July2014_GET TO KNOW YOUR HEALTH – Compounding

Compounding

Pharmacy, as most people know it, can be described by just two words: drug store.  This is because in our time – the time of modern medicine, manufacturing and drug companies – that is exactly what it has become.  Pharmacy has been travelling this path for a while; the first drug store was actually set up in Baghdad in 754 and by the 9th century these were state regulated.  Pharmacological knowledge however has been recorded in Egypt (1550 BC), Sumeria (600 BC) and Greece (400 BC).  This was obviously of a more rudimental nature where crude drugs and natural ingredients were discovered and used by a healer (physician and apothecary were only separated as professions in 1240 AD).

 

Pharmacy as we know it, like most things, is changing.  Patient centred care, medication management and disease state monitoring are some of the new looks the face of pharmacy is trying on.  Another changing aspect of pharmacy is more than just a new direction, it’s come full circle.  The art of pharmaceutical compounding was used for all medication at one point and even until the 1940’s pharmacists would still make up 60% of their prescriptions.  This part of our profession almost totally died out with the uptake of modern drug manufacturing techniques.  This means today community pharmacists will compound less than 0.8% of all prescriptions dispensed, however this number is growing.

  

The needs of the individual are becoming more and more prevalent in society and mass manufactured medicine, by definition, cannot accommodate this need.  It is this growing need that helped us to decide to open our new compounding laboratory in Dayboro.  Pharmaceutical compounding in today’s terms is the creation of a particular pharmaceutical product to fit the unique need of a patient.  This is done by using bulk ingredients, specialised equipment and specifically trained pharmacists.  It is this ability to customise a patient’s medicine that has led to the resurgence in popularity amongst health practitioners in the last ten years as the medical community realised the benefit of getting the “Perfect Fit” in patient medication.

Pharmaceutical compounding is by no means meant to take the place of manufactured medications, these medication are effective and play a major part of the healthcare spectrum.  Compounding is ideally used in the instance where these options fall short for one reason or another.

 

Some of the larger areas where this takes place are in conditions like Bio-identical hormone replacement therapy which can include sex hormones for women and men as well as specialised thyroid hormones.  There are even hormones to aid sleep more naturally.  Another area is paediatrics; often the manufactured medicine’s dose is for an adult so we can alter the dosage to the exact amount needed and we can even then put it in a lollypop!  Other important areas include veterinary, dermatological, dental and pain management.

Obviously reformulating medications can offer some ‘different’ options when it comes to how to administer and what it will taste like.  The dosage forms that can be made are mostly typical such as capsules of different sizes, solutions, suspensions, suppositories, gels, creams, lotions and sprays.  However sometimes really interesting doses can be made such as oral dissolving tablets, foams, lollypops, lip-balms, lozenges and even the aptly named rectal rocket (I’ll let everyone’s imagination have fun with that one…). 

When a dose is taken orally, compounding allows for it to be flavoured.  This doesn’t sound overly interesting, and for the most part it is simple things like spearmint, raspberry or liquorice.  However some of the more interesting (and amusing) flavours I have come across are blueberry marshmallow, eggnog, caramel butter fudge, pumpkin, pizza and cherry custard.  Finally, for all the inner alcoholics in us apparently there are also flavours for crème de menthe, peach butter rum, Pina Colada, sherry and even beer!  However, I did notice a distinct lack of rum and coke in the flavour menu…

Finally, just if you are interested, some examples of common non-prescription compounds we can make include fluoride drops, for children that are not getting any fluoride from drinking tank water, and anti-inflammatory creams that are stronger than manufactured ones.  Obviously this isn’t exactly an exhaustive list but it does give a hint of the possibilities.

That is about it for this month, not exactly a health article but hopefully still an interesting read.  If you wanted to know more about compounding or have any other question about any health issue, as always don’t hesitate to drop into the pharmacy for a chat or see another local health care professional.

Written by Andrew Harvey

(Your local pharmacist) 

Dayboro Pharmacy, Phone 3425 1435

Mon – Fri 8.30am – 5.30pm

Sat 8.30am – 12.30pm