Combination Therapy of Oral LDN and Topical Pentoxifylline, Rifampin, Clindamycin for Hidradenitis Suppurativa
Joe Bertrand, RPh, Matthew Bruno, PA-C, Andrew Komuves, RPh, FAPC, Nat Jones, RPh, FAPC, Kameryn Carper, CDT, MA, Fabiana Banov, RPh, MS, Maria Carvalho, PharmD, MRPharmS, PhD

Hidradenitis Suppurativa (HS) is a chronic inflammatory skin disease that may have profound effects on the patient's quality of life. A personalized HS combination therapy treatment was prescribed to a 54-year-old female suffering from multiple painful sores.

Ketamine for Pain in Hospice Patients - A Transdermal Gel Applied to the Painful Site
Robert M. Wood, BS Pharm

The author has been using ketamine to treat hospice patients for several years, with varying degrees of success, and reports being most successful with the transdermal-gel form. He has also had success with ketamine administered as a nasal spray. In addition to providing general comments on the use of ketamine in this context, he presents four brief case reports demonstrating the use of ketamine and other medications in treating pain associated with various types of cancer.

Pediatric Compounding: Coloring Outside the Lines
John Preckshot, RPh

Most new drugs are not labeled for certain populations, such as infants and children; and “off-label� use of drugs is common in pediatric patients. In this article, the author introduces pediatricians to the services of compounding pharmacists. He discusses topical anesthetic combinations, laxative formulations, medications for attention-deficit hyperactivity disorder, antinausea medications, diaper-rash medications, acne medications and head -ice medications. He concludes that the compounding pharmacist must use innovative thinking to formulate pediatric titrations of adult medications and to flavor those titrations to make them more palatable for children.

Acute Migraine Treatment with Timolol 0.5% Nasal Spray - Compounding Pharmacists Have an Important Role
John C. Hagan III, MD, Steven C. Kosa, MD, Tyler Chamberlain, PharmD

For the foreseeable future, timolol 0.5% nasal spray prepared by compounding pharmacists will be the only source for a potentially dramatic new paradigm in the treatment of acute migraine.1 It is also likely other medical conditions can be treated with the compounded timolol nasal spray that need extremely rapid therapeutic beta blocker blood levels when IV infusion is not possible or practical. This manuscript will review the research and development of compounded timolol medication over the past dozen years and reference previous articles in IJPC detailing how the pharmaceutical compounded product is prepared.2 A final goal is to engage physicians in a beneficial working relationship with compounding pharmacies to make immediately available to patients a nasal spray formulation of the beta blocker timolol 0.5% in solution. It has recently been demonstrated for the first time to benefit acute migraine treatment.

Compounding Trade Association Issues Ketamine, Office Pay Best Practices APC Also Updated Position Statements on Constructive Transfer and Peptide Compounding
Scott Brunner, CAE

The Alliance for Pharmacy Compounding recently released four resource documents aimed at shaping compounding best practices and regulatory compliance.