Compounding pharmacists

Prescriptions requiring extemporaneous compounding by the pharmacist do not require the extended shelf-life that commercially manufactured and distributed products do because they are intended to be used immediately on their receipt by the patient and used only during the immediate course of the prescribed treatment. However, these compounded prescriptions must remain stable and efficacious during the course of their use and the compounding pharmacist must employ formulative components and techniques, which results in a stable product. ... 

Pharmacists have an opportunity to extend their activities in patient care as the emphasis continues to shift from inpatient care to ambulatory care. The latter situation generally encourages a team approach to health improvement, prevention, health maintenance, risk assessment, early detection, management, curative therapy, and rehabilitation [12]. Ambulatory care offers a variety of opportunities for individualizing patient care through pharmaceutical compounding. In fact, it is the area where most compounding pharmacists practice. 

Pharmaeists have been using ehemicals and other materials for preseription compounding throughout history. In the past, these chemicals and materials have been made from natural produets, raw materials, and household ingredients. Today compounding pharmacists use ehemicals from various sources, depending upon their availability. 

Most FDA-approved veterinary drugs are for certain species, either food-producing or for a large target population (household pets). If veterinarian pharmaceutical companies do not perceive a sufficiently large market for a product, they will not seek FDA approval. This has left a large vacuum, or a potential market, that can be filled by compounding pharmacists. There are no FDA-approved products for exotic species due to the limited market and there are only few FDA-approved products for some of the more common species. Veterinarians need patient-specific products which pharmacists know how to prepare. Consequently, a team approach has been developed to the benefit of the veterinarian, pharmacist, and the animals. 

A number of criteria are used to select flavors during formulation. Different flavor concentrations produce highly subjective sensations. Specific requirements for balance and fullness are dependent, in part, on the drug substance and the physical form of the product. For this reason, when selecting a flavor system, the compounding pharmacist must take into account several variables upon which a desired response would depend. Some of these are product texture (e.g., viscosity of formulation, solid or liquid), water content, base vehicle or substrate, and taste of the subject drug. Notable specific examples to consider are ... 

Using the drug s pK, the formulation or compounding pharmacist can adjust the pH to ensure maximum water solubility I ionic form of the drug) or maximum. solubility in nonpolar media (nonionic form). This is where understanding the drug s acid-ba.se chemistry becomc.s important. Note Reactions 2-6 and 2-7 ... 

A. In the United States, compounding pharmacists (including hospital inpatient phamnacies) may obtain bulk quantities of pharmaceutical grade unithiol (eg,... 

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