Brought to you by the International Journal of Pharmaceutical Compounding
September 2, 2005 Volume 2, Issue 33
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IJPC Yard Sale
CT.com and USP Pharmacopeia Bundle
 
 
 
 
Louisiana Pharmacists Send Call For Help Through The Compounder's Network List

Thursday, September 2, 2005, Douglas Boudreaux, a Louisiana pharmacist, sent a call for help on IJPC's Compounder's Network List. For more information about what is needed and where it is needed. Click here: http://compoundingtoday.com/hurricane/

To keep up to date on hurricane relief and other compounding topics join the CNL today. Click here http://compoundingtoday.com/CNL/.

 
  Letter from the Editor
Loyd V. Allen, Jr., Ph.D., R.Ph.

Editorial: Priorities: First Three, Then Me!

With the hurricane disaster in Louisiana, Mississippi and Alabama, we are again confronted with "priorities". Time after time on the news reports we hear, "our family is alive and okay and all the rest of it can be replaced". The individual's priorities are now such that the safety and well-being of the family and friends is foremost. I think this is the first time, however, that I have actually seen news reporters break down during their interviews as the impact on these families is discussed. Many have lost everything they owned and now must start over; some have insurance and some do not. What a tragedy! There are several lessons to be learned from this experience.

First, there are warnings that precede an event. Hurricane warnings were broadcast days in advance and many, many people gave heed to the danger and left. Some, however, either could not leave due to lack of transportation, physical disability, some had no place to go or no money to travel, and some opted to stay and weather the storm. Each individual responded in some way.

Second, there should be preparation for an event way before the event occurs. Many coastal areas have accomplished construction projects to minimize the events and have plans in place for response when the events occur. It is difficult, however, to predict the magnitude of an event before it occurs so in general, we must prepare for the worst case scenario.

Third, there is the actual event that occurs and it is during this time that one feels very helpless because it is generally out of our hands to do anything. There are many forces to reckon with and some of them are known, but some are unknown.

Fourth, there is the response to the event where each of us wants to do something but oftentimes we don't know what to do. Also, the news media coverage brings the tragedy right into our living rooms and you have a feeling of wanting to do something to help to solve immediate needs of water, food, clothing, shelter, etc. In Oklahoma we are fortunate to have the headquarters for the Feed The Children organization (www.feedthechildren.org), which provides food to disaster victims all over the world, and the BGCO (www.bgco.org) services which are specially designed semi-truck trailers staffed by volunteers that cook thousands of meals daily that are delivered by the Red Cross, etc. These trucks were prepared to leave before the storm hit and left the day of the storm for staging for where they are needed.

Fifth, there is the cleanup and then rebuilding; this is what takes a long time and goes on well past the emotional aspects of the event itself. However, the families are still struggling to get their lives back together so they can go on.

Sixth, there is the impact on other aspects of our society. In this case, we all are affected; at least by the increase in gas prices and associated price increases in other commodities related to transportation.

Finally, we have to look at this event and see what we can learn from it to help minimize their occurrences or our responses in the future.

What can we do as pharmacists? Obviously there is a need to help our fellow pharmacists get back up and running so they can continue to serve their patients. If you know of anyone with a need, please submit it to the Compounder's Network List. (http://compoundingtoday.com/CNL) and we can see if other participants can provide any assistance to those in need by this communication network.

Having lived through the Murrah Building bombing in Oklahoma City, the events of 9/11, various hurricanes and, in Oklahoma, the destruction by hundreds of tornadoes, we learn something from each tragedy that shapes our preparation for the future. One of the things we continue to have reinforced is "priorities". I was taught years ago as a child to remember the phrase, "First Three, Then Me"! The first three are God, Country and Family. These three come first, before me. I think this has been evidenced many times in recent years by many, many people and pharmacists. Despite the challenges we have from nature or mankind, we respond to these events to help.

One last thing, we have many forces that are shaping pharmacy and especially, compounding pharmacy; some good and some not so good. We need to apply the same steps outlined above in preparing to respond to these forces so we don't experience a disaster where we will not be there to help our patients with individualized medications. We must prepare and be forewarned by constantly observing the political and regulatory activities of various agencies so we can adequately respond to protect our profession and our patients.


Loyd V. Allen, Jr., Ph.D., R.Ph
Editor-in-Chief

 
49 Articles Added to CompoundingToday.com This Week

Looking for articles related to compounding? Check out http://compoundingtoday.com/Articles/. This week 49 articles related to the topic of nuclear medicine/radiopharmaceuticals were included in the database. Below is a sampling of some of the citations added:

  • Barr TJ. Establishing safeguards for the use of imaging-related drugs. Am J Health Syst Pharm 2002; 59(15): 1449-1453.
  • Duong MH, MacKenzie TA, Malenka DJ. N-acetylcysteine propylaxis significantly reduces the risk of radiocontrast-induced nephropathy: Comprehensive meta-analysis. Catheter Cardiovasc Interv 2005; 64(4): 471-479.
  • Hung JC, Ponto JA, Gadient KR et al. Deficiencies of product labeling directions for the preparation of radiopharmaceuticals. J Am Pharm Assoc (Wash DC) 2004; 44(1): 30-35.
  • Mitterhauser M, Wadsak W, Krcal A et al. New aspects on the preparation of [11C]methionine-a simple and fast online approach without preparative HPLC. Appl Radiat Isot 2005; 62(3): 441-445.
  • Norenberg JP, Vaidya MP, Hladik WB 3rd. The effect of selected preparation variables on the radiochemical purity of 99mTc-sestamibi. J Nucl Med Technol 2005; 33(1): 34-41.

