) that Banamine was a specific for humans in Europe but that it was never researched for people in America because of the cost and the fact that there were already so many pain relievers in use here. This is purly anectdotal but the Vet was a pretty smart guy and the best Equine colic specialist I was ever priviliged to work with.

Also it is easy to obtain, most of the barns and boarding stables I work at have a jug or two of it laying around. I dunno just where I would get the stuff you mentioned.

Thank you for your input, this was the kind of information I was looking for.

NOW, what can you tell me about the Equine seditives Ace Promizine, Rompin and Dormosedan? In my experience the "Ace" seems to affect horses much as Valium. The Rompin is a lot stronger, I'm thinking sorta like Thorazine and the Dermosedan is the best horse tranqilizer I have ever used. When I give them 1/2 to 1 CC IV they just really mellow out and dont seem all ""doped up" and put all their weight on me. A 1200 pound drunk isnt easy to wrestle with. The only human I know of that has ever taken Dormosedan ( and she was REALLY a space case) stated that after taking it she "could hear me and my wife knocking on the door and talking but wasnt able to rise from her bed"

These three seditives ALL mention that "sudden death" may be a side effect. Is this common with all drugs of this sort? I surely wouldnt take any of these eccept in case of emergency but if I was in a situation where my wife was sawing my leg off with a hacksaw I belive I would be willing to try any or all of them to take the edge off the experience.

Thanks again and I hope I spelled everything right

[DrBaboon]

...Equine colic...

Keep in mind that equine colic isn't quite the same thing as it is in people, even though there are similarities. It's a more serious condition in horses.

Because I mentioned things like "COX-2" above, and it was already a lengthy post, I feel the need to point out that I am "leaving breadcrumbs" in what I post.

IOW - if people think I am already being too detailed or using too many fancy words, I would only clutter things up a lot more by getting into an explanation of "COX-2" above.

However, I strongly encourage people to perform searches on terms that are not familiar to them, or ask for clarification here - possibly as a new thread.

Since COX-2 agents have been in the news, and since attorneys are advertising to sue drug makers "if you had a heart attack or stroke because of being prescribed COX-2 agents," I am hopeful there is at least some familiarity among members that these drugs exist.

So what I ended up saying gently, was that BANAMINE would likely have pretty much the same risks in humans that COX-2 agents and NSAIDs have.

The only advantage you might have in using banamine is your own access to it.

Also it is easy to obtain, most of the barns and boarding stables I work at have a jug or two of it laying around. I dunno just where I would get the stuff you mentioned.

Yeah - that's the advantage for you. OTOH - I would have very little idea of how and where to find the drugs you have mentioned.


I don't see any advantage in whether it's a Rx item (it is), safety or benefit. Cost comparison? I don't know the veterinary medication costs. But an injectable human NSAID, such as brand TORADOL (generic ketorolac) is not very expensive - particularly the generic.


OK - so much for BANAMINE.

I'm not really cranky about what you've posted (I can't tell what you or anyone else might "hear" by reading what I've posted). But I am going to use it as an "excuse" to go deeper, and say some things that I think need to be discussed. Like the Godfather said - "It's nothing personal" - so don't take it that way. So thanks for (unintentionally) setting me up for these discussions - it needs to happen.


GENERAL PRINCIPLES

Some of the difficulties in having this kind of a discussion, is that I could give an answer that is 1 or 2 sentences long, and it would convey zero information. It would also please people who agree with what I might say, and confirm how much of an "idiot" I am to people who disagree with whatever I might say.

Unfortunately, I don't think that giving a "do this" or "don't do this" answer, or "do it this way" will be helpful for many (if not most) questions.

Like it or not, there is a learning curve for healthcare, and it is often steep. It means learning vocabulary. It means learning physiology, pharmacology, pathology, anatomy, etc.

If people think I am tossing stuff out just to use big words or anything else, I really am not. I am giving people credit for being motivated to learn and having the wherewithal to figure this stuff out.

IOW - if members will put the time and effort into it - I will do my best to help them learn.

Big words are simply time savers. They say in one word what takes a whole sentence to say. Learning those words also gives people the keys to reading and learning far beyond their current comfort zone.

