Editorial: Is "pharmacy" still a science-based profession?

The practice of pharmacy has undergone many changes over the past 25 years. I read a statement a few days ago of a dean that said that they preferred a certain textbook in their curriculum because it was "easy to read, simple, and did not have much science in it". Obviously, this was a very disappointing statement to read because I have always thought, and still do, that pharmacy is based on the "sciences" and that the practice of pharmacy should be science-based.

However, upon thinking about it, that individual may be right by saying that science is not really what is being taught and the inference is that the practice of pharmacy is not based on science. Let's look at these issues.

First, to be science-based, means to study the sciences and to use the scientific method in academic training. Obviously, the sciences are still taught in colleges of pharmacy, although not at the level that they used to be taught. At what point then, does it cease to be science-based? Is looking up information on MEDLINE or some other retrieval service a scientific function? Is it "searching" or "researching"? Does it generate any new information? How about what is taught in laboratories? Is it "cookbook" or does it require some preparation and thought prior to conducting the laboratory exercises in the courses that require laboratory exercise activities? Obviously, the answers to these questions depend upon the individual faculty members involved, their teaching method, the assignments provided to the students, and the approaches the students take in problem solving.

How about the practice of pharmacy? Is it science-based? With automation and robotics becoming a bigger part of the dispensing function and computerization helping to make more and more decisions, how much is the pharmacist "really" involved in making decisions using the scientific method, etc.?

I do know that pharmacists involved in compounding use their scientific background every day; they have to! I do know that pharmacy students enjoy compounding because of the knowledge it requires, the approach to problem-solving involved, and the joy of seeing a completed formulation they have either helped to develop or compound for a specific patient.

How about science and pharmacy? I really guess at this point in time it is up to the faculty members, students and practitioners; they can either make it science-based or they can make it a repetitive function involving dispensing with minimal patient and professional interaction. I really think that for the future and potential involvement in biotechnology, biogenomics and nanotechnology, we need to get back to the scientific foundation upon which pharmacy has been built and has prospered for so many years. This begins with our practices and letting the academic institutions know that our future pharmacists need to be "scientifically trained" and not only trained to do literature searches, discuss disease states, etc. The practice of pharmacy is so much more than that.

I think we really need to address this issue over the next few years to prepare pharmacy for a great new future that is slowly developing. It is evident that the majority of pharmacists are not going to be reimbursed monetarily at a level commensurate with their pay scales. Therefore, we need to address this problem and look at the various alternatives we have. I am afraid that the new Part D is not going to be the answer that so many have been looking for and counting on. As has been said many times, let's not put all our eggs in one basket��.let's diversify by looking at the options and preparing for them.

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

This week CompoundingToday uploaded the Oral Vehicle Tool which is an expansion of the Vehicle pH and Alcohol Tool. The new and improved oral vehicle tool includes 32 commonly used oral vehicles in pharmacy compounding. The tool provides information on various official (USP-NF) vehicles, nonofficial and commercial branded vehicles and lists their pH, alcohol content, main ingredients, and appropriate container for storage, synonyms and bibliographical references. And it�s all available with a click of your mouse. Check it out at www.CompoundingToday/OralVehicle

There is no other database in the world solely comprised of compounding related citations and abstracts. CompoundingToday.com (CT) now has more than 1900 articles from 614 different publications all related to compounding.

Just this week CT added approximately 40 stability and compatibility articles to this growing database. Here is a sampling of what was added:

• Chiadmi F, Lyer A, Cisternino S et al. Stability of levamisole oral solutions prepared from tablets and powder. J Pharm Pharm Sci 2005; 8(2): 322-325.
• Hui M, Kwok AK, Pang CP et al. An in vitro study on the compatibility and precipitation of a combination of ciprofloxacin and vancomycin in human vitreous. Br J Ophthalmol 2004; 88(2): 218-222.
• Lee TY, Chen CM, Lee CN et al. Compatibility and osmolality of inhaled N-acetylcysteine nebulizing solution with fenoterol and ipratropium. Am J Health Syst Pharm 2005; 62(8): 828-833.
• McCarron PA, Donnelly RF, Andrews GP et al. Stability of 5-aminolevulinic acid in novel nonaqueous gel and patch-type systems intended for topical application. J Pharm Sci 2005; 94(8): 1756-1771.
• Pathmanathan U, Halgrain D, Chiadmi F et al. Stability of sulfadiazine oral liquids prepared from tablets and powder. J Pharm Pharm Sci 2004; 7(1): 84-87.

