Custom Compounding

Nov 7, 2016

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

It was Saturday, Oct 29th and Eric was just about bursting with excitement. He asked what the date was, again. He asked how many days left it was, again. I asked him why he was so excited. He said, "So I can get candy!" I reminded him he could get candy, for free, on Halloween. He stopped to consider that. He agreed that Halloween was good and so was free candy. Then we drove past the sign again. "Coming Soon! Opening November 1!" Eric got excited all over again. "When is November 1?" "Tuesday" "How many days is that?" "3" "I can't wait to buy candy!" I think the new Fudd's Convenience Store already has a dedicated fan.

I can't explain why Eric would rather buy his own candy rather than get it for free on Halloween. In the pharmacy, sometimes I can't explain what I mean by custom compounding. Custom compounding is when a pharmacist creates a preparation that isn't commercially available for a patient at the direction of a physician, vet or dentist. That usually doesn't mean much to most people. I often must show people what we do in our compounding lab for it to make sense to them. Fortunately, at the Dauphin Clinic Pharmacy, the compounding lab is right out front, with nice big windows so you can see what we are doing.

What can we compound for people? In January, I usually talk about how we can compound nicotine lollipops to help people quit smoking. Our most popular compound is called a diclofenac cream. It can be rubbed directly on a sore knee or shoulder to reduce the pain without bothering the stomach. What we can compound is really only limited by the imagination.

A couple years ago a customer came into the store and told me she didn't know the Dauphin Clinic Pharmacy was so special. The customer had just got back from Toronto where her child was seeing a specialist. Her child was taking Vitamin K and it is only commercially available as liquid. We compounded the Vitamin K into a capsule. The child was happier taking the capsule and the Toronto specialists were impressed that we could help her child in little old Dauphin. The customer said she didn't know that the custom compounding we did here for her child was so unusual. There was another local child who was in hospital in Alberta. The Alberta specialists didn't believe the parents that a Dauphin pharmacy had made a liquid form of aspirin for their child. You see if aspirin is just crushed and mixed with water it will break down. So, we mixed it in an oil base. I had Alberta hospital pharmacists phoning us to get our formula for the liquid aspirin so the child could continue to receive the medication in the Alberta hospital.

We have been asked to make various kinds of wound preparations. One of the interesting bases we use is a gel that is liquid in the fridge but solidifies at body temperature. We have put antibiotics, medications to increase blood flow, medications to improve healing, pain killers, and others into the gel at the doctor's request. The neat thing is the nurse gets to pour the right amount of liquid medication directly into the wound. The liquid conforms nicely to all the crevasses in the wound and then it solidifies into a gel the consistency of Jello. Another interesting would treatment came from Dr. Kish. He calls it Sugar Paste and it is basically a bunch of different sugars and some stuff to hold them together. It goes directly into the wound, absorbs exudate and promotes healing quite well.

For animals, under a vet's direction, we have made a variety of products. We have compounded a liquid antidote for a dog who ate rat poison. We compounded an antibiotic for a fussy cat. We started with a human medication, ground it up and put it into a special fish paste that most cats love. However, this cat didn't like fish. So, we did it again in a chicken paste. When the patient is a cat, it is still important to listen to the patient's likes and dislikes.

When you are next in the Dauphin Clinic Pharmacy, press your nose up against the glass and have a look in the compounding lab. Check out what we do first hand. When you are watching us mix something together you might get an idea of how we could help you, your family or your animals. Then knock on the glass and ask me your questions. At least I won't have to explain custom compounding to you.

Starting a new business both difficult and exciting. Fudd's Convenience is on Mountain Road where Mr. T's used to be. It can be hard to convince people that they should spend their hard-earned money on products in your store. But sometimes you manage to tap an unmet need just as we do with custom compounding. Fudd's Convenience seems to have tapped into boys who want to spend their money on candy, even though they have a Halloween bag of it at home. So good luck to Fudd's Convenience. If the excitement they've generated amongst 11-year-old boys in the neighborhood is any indication, they should have a long and successful run.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca

As always if you have any questions or concerns about these or other products, ask your pharmacist.

 


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