Brought to you by the International Journal of Pharmaceutical Compounding
March 3, 2006 Volume 3, Issue 9
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Quality Assurance in the Compounding Pharmacy
A Pharmacist's Guide to Providing Veterinary Prescription Services
 
 
 
 
  Letter from the Editor
Loyd V. Allen, Jr., Ph.D., R.Ph.
Editorial: Pharmacy Organizations: Do they Support You or Themselves?

Most organizations in our society are formed for good reasons and have specific goals and objectives in mind. This is true in the case of the profession of pharmacy. We have many, many, many, many organizations. Each has been formed because of an apparent need that existed at the time of its formation. In many cases, the need is still there and the organizations are vitally important as a "voice" for its membership.

What happens in the life of an organization? During its formative years, there is a great deal of enthusiasm and effort put in by its membership and much of the work is handled by volunteers. As the organization grows, generally a staff is hired to conduct the administrative affairs of the organization. The staff responds to the elected officers and to the resolutions passed during annual or biannual meetings. This is all well and good for the organization. However, let's look at what sometimes happens over time.

As time goes on, the purpose for which an organization was formed may disappear, and the organization is faced with "reorienting" its goals and objectives. In many cases, this is due to technology changes, practice changes, etc. and can serve a good purpose. In some cases, however, it may be best if the organization was just dissolved and "went away" rather than to struggle and be relatively ineffective.

In another scenario, an organization may continue to grow to the point that it becomes "isolated from its goals and objectives" and no longer serves its original purpose. In this case, it is up to the membership to hold the elected officers and staff responsible for meeting the purpose of the organization and even "reorient" the organization back to where it should be. Changes can occur in an organization quite easily and it can get "off-track." This can occur because much of the membership is not very active and the voices of a few "activists" can change the structure and purpose of the organization to something other than what it was intended.

Another scenario that occurs when an organization continues to grow is that it becomes a "staff-based" organization rather than a "member-based" organization and the organization tends to revolve around the wants and needs of the "staff" rather then the "membership." This seems to be what has happened and is happening with some of our major pharmacy organizations. Many staffs have not practiced pharmacy and many are not aware of the day-to-day situations pharmacists must face and be responsive to. Is the purpose of the organization to serve pharmacy and pharmacists? OR, is it to maintain the level of staffing at the administrative offices? How can we tell? Let's look at a few signs and ask a few questions.

  1. Is the organization serving the profession of pharmacy and pharmacists in the vast majority of its activities?
  2. Is the budget set up so that most of the monies go towards supporting pharmacy issues and pharmacists' concerns?
  3. Does it seem that there are numerous "levels of bureaucracy" that must be challenged to get something done?
  4. Is the primary goal of the organization "raising money" or "serving its members"?
  5. Are the annual or biannual meetings set up so that employee pharmacists can afford to go or are they priced so high that only administrative pharmacists, pharmacy owners, etc. can afford to go and write it off as a business expense?
  6. Is the organization subject to some (even a little bit) control by sponsors of various events, programs, etc. that the organization agrees with for financial purposes?
  7. Are the "books" or complete and detailed financial records available to each member upon request, including salaries and "perks"?
  8. Is there a requirement for full disclosure for all the staff of the organization that is responsible to the membership?
  9. Is the organization controlled by staff and major decisions made by staff with just agreement by the officers who serve relatively short terms?
  10. As successes occur in the overall politics of pharmacy, does the organization all of a sudden jump on the bandwagon and take credit for the success even though they were not really involved in the "nitty-gritty" work in the issue?
  11. How willing is the organization to take an "unpopular" stand even though it is in the best interests of pharmacy?
  12. If you have served as an officer, did you feel that you accomplished something or did you feel that you just gave voice-approval to the staffs' projects?

We could go on and on about this topic. I believe, however, that too many organizations do not really exist "for pharmacy" but exist "for their staff." I want to point out that if an organization is too big to listen to its individual members, it no longer is serving its original purpose.

In all honesty, however, how does all this happen? It happens because either too many pharmacists are not members or they are members but are not involved. If members of an organization are not sufficiently interested in the purpose and welfare of the organization to be involved, then I guess they get what they deserve. However, pharmacy and pharmacists may suffer for this lack of participation. Let me encourage everyone to select one or two or three national organizations, a state organization, and even an international organization and become active. Pharmacy is at its present position today because of the efforts of many in the past. What we leave behind for future pharmacists is up to us.


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

 
Oxytocin Stability Study Available for FREE!