While it's possible to have SMO's (standard medical orders) for common, repeatedly encountered situations that a First Responder might encounter, those SMO's are good for initial care NO MATTER if something else is going on.

The problem any of us face with prolonged care of patients in austere circumstances is that we have to recognize subtleties that we don't consider in the first hour of care. Patients become less and less alike, even with the same conditions, the more time goes on.

IOW - sooner or later, any of us involved in rendering care to patients, end up needing to substantially increase our knowledge and skills. That's true for other members - it's also true for me. I don't do orthopedic surgery for a living. And yet I might need to increase the scope of my practice if there were no one else available.


Equine seditives

Ace Promizine
http://www.wedgewoodpharmacy.com/monographs/AcepromazineMaleate.asp
It's Acepromazine

Rompin
It's Rompun
http://www.animalhealth.bayerhealthcare.com/491.0.html?&tx_bahprdmx_pi1%5BshowUid%5D=32&cHash=a947eb9406
http://www.rompun.vision-concept.com/horses/horses.php

Dormosedan
http://www.pfizerah.com/product_overview.asp?drug=DS&country=US&lang=EN&species=EQ

NOTE its generic name -- detomidine hydrochloride -- this in important in the discussion below.

In my experience the "Ace" seems to affect horses much as Valium.

I can't argue with what you've observed, or how things seem. But it's not something I'd expect from knowing the drug families to which those agents belong.

Acepromazine is a phenothiazine, so compared to what you observe below, it's actually in the same family as thorazine.

Thorazine is a brand name for chlorpromazine:

http://en.wikipedia.org/wiki/Chlorpromazine

Valium (diazepam) is a benzodiazepine. It has some similar effects (sedation, relief of dizziness/nausea), but works in completely different ways (pharmacology, physiology), and they have a range of different intended or unintended effects as a result of the differences in the 2 medication classes.

The Rompin is a lot stronger, I'm thinking sorta like Thorazine and the Dermosedan is the best horse tranqilizer I have ever used.

ROMPUN and DORMOSEDAN are actually related pharmacologically to each other - they are "alpha-2 agonists."

Bread Crumbs (gotta leave bread crumbs, even if the birds eat them like happened to Hansel & Gretel)...

http://www.anaesthetist.com/anaes/drugs/Findex.htm#alpha2.htm

http://www.anaesthetist.com/anaes/patient/ans/Findex.htm#nadr.htm

These outline catecholamine receptor types, including the alpha-2's, and AGONISTS (stimulate whatever is connected to that receptor) or ANTAGONISTS (reduce or block whatever is connected to that receptor).

IOW - an alpha-2 agonist augments/stimulates what is controlled/linked to the alpha-2 catecholamine receptors.


The only human I know of that has ever taken Dormosedan ( and she was REALLY a space case) stated that after taking it she "could hear me and my wife knocking on the door and talking but wasnt able to rise from her bed"

OK - remember where I said that knowing the generic name for DORMOSEDAN (detomidine hydrochloride) was important?

In the US, there are 2 alpha-2 agonists available for human use.

Clonidine has been around for ages, and is mainly used orally and by transdermal patch for control of hypertension, and to some extent, in the control of chronic pain.

http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202152.html

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682243.html

http://www.spineuniverse.com/displayarticle.php/article1614.html

Get ready - here it comes...

The other alpha-2 agonist in the US is dexmedetomidine

http://www.eurosiva.org/Archive/Goteborg/Abstracts/Aantaa.htm

I ran across a Continuing Education program on Dexmedetomidine a couple years ago. It mainly focused on giving the drug IV for pain relief in sedated Intensive Care patients who were on mechanical ventilators.

The reason this is attractive, is that there is LESS depression of breathing, so it is less of an interferance in getting people off of ventilators. It doesn't eliminate the problem of respiratory depression, it reduces it.

The purchase price for Dexmedetomidine is steep - I have been told it's about $225 for 50ml, which converts to be about 6 hours worth of dosing.

That's what's making it rarely used in humans. I have yet to see it actually given in the ICU to patients.

So what's to learn about these drugs?

The pharmacology/physiology is the main thing to learn.

None of us can put this stuff into use if we don't get a basic idea of what it is and what it might do, how it works (to whatever extent we have information to understand it).

