Abstract
Polypharmacy is a term that describes the inappropriate, concurrent use of multiple drugs in an individual patient. Zoological medicine practitioners must take approved agents (veterinary or human) and extrapolate their use to non-approved species often with little species-specific pharmacological evidence to support their decisions. When considering polypharmacy, even less information exists concerning multi-drug pharmacokinetics, pharmacodynamics, or potential drug-drug interactions in non-domestic species. Unfortunately, captive, zoological species are susceptible, just like their domestic counterparts, to chronic diseases and co-morbidities that may lead to the usage of multiple drugs. Polypharmacy is a recognized and important issue in human medicine, as well as an emerging issue for veterinarians; thus, this paper will discuss the novel, potential risks of polypharmacy in zoological medicine. Hopefully, this discussion will help bring the attention of veterinarians to this issue and serve as an interesting discussion topic for pharmacologists in general.
Highlights
Polypharmacy describes the inappropriate, concurrent use of multiple drugs in an individual patient
Pharmaceutics 2017, 9, 10 potential drug-drug interactions, efficacy, and pharmacokinetics for the approved labeled species, generally no label information exists for the non-domestic species requiring treatment
With more drugs commercially available, zoological medicine veterinarians may become more likely to use multiple drugs for the treatment of complex clinical conditions. This usage of multiple drugs can be associated with unexpected adverse effects, a situation that advocates for both the discussion and consideration of polypharmacy in zoological medicine
Summary
Polypharmacy describes the inappropriate, concurrent use of multiple drugs in an individual patient. Underlying many cases of polypharmacy is a temptation toward using several of the available drugs to address a given clinical problem. This may be an extension of the fallacy that if a small dose works, a larger dose is better, or if one drug works, an additional drug should be better. Veterinarians practicing zoological medicine have very few species-specific, labeled drugs and must take approved agents from the companion animal or human pharmacopeia and extrapolate their use to non-approved species [3]. Pharmaceutics 2017, 9, 10 potential drug-drug interactions, efficacy, and pharmacokinetics for the approved labeled species, generally no label information exists for the non-domestic species requiring treatment. This review will attempt to provide novel insight into polypharmacy in zoological medicine and highlight what some of the potential risks are when it is employed in this wide variety of species
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