Compounded or “pre-mix” controlled substance (CS) drugs are often a part of HVSN drug protocols. HQ has an easy tool for adding and logging controlled drugs that are pre-made by the bottle.
Add in Your CS Drug Bottles
The first step of creating a compounded drug is to add the constituent CS bottles in the container log. Learn how to add controlled drugs into Patient Flow HERE. In the case of TTDex, you will first add in your tiletamine-zolazepam and butorphanol bottles.
Non-Compounded Drug Mix
If a drug is mixed up by the syringe for each patient, this would not be logged as compounded in HQ. Simply log the drawn amount of each drug in Patient Flow.
Create the Compounded CS Drug
Step 1: Navigate to the Compound Creator:
- Start your daily drug log under Clients > Medical > Drug Logs.
- In the left navigation panel, click Go to Settings.
- Go to Patient Flow Setup > Setup Controlled Substances and Compounded Controlled Substances.
- Click Setup Controlled Substances and search for your drug mix. Note: Be cautious here. The same controlled mix can have multiple recipes with different concentrations or drug names. If you do not find the right mixture here, please submit a help ticket to get that added.
- Once you find the correct mix, click Select.
- Enter the total volume your clinic will typically make per bottle. For example, 5mL TTDex.
- Review the concentrations (mg/mL) of each drug and the volumes. If they are correct, click Continue. If they are not correct, go back to search or request a mix if we don’t have it.
- You will be redirected to the container log for that drug. Click Add New Batch of Bottles. The compound creator popup should appear.
Step 2: Create the bottle:
- You will need to open each of the controlled drugs in the mixture. To do so, click Open New Bottle. Tick the boxes for each bottle you are pulling from.
- Write in the total volume of your mixture in the Amount (mL) box, located in the top right corner. You will see the required drug amounts calculated under the Amount column.
- Verify the values in each textbox under Bottles are the correct amount you are drawing up. The totals should match the calculated Amounts.
- The number in the upper left corner is the controlled bottle you are making. Verify the prefix and number are correct.
- Verify the bottle numbers for each controlled drug match the bottles you are physically pulling from.
- Lastly, click Save. If a CS bottle was finished, a popup will appear asking you to mark the bottle Done. Click Save or exit out of the popup if it is not finished.
![]( "Making a bottle of TTDex.")
Making a bottle of TTDex.
Logging Compounded Drugs
Once controlled compounded drugs are added to your container log, you are able to log them in Patient Flow. Learn more about PF drug logging HERE.
Troubleshooting Issues
Totals Don’t Match
If the total does not match the recipe, first check your total volume. The total volume is the sum of all components in that drug mixture, including non-controlled substances. Next, check your values in each of textboxes under Bottles. You will see which drug does not match the recommended amount to draw. Your total should reflect what you are actually drawing in person.
In rare cases, the bottle total (amount you are drawing) may be different from the recommended amount. Verify with your veterinarian that this is the correct recipe and amounts. If it is, you can force the system to make the bottle anyway by clicking Give negative balance/Make anyway.
Incorrect Amount Logged
If you’ve just made a bottle that day and a mistake was made when you created the compounded bottle, you can undo this by deleting the compounded bottle. It will revert all drug amounts back to their original bottles and you can recreate it.
If a mistake is caught after the bottle has already been used, or the drug log is finalized, you will be prevented from deleting the bottle. The only solution is to add a note to the daily log indicating the error and correct bottle numbers/amounts drawn.
Incorrect Bottle Number
If the bottle number or prefix of the new compounded bottle is incorrect, the bottle must be deleted and recreated.
