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As incidents of terrorism become more common, pharmacists and other healthcare professionals must plan for a possible domestic terrorist attack involving biological, chemical, or nuclear weapons. Federal, state, and local agencies must have the knowledge, intelligence, training, and supplies to counter this threat. Pharmacists have a unique role to perform in providing needed pharmaceuticals and information to their communities, and they should be involved in a community's planning for response to bioterrorist or terrorist attacks.
Compounding may be involved in treating not only patients suffering from exposure to nerve gas, biological weapons, or trauma, but also victims of a bombing. Pharmacies' maintenance of just-in-time inventory works against an adequate response to disasters and terrorism. Competition for limited resources could challenge the ability to maintain civic order. Pharmacists involved in an emergency situation may find that providing information is relatively simple but providing pharmaceuticals is more difficult because pharmacies routinely stock commercially available products in limited quantities only. Many pharmacists can compound some preparations to help fill the need until commercial stocks are replenished. Compounding pharmacists can provide various dosage forms to all types of patients.
An effective response to bioterrorism will require prepared, well-trained local responders who can interact with state and federal agencies. Training for responders should cover the characteristics of biological and nonbiological agents that can be used in destruction. Pharmacists should be trained in their duties as responders, and they should be protected in the event of an attack so they can perform those duties. Security of the pharmacy may be a top concern because break-ins to obtain medications may occur. Although the threat of terrorist attacks has grown in recent years, natural disasters such as floods, hurricanes, and tornadoes are a recurring cause of mass destruction. For these situations, too, pharmacists should be involved in local disaster planning. Even small communities must be prepared to handle a mass casualty incident until state and federal assistance arrives. In such circumstances, healthcare providers must manage many patients who require urgent care, and pharmacists are likely to be pressed into action to deliver the medications needed to save lives; relieve pain; and limit potential damage from exposure to caustic, infectious, or other harmful agents.
More next week.
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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