The Compounders Network List, a free email network for compounding pharmacists, spent most of last week networking to get needed medications to Hurricane Katrina affected areas as requested by pharmacists Douglas Boudreaux and Gigi Davidson for humans and animal patients. For more on this see www.CompoundingToday.com/Hurricane.

• A formula for Interferon ophthalmic solution with beyond-use dating
• A formula and dosing for topical theophylline in felines
• Tapazole formula for a feline
• A formula for Ketoprofen in PLO and other topical delivery systems
• A formula for "Lahey #3"
• A dye-free morphine solution formula
• Dosage documentation on sildenafil cream

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

New Fax Rules Affect Direct Marketing Via Fax Communications
President Bush signed the Junk Fax Prevention Act of 2005 into law in July 2005. While the bill maintains the "established business relationship" (EBR) exception that allows business to send unsolicited commercial faxes to their members and clients, there are several requirements. Read more>>.

IACP Responds to AVMA
IACP recently sent a letter to the American Veterinary Medical Association (AVMA) expressing concern with a new policy that characterizes compounding pharmacists as "contentious exhibitors" at trade shows. Read More>>.

APEx Kinetic Aseptic Training Program
The United States Pharmacopeia (USP) has published enforceable requirements, USP Chapter <797>, that addresses the proper preparation of compounded sterile preparations. USP <797> has redefined the practice of compounding sterile preparations in all practice settings (hospital, retail, institutional, and home infusion). Many states have adopted USP <797>, while some have developed their own more stringent regulations for compounding sterile preparations and have begun to inspect pharmacies for compliance with these regulations.

The Aseptic Training Program offered by Clinical IQ, LLC in cooperation with the Contamination Control Institute (C2I) will offer participants the unique opportunity to combine classroom training and hands-on practice to develop and enhance their sterile compounding skills, while learning how to integrate quality into their daily activities. Attendees will have the opportunity to work in cleanrooms, barrier isolators, biological safety cabinets and laminar airflow workbenches and will undergo aseptic media fill qualification, learn how to establish an environmental monitoring program, perform environmental sampling, cleaning and sanitizing, designing and building a cleanroom.

The cost of the program (tuition) is $1,895 per person. Call for group discounts. The program is ACPE approved for 21.25 hours of ACPE credits. Attendees will also receive sample policy and procedures that will help them meet or exceed USP <797> requirements for environmental monitoring, aseptic media fill and cleaning.

Class Dates: October 3-5, October 31-November 2, and December 12-14, 2005
Editor's Note: Due to the recent hurricanes, the October 3-5 class has been canceled.

The faculty will include:

• Kym Faylor, Quality Assurance Manager, Microbiological Environments, LLC
• Eric S. Kastango, RPh, MBA, FASHP, President, Clinical IQ, LLC
• Holly Simmons, RPh, President, Impact Solutions Group, LLC
• James T. Wagner, President, Controlled Environment Consulting, Inc

The class is conducted at a state-of-the-art training facility located in Bethlehem, PA, located within minutes of the Lehigh International Airport. For more information, call 973.765.9393 or download a C2I Registration Form.

Educational Review Systems is approved by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmaceutical education. Individuals may obtain up to 21.25 hours of credit or 2.125 Continuing Education Units (CEUs). Statement of credit will be awarded to attendees that attend the entire program and complete an evaluation form. Statement of credit will be mailed via first class mail to attendees with 6 weeks of the program.

Need a quick disposable funnel?

Cut the top and part of the shoulder off of a plastic bottle and wash it thoroughly. Invert it and use it as a funnel and then discard it. Bottles from the size of a soft drink to a gallon bottle formerly filled with water works great; the gallon bottles can even be cut so the handle is still useful. Please be sure they are thoroughly cleaned prior to use.