FWIW - the alpha-adrenergic portion of how pain is sensed/transmitted/perceived is a whole additional layer of how the body works, and is a pretty advanced topic for physicians.

Your description of what your friend's sedation experience was like seems to match pretty well with what people have seen in ICU patients on ventilators. Depending on dose administered/degree of sedation, ICU patients have been able to do some things while sedated - such as have a meaningful neurologic examination.

These three seditives ALL mention that "sudden death" may be a side effect. Is this common with all drugs of this sort? I surely wouldnt take any of these eccept in case of emergency but if I was in a situation where my wife was sawing my leg off with a hacksaw I belive I would be willing to try any or all of them to take the edge off the experience.

That's where you've got to look at the physiology/pharmacology, and anticipate the situations where those risks are higher and see if there's a way to reduce those risks.

Funny thing - you've considered a REALLY advanced idea for how you would have your wife amputate your leg... The reason you've considered that plan is your experience and what things you have access to.

I'm not sure a people doctor would rush to do that, at least not yet.

For cost and availability, my initial thought would be using ordinary lidocaine.

Depending on what other tools I have available, I could give spinal anesthesia, epidural anesthesia, local anesthesia or a plexus block or some other nerve block, or I could even give INTRAVENOUS REGIONAL anesthesia.

A less-trained person would probably stick to local anesthetia or INTRAVEOUS REGIONAL techniques.

I would also think the monitoring demands of running an alpha-2 agonist would call for more skill from a layperson than using local anesthetia or INTRAVENOUS REGIONAL. IOW - in the example you gave about your wife sedating you, she would need to monitor depth of sedation, be ready to address drops in blood pressure, and have some kind of means of reversing the effects of the alpha-2 agonist.

The key ingredient in INTRAVENOUS REGIONAL anesthesia IS effective use of the tourniquet - at the beginning and the end of the procedure, as well as in the middle of the procedure. The dose of lidocaine injected is excessive/reasonably likely to be fatal if you were to just give an intravenous injection without taking all the steps with the tourniquet.

Similarly, the main task in safely giving lidocaine local anethesia is to avoid an excess dose from being absorbed. 1% lidocaine has 10mg lidocaine per milliliter. So for those members with paramedic backgrounds, you'll recall that more or less 1mg/Kg body weight is an intravenous loading dose to suppress ventricular ectopy -- IOW -- 7cc is 70mg, which is an "average" sized man. Not all of that's going right into the circulation if it's injected into the soft tissue, but have in mind how much drug you are injecting and how much might be passed on to the circulation. A toxic dose is higher, but still in the same "order of magnitude."

What makes INTRAVENOUS REGIONAL ANESTHESIA safe enough to perform is that you end up pickling the tissue of that limb in lidocaine, so very little of it escapes into the circulation to cause toxic effects at any one time. IOW -- the amount of lidocaine injected is in the 100's of milligrams.

The so-called "Bier's Block" - aka Intravenous Regional Anesthesia:

http://www.nda.ox.ac.uk/wfsa/html/u01/u01_003.htm

Lidocaine is probably the most versatile of the local anesthetics. No epinephrine in the lidocaine for this use. And while we're on the subject of vocabulary, the Brits call lidocaine "lignocaine."



OK - enough for now.

I know I've dumped a whole lot of stuff out there.

Follow the bread crumbs.

We'll all have a lot more to talk about. It's hard to imagine reading this stuff and not having questions or ideas.



Extra Credit Reading (yeah, right!)

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=548630

http://www.vasg.org/alpha_2_agonists.htm

http://www.findarticles.com/p/articles/mi_qa3892/is_199910/ai_n8873286 (psychiatric/ADHD uses of alpha-2 agonists)

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8096770&dopt=Abstract

http://www.nature.com/npp/journal/v21/n5/abs/1395384a.html

[DrBaboon]

I left my earlier comment about the dexmedetomidine price in place.

But it turns out it was a bit on the high side.

http://uuhsc.utah.edu/pharmacy/bulletins/dexmedetomidine_hcl_injection.html

24 hour cost (70 kg patient)* Dexmedetomidine (Precedex®) 100mcg/mL 2 mL $55.00 200 mcg in 48 mL of NS $220.00-385.00 (4-7 vials) 70 mcg LD + 336-1176 mcg

It's still pretty costly. I simply felt I should be transparent about correcting what I had posted.