 
Get pH-Altering Information Quickly Using CT.com's New pH Tool

The USP 28-NF23 specifically lists 14 acidifying agents and 9 alkalizing agents. These agents and their effects are now in a new e-tool on CT.com.

The pH is important in aqueous, drug-product formulations, especially since it involves drug solubility, activity, absorption, stability, sorption and patient comfort. The pH is also related to certain physical characteristics, such as the viscosity of some polymers used as gel-forming agents and in suspensions. The pH is adjusted by using acidifying and alkalizing agents. Acidifying agents are used in a formulation to lower the pH and alkalizing agents are used to increase the pH.

For all the reasons cited above, many times a formulation may already contain one of these agents to achieve a desirable pH. In all cases, before finishing up preparing a formulation that contains water, the pharmacist must check the pH and adjust it, if needed. Generally, because of easy incorporation, freshly prepared solutions of these agents can be used to adjust pH in such formulations.

Click here to start using this new tool - www.CompoundingToday.com/pHAdjust.

 
Pharmacists Find Needed Info On CT.com

More and more pharmacists are finding what they need to fill individualized prescriptions, comply with regulations and grow their businesses. Here is what pharmacists downloaded in the last seven days on CT.com:

  • 459 Formula Downloads
  • 249 Standard Operating Procedures
  • 132 Patient Advisory Leaflets
  • 81 Abstracts and Citations
  • 47 Veterinary Transdermal Tool
  • 34 Compliance Articles (DEA, FDA, NIOSH, and USP)
  • 28 Vehicle pH and Alcohol % Tool
  • 25 Screen Saver
  • 14 NaCl Equivalent Value
  • 14 Bacterial Endotoxin in Sterile Preparations Tool
  • 13 Filter Tool - Membrane Compatibility
  • 13 Flavoring Tool - General Recommendations by Taste
  • 12 Base-Salt-Ester Weight Conversion Tool

Top Ten Keywords Searched on CT.com in the Last Week

  • ketoprofen
  • progesterone
  • testosterone
  • lidocaine
  • hydrocortisone
  • fentanyl
  • thyroid
  • prilocaine
  • hydroquinone
  • nifedipine

 
CT.com Helps You Get Compliant with USP Regulations by Providing SOPs

Five new Standard Operating Procedures uploaded to CT.com this week. Two were added to the "Administrative" category and three to the "Equipment" category. The new SOPs include:

  • 1.043 Receipt of Bulk Chemicals
  • 1.018 Shipping of Prescriptions
  • 6.013.16 - Acculab A-D GR 120 Analytical Balance
  • 6.013.17 - Acculab A-D GR 200 Analytical Balance
  • 6.038 - IKA Homogenizer - Use, Maintenance, and Cleaning

SOPs are critical for compliance to USP Regulations. Get your SOPs today at http://compoundingtoday.com/SOP/. You can then choose from the following categories:

  • Administrative
  • Training
  • Safety
  • Facility - Equipment and Maintenance
  • Facility Cleaning
  • Equipment
  • Personnel
  • Compounding Procedures
  • Quality Assurance
  • Inventory Control
  • Reference Documents
  • Veterinary Compounding
  • Miscellaneous

 
Regulatory Update

This Regulatory Update has been provided by the International Academy of Compounding Pharmacists. For more information, www.iacprx.org.

Ohio Drafts Regulations for Office Use Compounding
SB 18, legislation allowing compounding for office use, was signed into law by the Ohio governor on May 18, 2005. It becomes effective 90 days after final signature. The Ohio Board of Pharmacy commissioned a committee, which included a number of compounding pharmacists, to draft the regulations associated with the new law. Regulations are being revised and reviewed by the Board. Contact IACP to review a copy of the regulations.

IACP Submits Comments Regarding CHASM Petition
IACP recently submitted comments in opposition of a citizen petition filed by the Consumer Alliance for Safe Medication (CHASM) asking that the Food and Drug Administration (FDA) take extensive regulatory action regarding labeling and advertisements for compounded, aqueous-based drugs for inhalation. To view the full text version of the comments, visit www.iacprx.org/pdf/CHASMresponse.pdf

Medical Error Reporting Legislation Passed
Congress recently passed legislation that keeps voluntarily reported medical errors from being used in most criminal investigations. The Patient Safety and Quality Improvement Act (S. 544) is intended to allow healthcare personnel and organizations to voluntarily and confidentially report medical errors to patient safety organizations. Under the legislation, voluntarily reported medical errors are shielded from discovery in civil cases and, in criminal cases, are subject to a judge's review to determine relevance and decide whether to make the information public. The legislation further requires that an accreditation process be established for patient safety organizations that collect medical error data.

 
Compounding Tip of the Week

When mixing two liquids of different viscosities (such as glycerin and water), place the less viscous (water) in the container first and then add the more viscous (glycerin) and it will mix much faster and save time.

The same principle applies to two liquids of different densities, add the less dense liquid to the container first, followed by the more dense liquid. As the more dense liquid passes through the less dense liquid, it will set up a "circulatory displacement" method of mixing and save time.

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International Journal of Pharmaceutical Compounding
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