The March/April Issue of the International Journal of Pharmaceutical Compounding is on its way to subscribers. However, if you sign up for a FREE trial of CompoundingToday.com between now and April 15, you can download a free copy of the article "Extended Stability of Oxytocin in Common Infusion Solutions," a stability study by Larry Trissel et al. http://CompoundingToday.com/Temporary/Oxytocin.cfm

 
Literature Search on CT.com Grows to 2700 Abstracts

One of the most accessed tools on CompoundingToday.com is the literature search database. This database now has more than 2700 article abstracts and citations all related to compounding topics with links to the original publishers. More than 415 abstracts have been accessed in the last 30 days.

Pharmacists use these accessed, downloaded, and printed abstracts to give to physicians who request literature to substantiate their prescribing decisions for a compounded medication.

Each week, article abstracts and citations are added to CompoundingToday.com from the most recent literature and from past literature depending on the topics. This week 48 articles were included discussing the treatment of itch as a symptom of systemic disease such as cholestasis in liver disease, uremia in kidney failure, side effects of opioid therapy, etc. Two articles relevant to C. difficile infection (i.e., probiotics) were also added. Here is a sampling of the articles included and now available on CompoundingToday.com:

  • Biro T, Ko MC, Bromm B et al. How best to fight that nasty itch—from new insights into the neuroimmunological, neuroendocrine, and neurophysiological bases of pruritus to novel therapeutic approaches. Exp Dermatol 2005; 14(3): 225-240.
  • Dawn AG, Yosipovitch G. Butorphanol for treatment of intractable pruritus. J Am Acad Dermatol 2006; 54(3): 527-531.
  • Greaves MW. Itch in systemic disease: Therapeutic options. Dermatol Ther 2005; 18(4): 323-327.
  • Guarneri C, Terranova M, Terranova G et al. The future: Critical knowledge about anti-itch therapy. Dermatol Ther 2005; 18(4): 363-365.
  • Jones EA, Zylicz Z. Treatment of pruritus caused by cholestasis with opioid antagonists. J Palliat Med 2005; 8(6): 1290-1294.

Start your literature search now: http://compoundingtoday.com/Articles/

 
Standard Operating Procedures: 2774 Downloaded in Last 30 Days

There are approximately 300 Standard Operating Procedures on CompoundingToday.com that can be downloaded and customized for your pharmacy. This week we expanded and revised SOP 6.017 - Graduated Cylinders - Use and Calibration. Download it now. http://CompoundingToday.com/SOP/SOPCat.cfm?lngSOPCatID=6

 
CompoundingToday.com Offers New Patient Advisory Leaflets

CompoundingToday.com saves pharmacists time and money by offering resources, tools, and practical information that can be downloaded and used at the click of the mouse. Therefore, we're adding to our Patient Advisory Leaflets (PALs). This week we added "Transdermal Treatment Options for Hospice Patients." It's in an easy-to-print, professionally designed PDF file. Click here to see all of our PALs http://CompoundingToday.com/PAL/. Watch for this section to grow!

 
CNL: What's Hot

This week pharmacists discussed a wide range of topics on the Compounder's Network List. Here is a sampling of some of the topics:

  • Treatments for dry, splitting nails
  • White iodine
  • BHRT - Letters from patients to US Food and Drug Administration campaign
  • BHRT - Treatment in a patient with non-Hodgkin's lymphoma
  • Compounding pharmacist position wanted in New Jersey
  • Formula for diclofenac or ketorolac suppositories
  • Dantrolene suspension for a horse
  • Capsule machines for 00 and 000 gel caps
  • Dry-heat sterilization
  • "Tornado" dye for display
  • Convection ovens
  • Doxycycline monohydrate formulation stability
  • Diltiazem 2% topical gel for anal fissures

Tune in next week to this network of more than 1000 pharmacists worldwide. It's free. Just click here to get started http://CompoundingToday.com/CNL/.

 
Compounding Tip of the Week

Olfactory Checking of Drugs and Drug Preparations/Products
As many are aware, USP-NF has some descriptions of odor for many of its official substances. We also need to occasionally "smell" chemicals and final compounded preparations as a check to confirm what is present is what it should be. In "smelling" a chemical or a preparation, one should open the container and hold it several inches away from the nose and "waft" the hand over the top opening of the container moving the odor/vapor towards the nose for the smell test. One should NOT open the container and stick their nose over the top of it as this can be hazardous. The pharmaceutical industry uses an "electronic nose" but we can depend upon our "anatomical nose" for our purposes.

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