I also found veterinary use of dexmedetomidine while I continued looking.

How does all of this compare to the cost of veterinary detominidine?

http://www.piribo.com/publications/generic_drugs/patent_reports/detomidine_vet_pipeline_selector.html

This is a source from the UK, which shows the price there is comparable to US prices.

http://www.endlessmeds.com/vet.html scroll down to:

Dormosedan (Detomidine)
IV or IM 0.2 to 0.4 ml. per 220 lbs. 5 cc vial $53.95, 20 cc vial $224.95

It doesn't look like this is an inexpensive drug to purchase. The main reason you would consider using it is that you already have access to it. It's also one thing to give a single dose, and another to continue the drug during a surgery or in the time following the surgery.


What makes it cost-effective for equine use is keeping horses out of trouble while under sedation/while under anesthesia, and overall cost of caring for the horse (surgery, length of care, total cost of all drugs, etc.) compared with the cost of replacing the horse. While I don't know horses, wasn't that the concern when that champion race horse had its leg put back together a few months ago? IOW - whether it would recover well enough to live and be able to breed? Meaning that the kinds of complications horses develop when they have trouble moving around raises the odds of a dead horse.


More on applicable veterinary anesthesia (often as a cocktail including alpha-2 agonists):

http://www.animalnetwork.com/vpn/detail.aspx?aid=15685&cid=3872&search=

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=545981

http://ocw.tufts.edu/Content/5/lecturenotes/216004 "restraint of wildlife"

http://www.ingentaconnect.com/content/evj/evj/2006/00000038/00000003/art00010
(article discusses "reversal of detomidine" -- aka -- giving an agent to counteract its effects).





BTW - thanks for asking what I think has been the most advanced question on the board so far - whether or not it seemed that way to you when you brought it up.

[HottAK47]

Wow, Doc , you dont fool around much when you answer a question, do you? Thanks for all the info, I'll respond with a few further questions when I digest all the links you provided. I have always wanted to be able to network with a real live MD.

I got an 8th grade education but I have had a lifetime of hands on experience working with the critters involved in a rural lifestyle. I have learned what works and what dont through bitter experience, trial and error and profiting from the mistakes of others. My experiences with treating animals has sure made me respectful of anyone with the 'nads to take a human life in his/her hands.

I'll pass along an anectdote on translating animal/ human dosages: A lady called me late one Friday night with a badly absessed tooth wanting to know if the antibiotics her Vet prescribed for her Labrador ten years ago would help, if I had I taken them and how much should she take.

I told her I take them all the time , I thought that out of date dog drugs should do her just fine and as for the amount, I usualy start with a high dosage and back off of it a little bit when I get an uncontrolable urge to lick my testicles.

I find that with my lifestyle its important to keep a sense of humor.

[DrBaboon]

I'll respond with a few further questions when I digest all the links you provided. I have always wanted to be able to network with a real live MD.

Take all the time you need - I'm happy to work it through with you.

I got an 8th grade education but I have had a lifetime of hands on experience working with the critters involved in a rural lifestyle. I have learned what works and what dont through bitter experience, trial and error and profiting from the mistakes of others.

Life's an education. You already know that. I have patients with grade school educations who are sharp, and know their 3 R's (Reading/wRiting/aRithmetic) better than most college educated folks.

I think you already know that I didn't post that stuff to dazzle you, but because I am betting you will be able to make use of it with a little time (and maybe a little discussion).

out of date dog drugs should do her just fine and as for the amount, I usualy start with a high dosage and back off of it a little bit when I get an uncontrolable urge to lick my testicles.

Yeah - I can picture that... ;)

You really gotta watch out so you don't get run over by a car when you're licking your balls in the middle of the street!!!


I find that with my lifestyle its important to keep a sense of humor.

Ain't that the truth...



You've got the tools to learn more.

Let me know how I can help.





You know -- this thread has been a LOT MORE INTERESTING to me now that I've seen what you're asking about. I would have guessed it was going to end up being more about getting a couple different meds at Farm & Fleet or something (that's kind of been a fairly common discussion I've had with different people off and on for a few years).

