Off-label

Re: Off-label

Mike Martin — Wed, 24 Feb 2010 09:12:57 GMT

[quote user="Arlo Guthrie"]but who compiles the off-label uses in the formulary? [/quote]

Its compiled by experts in each discipline. There's probably 15-20 contributors with an editor in chief.

Yes, its down side would be that it is not constantly being updating - which should be feasible this day and age with internet. A wikipedia-style formulary seems attractive; but it would seem nice to start with the BSAVA Formulary info first - then add to that. The other down side of wiki' is maybe the lack of consistent expert opinion drifting towards anecdotal 'cures'. But there must be some way to achieve a compromise in order to share the wealth of genuinely useful information that practitioners have (and not part of the under graduate curriculum).

Re: Off-label

Laurence Webb — Tue, 23 Feb 2010 22:13:59 GMT

[quote user="Mike Martin"]

But I guessing it might not cover everything, particularly small furries and the like...?

[/quote]

I think this would be the main advantage of this. The formulary has well accepted doses and uses, but not everything. Mirtazipine is absent from the edition I use for example. Unusual uses for common drugs is be another thing that is absent from the formulary. As an example I used Tardak for aggression in a male duck once. It worked, but I doubt you'd find that in the formulary (it may be, but to be fair I haven't looked in the newest addition)

Re: Off-label

Arlo Guthrie — Tue, 23 Feb 2010 18:34:48 GMT

[quote user="Mike Martin"]But I guess the BSAVA Formulary would be hard to compete with. It already list drugs and dosages for off-label use.[/quote]

I haven't seen it, but who compiles the off-label uses in the formulary? Is is something that anyone can contribute to, as would be the case here?

Re: Off-label

Mike Martin — Tue, 23 Feb 2010 17:42:22 GMT

I think developing this website is great. But I guess the BSAVA Formulary would be hard to compete with. It already list drugs and dosages for off-label use. But I guessing it might not cover everything, particularly small furries and the like...? Most of the human heart drugs we use are all in there.

Re: Off-label

Laurence Webb — Tue, 23 Feb 2010 14:31:01 GMT

Yes, I think it would be a useful resource. Would it be feasible to make the database searchable by drug and also indication?

Re: Off-label

Gillian Mostyn — Tue, 23 Feb 2010 13:47:00 GMT

Yep - useful.

Re: Off-label

Arlo Guthrie — Tue, 23 Feb 2010 11:38:40 GMT

Thanks Vikki

[quote user="Vikki Halliday"]The only other problem I can forsee is the organisation of information to avoid having to scoll through pages of posts, so perhaps a tag or two and a searchable system would be the best Arlo?[/quote]

That's what I have in mind ... I've decided to blow some more cash installing a supercharged search system on this site, should be more news on this later this week.

Would appreciate any thumbs up / down to this idea from others - it's helpful for me to have an idea of scale here (i.e. if lots of people think it could be useful or not)

Re: Off-label

Arlo Guthrie — Tue, 23 Feb 2010 11:33:39 GMT

Thanks Evelyn

What I have in mind would transform the informal discussions in the forum into a more easily searchable database.

I see the danger of it being dismissed as anecdote, but think that danger mainly exists if it were positioned as more than anecdote. Provided readers realise that it IS anecdote at the outset, it can hardly be dismissed as anecdote! My thinking is that provided anecdotal stuff is recognised for what it is, it could still be a valuable resource to stimulate thought.

I've already been on to the VMD regarding the cascade, and would make sure that the corrrect guidance is given to ensure that members don't fall foul of the cascade.

Re: Off-label

Vikki Halliday LLB — Tue, 23 Feb 2010 11:14:40 GMT

Most Veterinary Pharmaceutical companies maintain an informal "register" of off licence doses and uses for some of their products. I have found that they can be extremely helpful where you are considering using a product off licence as they may have some data available.

Whilst much of this may be anecdotal, some may have been conducted by researchers in universities, and therefore better controlled perhaps than anecdotal evidence.

However returning to the question of off licence use and posting on this site, I can see no problem with it, so long as the cascade has been followed. Where it has been ignored, then users could be posting at risk of being taken to task by the VMD if they so wished.

I am a great believer that we spent so long learning pharmacology, we should in certain cicumstances be able to make use of our experience and knowledge, and if this benefits other users of this site in terms of posting information then great.

Perhaps we could start with use of POM-V products in small furries and exotics ( as there are rarely any products licenced in this area), and see how it goes.

The only other problem I can forsee is the organisation of information to avoid having to scoll through pages of posts, so perhaps a tag or two and a searchable system would be the best Arlo?

Vikki

Re: Off-label

Evelyn Barbour-Hill — Tue, 23 Feb 2010 10:45:42 GMT

It's a good idea. To some extent the forum is doing this anyway.

Two disadvantages possibly:

1. It might be criticised a lot as "only anecdotes".

2. People might be reluctant to post in case they incriminate themselves as having unwittingly (or indeed knowingly) having offended against The Cascade.