This week I have the opportunity of visiting Barcelona, Catalonia, Spain (Catalonia is an independent "state" of Spain with a very unique history). During the week, I have presented five lectures and held one question and answer session on pharmacy compounding. Four of the lectures were held at the University of Barcelona (two lectures to second year pharmacy students; one lecture to pharmacy faculty; one lecture to pharmacy graduate students). The University has about 2,000 pharmacy students, and their course of study is still heavily oriented towards the sciences. It is a 5-year curriculum with about half of the last year devoted to rotations. There was an evening special lecture to the professional association of Pharmacists of Barcelona and on another evening, a banquet of the Catalonia Association of Pharmacists, where a question and answer session, lasting for about an hour, was conducted.

Pharmacy compounding comprises only about 0.3% to 0.7% of the prescriptions dispensed in Barcelona and Catalonia. The "manufactured" prescriptions are all paid for by the government. In contrast, "compounded" preparations are not necessarily paid for by the government. However, when the government does pay for them, the reimbursement oftentimes does not cover the ingredient cost or time to compound preparations. Therefore, patients will often pay out of pocket for their compounded medications.

Pharmacists of Barcelona and Catalonia are very interested in the way compounding is handled in the US, where we are concerned with our patients and cultivate the physician-patient-pharmacist relationship. Pharmacists here in Barcelona are interested in the dosage forms prescribed, the quality standards we have in place in the US, the United States Pharmacopeia standards, and how compounded services are marketed to physicians and patients.

On Wednesday afternoon, three pharmacists and I visited the Royal Academy of Pharmacy of Cataluna (Reial Academia de Farmacia de Catalunya). One of the pharmacists was a member of the Academy. It was a very impressive facility (one of the Knights of Malta former hospitals), and its membership is very active. In fact, they are expanding the facility in the next few weeks. Invitation into the Royal Academy is very selective, and each candidate, nominated and evaluated by members, is voted on (using black and white balls) to determine their worthiness for membership.

As was often said to me this week, "You, in the United States, are setting the standards for compounding worldwide that we want to follow. Please continue working with us so we can increase our compounding activities and provide better care for our patients. We want to follow what you are doing."

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

This discussion group of 1070 pharmacy personnel worldwide continues to be active, with an average of 10 posts each day, 24 hours a day, 7 days a week, 365 days a year. Some of the most recent topics include:

• Belladonna and opium suppositories
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Join the list today at www.compoundingtoday.com/CNL and read what others have to say and/or contribute, and what questions are posted. It's easy, free, and informative.

Committee E of the American Medical Association (AMA) House of Delegates will present Resolution Number 521 regarding compounded respiratory medications at their meeting on June 12 through 14, 2006. For more information on this resolution, go to: www.ama-assn.org/ama1/pub/upload/mm/471/521a06.doc.

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Check your bulk density!
Ever had capsules that were not full or were too full? Each time you get a new batch of lactose or other diluent, check its bulk density. For example, if you weigh a standard quantity of the lactose (e.g., 50 g) and you place it in a graduated cylinder and it measures "X" mL, the bulk density will be the weight divided by the volume. Subsequent lots of the lactose should be the same. However, if you obtain a lot and the bulk density is different, i.e., you obtain a different volume for the 50 g, then your capsules will not be filled the same as the actual amount of space occupied by your previous lot of diluent. This is a quick check that can make compounding of capsules easier and minimize weight variation. It is also simple to adjust the quantity required by adjusting the lactose in the graduated cylinder to the volume you are accustomed to, determining the new weight, and adjusting the formula to accommodate the change. Hint: You can actually just track the volumes the weighed quantity occupies and make it even faster.