The reality is that you've ended up bringing up some really hot stuff, whether it seemed that way to you when you posted or not.


I haven't had any good way to discuss it other than digging in and tossing out what I have been able to find on the subject (or what I know) or whatever.

Like I said - if people want to learn, I'll help them goose it up a bit.

[saw59]

two good books are where there is no doctor and where there is no dentist both by david werner.

[dakdak]

Doc...ThANKS for all the hard work.
I have and I am learning a lot !

[shob77]

25mg of one brand may not be 25mg of another. Concentrations can and do vary by manufacture intended use, the net weight of the pill may be the same, but not the net weight of the active ingredient.

I have snooping eyes when I'm in a waiting room at a physicians office and I read everything. Having administered antibiotics to livestock while working on a farm I did notice that some types of penicillin found on the farm were more concentrated that what I read at the family doctors office.

My example will be Penicillin G aka Procraine. The concentration of penicillin is measured in units/mL. I can't tell you what a "unit" represents, but that penicillin is dosed in units/Kg body weight. At the farm the penicillin was concentrated at 25units/mL, at the doctors office 10-15unitl/mL depending on the brand. So less mL of the stuff at the farm, in this case, would be needed to get the same net dose. Cheaper to buy, cheaper to use. Probably not a pizza yet, but I grew up with the adage "a penny saved is a penny earned".

Dosages for penicillin are a case by cases basis and the minimum amount needed to kill everything should be used. I have found reference to this before on the internet at medical sites. Pneumonia patients may get a higher dose that those with bronchitis. Heavier patients will get a higher dose than lighter patients for the same illness.

As far as buying it, I'm not sure. At TSC and other farm supply stores I have purchased powdered tetracyline but never a refridgerated penicillin. No questions asked while buying tetracyline. I have dosed myself with Procraine, but never tetracyline, which I hear, can be dosed to humans as one would with hogs. I have successfully warded off a case of bronchitis via using procraine, on the farm it was free (ok per the farmer), and that was enough to have bought several pizza's.

[therealsteamer]

Check out "Survivalist's Medicine Chest" by Ragnar Benson..

That being said, I spent some time working on a 1400+ Sow Production Breeding facility.... The number of antibiotics available to those in the animal industry is amazing, We used Amoxy like it was pig crack... Sprinkled it on the feed, mixed it with milk, made a base mix for the barn water supply medicator.. This stuff was the SAME as has been prescribed for my 5 year old daughter.. No where did it say anything on any labels about livestock... We would go through thousands of bottles... With no accountability.. We had penicillin, ampicillin, tetracycline, tylan/tylox, neomycin all over the place. We also had things such as banamine/ flunixin meglumine, gentamicin, lincomycin, predef, dexium/dexamethasone, excenell, exceed.. (some of these are product names not drug names).. All Injectibles... Most all of these can be gotten at the RIGHT places over the counter... Vet supply houses, feed mills, grain elevators, MANY online suppliers... With the right amount of research and careful use most of these and many others can be a valuable tool in the "preparedist's" aid kit... Please do the research and act responsibly with in this realm...

There are many other ointments and such that are used in vet medicine that have an almost magical healing property on humans... My grandfather was a Vet for over 50 years and I could not even begin to count the number of tubes of Panalogue that I have seen floating here and there... It seemed that every female had a tube in their purse, in the car, and in a drawer or two.. IT was great for the cuts and scrapes of growing up in the south...

Lets also not forget wound dressings, bandages, vet wraps, syringes, needles, IV kits, suture supplies, intake fluids... As my wife has said "Sterile is sterile!"

This thread might be of some use as well:
http://neardeathexperiments.com/smf/index.php?topic=515.15

[DrBaboon]

My example will be Penicillin G aka Procraine. The concentration of penicillin is measured in units/mL. I can't tell you what a "unit" represents, but that penicillin is dosed in units/Kg body weight. At the farm the penicillin was concentrated at 25units/mL, at the doctors office 10-15unitl/mL depending on the brand. So less mL of the stuff at the farm, in this case, would be needed to get the same net dose. Cheaper to buy, cheaper to use. Probably not a pizza yet, but I grew up with the adage "a penny saved is a penny earned".

