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Editorial: What is Compounding Pharmacy, Part VII: Education and Training of a Compounding Pharmacist
"Well, way back when I was a student�." Have you ever heard that before when talking with other pharmacists? Even though we sometimes say it in jest, it does provide us something to think about. Pharmacy education has changed over the years from apprentice-type training to didactic training to didactic-apprentice training, where we currently reside. In other words, in a six-year minimum program, about five years is on-campus and one year is in an apprentice-type (externship, internship, etc.) program. There is good and bad with all of the models.
However, for this editorial, let's look at the content of the didactic portion of the pharmacy curriculum. "Way back when�" the curriculum emphasized the various sciences involved with pharmacy. Then, along came the business course additions as most pharmacists were practicing in drug stores in the 1950s (and still do today). Shortly thereafter, hospital pharmacy was introduced in the 1960s into a curriculum that was heavy in laboratory experiences to supplement and put into practice the didactic course material.
Clinical pharmacy was introduced in the 1970s and in the 1980s, a dramatic change took place where many of the science courses were deleted to make room for clinical courses; also, some of the science courses were "incorporated" into other courses and "team taught." Also, laboratories were eliminated from many schools' curriculum and one of the most important courses of all, Pharmacy Calculations, was either eliminated or downgraded to a minimal effort in many schools. It appears that the emphasis has shifted from knowing the information to just knowing where to get the information�and that doesn't work because one doesn't always have access to the information and in some cases have difficulty understanding and applying it in a clinical case situation!
So, where are we now? We are at a position where the sciences must be reintroduced back into the curriculum; Pharmacy Calculations must be an intensively taught course because this is where patients are being killed today due to errors. Compounding pharmacists must have a solid background in pharmaceutics, formulations, pharmaceutical chemistry, medicinal chemistry, natural products chemistry, microbiology, nonsterile compounding, sterile compounding, etc. and not just an introductory course, but courses where they are truly developed into drug experts. We need to review the situation where students are "farmed out" for an entire year, or even more, where some of their experiences are quite valuable and in other cases, they are simply a tool for getting work done and papers published for their mentors.
Does this seem harsh? Not really! We have been working for over 40 years to try to make all pharmacists clinical pharmacists and have neglected the "pharmaceuticals" involved in which we are the supposed experts! There is nothing wrong with being an expert in "Pharmaceuticals" as well as in "Pharmaceutical Care"! In fact, one will find that compounding pharmacists are among the best clinical pharmacists in practice today! Why? It is because physicians seek them out to help resolve issues beyond what they themselves can handle. It's time that our curriculum is changed to provide the necessary training in compounding to personalize care through personalized compounded medications. This should start in the colleges of pharmacy today.
Loyd V. Allen, Jr., PhD, RPh
Editor-in-Chief
International Journal of Pharmaceutical Compounding
Remington: The Science and Practice of Pharmacy Twenty-second edition
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Lidocaine Not for Teething Babies, FDA Warns
The FDA has warned against using a lidocaine solution as a pain reliever on teething babies' gums, saying it can cause deaths and serious injuries in infants and toddlers. The agency will require a boxed warning on the label for prescription oral viscous lidocaine 2% solution to highlight that it should not be used for teething pain. The issue is that when too much viscous lidocaine is given to infants and young children or they accidentally swallow too much, it can result in seizures, severe brain injury, and problems with the heart.
http://www.reuters.com/article/2014/06/26/usa-fda-teething-idUSL2N0P714C20140626
Pay-for-delay Investigations to Increase
The FTC has initiated new investigations into agreements between generic and brand-name companies that may result in suits for disgorgement of revenues. The Commission says their goal is to bring an end to this practice by whatever means are available. Their enforcement efforts gained strength last June when the Supreme Court ruled antitrust law may bar deals in which brand-name pharmaceutical companies compensate generic companies for delaying sales of a particular medication. They estimate the deals cost consumers $3.5 billion a year.
http://www.bloomberg.com/news/2014-06-23/u-s-steps-up-probes-of-deals-to-block-generic-drugs.html
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�that now that Oklahoma has surpassed California in the number of earthquakes, it is interesting to hear different scientists expound on their "facts and theories," which are largely "opinions," on causation? Whereas we formerly held "Science" as something almost sacred, it has lost credibility over the last 50 years in many areas, especially involving "politics and science" where those involved seem to twist "science" to get federal funding or one's "15 minutes of fame"! We must realize that much of what is presented as science is no more than opinion.
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