DE DOCTEUR EN PHARMACIE. Présentée Et Soutenue Par Vincent GAIN Le 03/07/2014 À Nantes

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DE DOCTEUR EN PHARMACIE. Présentée Et Soutenue Par Vincent GAIN Le 03/07/2014 À Nantes UNIVERSITÉ DE NANTES UFR SCIENCES PHARMACEUTIQUES ET BIOLOGIQUES ANNÉE 2013/2014 N° 079 THÈSE pour l'obtention du DIPLÔME D’ÉTAT DE DOCTEUR EN PHARMACIE. Présentée et soutenue par Vincent GAIN le 03/07/2014 à Nantes. Dispensation à l’officine des médicaments vétérinaires destinés aux bovins : contexte, spécificités et place du pharmacien. Directeur de thèse : Mr Fabrice PAGNIEZ Membres du jury Mme GAUTIER Hélène Maître de Conférences en Pharmacie Galénique, Nantes Président. Mme Fabrice PAGNIEZ Maître de Conférences en Parasitologie, Nantes Directeur de thèse. Mme ROUSSEAU Pascale Docteur en pharmacie, Nantes. 1 Remerciements: A MES JUGES, Madame Hélène GAUTIER Maitre de conférences en Pharmacie Galénique. Laboratoire de Pharmacie Galénique Faculté de Pharmacie de Nantes Vous m'avez fait l'honneur d'accepter la présidence du jury de cette thèse. Sincères remerciements pour le temps que vous m'avez accordé. Monsieur Fabrice PAGNIEZ Maitre de conférences en Parasitologie. Servie de Parasitologie et Mycologie médicale Faculté de Pharmacie de Nantes Vous m'avez accompagné dans ce travail par votre aide et vos précieux conseils. Soyez assuré de mon profond respect. Madame Pascale ROUSSEAU Pharmacien d'officine à Ligné (44). Vous avez participé à ma formation depuis mon arrivée à Nantes et avez accepté de juger cette thèse. Hommages respectueux. 2 Remerciements: À tous ceux qui ont pris part à ce travail, de près comme de loin, À Clémence, À mes parents, À mon frère, À ma famille, À mes proches et amis, À mes compagnons à quatre pattes. 3 Dispensation à l’officine des médicaments vétérinaires destinés aux bovins : contexte, spécificités et place du pharmacien. 4 Sommaire: Remerciements: ......................................................................................................................... 2 Sommaire: .................................................................................................................................. 5 Liste des abréviations: ................................................................................................................ 8 Liste des figures: ......................................................................................................................... 9 Liste des tableaux: .................................................................................................................... 12 Introduction:............................................................................................................................. 15 1. Organisation et enjeux de la politique sanitaire dans les élevages français et présentation des spécificités du médicament vétérinaire, sa législation, son circuit, son économie et ses caractéristiques: ............................................................................................ 16 1.1. Enjeux sanitaires et santé publique : ....................................................................... 16 1.1.1. L’organisation sanitaire en France : ................................................................... 17 1.1.2. Traçabilité, identification bovine et registre d’élevage : ................................... 23 1.1.3. Maladies animales réglementées :..................................................................... 25 1.2. Lutte contre l’antibiorésistance : le Plan écoAntibio 2017. ..................................... 29 1.2.1. Les indicateurs de la consommation d'antibiotiques: ....................................... 29 1.2.2. Les chiffres de la consommation d'antibiotiques: ............................................. 29 1.2.3. Principales résistances bactériennes en médecine vétérinaire: ........................ 31 1.2.4. Les antibiotiques critiques: ................................................................................ 35 1.2.5. Le plan écoAntibio 2017: .................................................................................... 36 1.3. De la conception à l’administration: le circuit du médicament vétérinaire : .......... 38 1.3.1. Définition du médicament vétérinaire: .............................................................. 38 1.3.2. Recherche et essais clinique. ............................................................................. 39 1.3.3. Autorisation de mise sur le marché: AMM et ATU: ........................................... 40 1.3.4. Production, distribution en gros, commercialisation et publicité. .................... 41 1.3.5. Les ayants droits de la dispensation du médicament vétérinaire : ................... 45 1.3.6. La pharmacovigilance. ........................................................................................ 46 1.4. Marché et économie du médicament vétérinaire. .................................................. 48 1.4.1. Présentation du Marché mondial et des grands laboratoires: .......................... 48 1.4.2. Répartition du marché français par classe de médicament, par domaine et par ayant droits: ..................................................................................................................... 49 1.4.3. Contexte et démographie des élevages en France : concentration, spécialisation et mondialisation. ...................................................................................... 53 1.5. Les utilisations du médicament vétérinaire : ........................................................... 55 5 1.5.1. Objectifs et domaines d'usages.......................................................................... 55 1.5.2. Classement des médicaments vétérinaires: ...................................................... 58 1.5.3. Aspect galénique : le matériel et les formes utilisées........................................ 60 2. Principales pathologies rencontrées dans les élevages bovins: ...................................... 73 2.1. Maladies faisant l’objet d’une réglementation, inscrites dans la liste des dangers sanitaires: ............................................................................................................................. 74 2.1.1. Le botulisme: ...................................................................................................... 74 2.1.2. La brucellose: ...................................................................................................... 76 2.1.3. L’encéphalopathie spongiforme bovine: ........................................................... 78 2.1.4. La fièvre Aphteuse: ............................................................................................. 81 2.1.5. La fièvre charbonneuse: ..................................................................................... 83 2.1.6. La fièvre catarrhale ovine (FCO): ........................................................................ 85 2.1.7. La fièvre Q: ......................................................................................................... 87 2.1.8. La tuberculose: ................................................................................................... 89 2.2. Maladies parasitaires des bovins: ............................................................................ 92 2.2.1. Maladies causées par des parasites internes: .................................................... 93 2.2.2. Plans de vermifugation des bovins et molécules utilisées. .............................. 103 2.2.3. Les affections dues aux parasites externes : .................................................... 107 2.3. Maladies et infections des voies respiratoires : ..................................................... 116 2.3.1. La broncho-pneumonie infectieuse enzootique (BPIE). .................................. 116 2.3.2. La rhinotrachéite infectieuse bovine (IRB). ...................................................... 119 2.3.3. Strongylose respiratoire ou dictyocaulose. ...................................................... 122 2.4. Pathologies digestives des bovins : ........................................................................ 122 2.4.1. Complexe diarrhée virale bovine / maladie des muqueuses (BVD-MD). ........ 122 2.4.2. Les entérotoxémies. ......................................................................................... 125 2.4.3. La paratuberculose ou entérite paratuberculeuse. ......................................... 128 2.4.4. Les salmonelloses. ............................................................................................ 130 2.4.5. L’ingestion de corps étrangers. ........................................................................ 132 2.4.6. Intoxications par des végétaux......................................................................... 133 2.5. Affections rencontrées chez les jeunes bovins : .................................................... 136 2.5.1. Les entéropathies diarrhéiques des veaux....................................................... 136 2.5.2. Les affections ombilicales: ............................................................................... 138 2.6. Pathologies fréquemment rencontrées dans les élevages laitiers : ...................... 139 2.6.1. La fièvre de lait ou fièvre vitulaire: .................................................................. 139 6 2.6.2. Les affections de la mamelle : les mammites. ................................................. 141 3. De la prescription à la délivrance du médicament vétérinaire : la place du pharmacien d’officine. ................................................................................................................................ 144 3.1. Prérequis
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