Thanks for adopting the pizza comparison ;)

Here is a link showing units vs. miligrams for benzyl penicillin G:

http://home.intekom.com/pharm/intramed/benzpen.html

Keep in mind - Penicillin G is injected, Penicillin V is oral. There are also different kinds of Penicillin G.

Penicillin G and Penicillin V are different chemically. Penicillin V is measured in miligrams.

It seems to me that we persist in using Units for Pencillin G to be able to compare how much Penicillin G of one sort or another is present, particularly in a mixture -- such as in Bicillin and similar products. The weight of 1.2 million units of Benzathine Penicillin G in Bicillin C-R would be different than the weight of 1.2 million units of Procaine (benzyl-penicillin) Penicillin G that are also in Bicillin C-R. But there are ultimately the same number of penicillins of each type of penicillin G in Bicillin C-R. Keep in mind, that 1 benzathine penicillin molecule breaks apart into 2 penicillin G molecules.

Penicillin G types (as well as different formulations of Bicillin) also have a LONG TRACK RECORD of causing confusion among healthcare professionals:

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4835a2.htm

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5409a1.htm

AQUEOUS Penicillin G is what is given INTRAVENOUSLY.

The other varieties of Penicillin G (including the mixtures of penicillin G types in Bicillin) are for intramuscular injection.

This is a reasonable article on penicillins in general, and should clarify Penicillin G types:

http://en.wikipedia.org/wiki/Penicillin

Here's the package insert on Bicillin LA (all benzathine penicillin G, not a mixture like Bicillin C-R, and has not yet broken apart in the body into 2 penicillin G molecules):

http://www.fda.gov/cder/foi/label/2002/50141slr219lbl.pdf

HTH

Dosages for penicillin are a case by cases basis and the minimum amount needed to kill everything should be used. I have found reference to this before on the internet at medical sites. Pneumonia patients may get a higher dose that those with bronchitis. Heavier patients will get a higher dose than lighter patients for the same illness.

Penicillin G dosing & type of penicillin G has to be well matched to the needs of the condition being treated. The syphilis example is a case in point. There are even differences in how penicillin G is given depending on how advanced a case of syphilis is.

Honestly, unless we're treating something specific, it's not that common to be able to confidently use Penicillin G.

[DrBaboon]

TRS

Welcome to the forums.

I'm not sure what your link was intended to say - when I try it, I get an error message.

The main suggestion I would make about counting on antibiotics that are in widespread use in your vicinity (such as on the farm), is that is exactly the situation where bacteria are likely to have developed resistance to those same antibiotics.

[therealsteamer]

I just tried the link and it came up good... Must have been a goof...

http://neardeathexperiments.com/smf/index.php?topic=515.15

Essentially it is a parallel discussion on Vet meds..kinda...

Luckily I am several miles away from the farm and now have limited contact with the facility... In the event it is SEVERELY needed this stuff is "available". But during the infection (PRRS 184) We were going through ALL the mentioned stuff by the case...

And yes I do agree about bacteria becoming resistant to most drugs due to over use... After about a month there I contracted a URI that developed into pneumonia... 14 days sick, a full run of Keflex, then IM Rocephen (sp), and finally Biaxin... IT had to be some chernobyl strain of swine yuck...

[shob77]

"Thanks for adopting the pizza comparison"

You're welcome. I will forever use it. I like pizza, probably too much.


After reading much of this post I'm thinking that perhaps a best bet would be to:

Contact the county health department of your area and wherever you may plan to bug out to and get information on the most common cases for that area. Then what meds would be likely prescribed and what dosage for those diseases, include your family or whomever may be with you. I imagine your family physician would be a good person to ask.

The Ag department or DNR may be able to give you information on diseases found in animals of the area that may be passed on to humans.

Stock up on meds for ailments you have been susceptible to in the past.

Keep handy a good general purpose antibiotic.

Anesthetics, though nice, aren't a necessity. Though it may not be a bad idea to be able to have something to help in coping. Tylenol 3, Vicodin, or pain ointments. If all fails, moonshine isn't hard to make.

Have a well developed hygeine plan, prevention is always less expensive that treatment, imagine all the pizza!