State-related actions on compounding pharmacy

While the controversy over compounding for animals is contemporary, the practice of compounding for animals is not. Pharmaceutical compounding is an ancient art and science. Compounding has been an integral part of the practice of veterinary medicine since the first cures were blended together to help an animal patient. Skilled healers have utilized compounds for both human and animal patients for thousands of years. With hundreds of species requiring treatment and dozens of new diseases emerging, the half-life of truth in veterinary medicine is particularly short. As a result of a complex and lengthy approval process, the veterinary pharmaceutical industry can never be expected to adequately supply labeled products to treat every disease encountered in every species. Consequently, in order to provide state-of-the-art veterinary therapy, the veterinarian must frequently alter commercially available dosage forms to meet needs for individual patients. This activity is defined as compounding by the major veterinary drug regulatory agencies in North America, the Canadian Bureau for Veterinary Drugs (BVD) and the United States (US) Food and Drug Administration Center for Veterinary Medicine (FDACVM). In some cases, as with potassium bromide and cisapride, there are no commercially available products for any species, and these life-saving therapies must be compounded from raw chemicals. Often, the safety of the caregiver also depends on the ability to get medications into the animal in the least invasive, most palatable manner possible. Compliance is paramount in achieving successful therapeutic outcomes, but many owners will not administer unpalatable or invasive therapies if they perceive that their pet will “hate” them as a result. Compounding based on individual patient need is an ageless solution for all of these problems.

Medications may be specially prepared, or "compounded," to meet the needs of patients who cannot use standard formulation. The United States Pharmacopeia (USP) Convention is a private, nongovernmental organization which independently develops guidelines for pharmaceuticals. The purpose of this survey study is to better understand the extent to which state boards of pharmacy currently incorporate relevant USP guidelines into their compounding regulations. Executive directors or other administrative representatives of each state board of pharmacy were invited to respond to six open-ended questions. Their free text responses were analyzed by two reviewers (KR, SI) using qualitative research techniques. The response rate was 71% (36/51). Almost all (35/36, 97%) indicated that they implement USP compounding standards at least in part. Eighteen boards (18/28, 64%) reported that 'some, but not all standards' are enforced, most commonly < 795 > and < 797 > , but not < 800 > (9/28, 32%). Ten (10/28, 36%) indicated that 'all' USP compounding standards are enforced. Eighteen (18/21, 86%) only implement finalized USP standards, whereas three consider newly proposed chapters (3/21, 14%). Over half (22/36, 61%) employ a committee or similar process to select standards. Almost all responding state boards of pharmacy incorporate finalized USP compounding standards into their regulations, usually via a formal rulemaking process, with boards commonly implementing some standards but not all. Chapters < 795 > and < 797 > are implemented more commonly than < 800 > . Since Congress passed the Drug Quality and Security Act (DQSA), pharmacy boards are becoming increasingly observant of USP compounding standards.

Should a Pharmacy Dean be a Pharmacist?

Comparison of NAPLEX pass rates for non-modifiable determinants of pharmacy programs in the United States

This study identifies attitudes of organized pharmacy, organized medicine, and the pharmaceutical industry about prescribing authority for pharmacists. A questionnaire designed to assess the impact of a legislative bill permitting a pharmacist in an organized health care setting to initiate or modify drug therapy was mailed to state pharmacy associations, state hospital pharmacy associations, state pharmacy boards, state medical associations, Pharmaceutical Manufacturers Association (PMA)-member manufacturers, and non-PMA-member generic manufacturers. Responses from 194 of the 307 invited organizations were used. The six organization types viewed the impact of the legislative bill differently (p less than 0.05). Hospital pharmacy associations and boards of pharmacy, to a lesser extent, supported the legislative bill; non-PMA-member generic manufacturers and state pharmacy associations were relatively neutral. The medical associations and the PMA-member companies opposed the passage of the bill. Furthermore, medical associations believed that the bill would not be passed in the majority of states in the next five years.

Pharmacist authority to provide HPV vaccine: Novel partners in cervical cancer prevention

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Pharmacist Licensure: Time to Step It Up?

With healthcare costs on the rise, a global initiative was launched in 2007, called Exercise is Medicine, to prescribe and counsel patients on exercise to aid in the prevention and treatment of chronic diseases. Since community pharmacists are one of the most accessible healthcare providers, this is an opportunity for pharmacists to also engage in this initiative. This study aimed to assess pharmacy student perceptions and knowledge on exercise to determine whether they are adequately prepared to counsel patients on exercise prescription. Third and fourth year pharmacy students were surveyed to test their basic knowledge of exercise prescription. Results show that 93.5% of students agreed or strongly agreed that it is important for pharmacists to counsel patients about exercise. The mean (SD) score for the 11 basic knowledge quiz questions on exercise prescription was 28.9% (SD 16.8), with no significant difference between third and fourth year pharmacy students. While students deemed exercise counseling as important, students proved deficient in exercise prescription knowledge. Schools of pharmacy may consider increasing curricular content to be congruent with this initiative.

Compounding Pharmacy Conundrum: “We Cannot Live Without Them but We Cannot Live With Them” According to the Present Paradigm

Color lines: Disparities in pharmacy treatment, education, and practice

The public, at least in the United States, has long held the pharmaceutical profession in high esteem and pharmacists are among the most accessible healthcare providers (Gallup News Service, 1997). Often the community utilizes the pharmacist as a reliable and available source of medical and pharmaceutical information. The profession of pharmacy has a covenant with society regarding safe and appropriate medication use. Pharmacists possess a unique knowledge base that brings together the pharmacology, pharmacokinetics, pharmacodynamics, toxicology, mechanism of action, adverse effects and interaction potential of pharmaceutical agents. Pharmacists then integrate this knowledge with an in-depth understanding of pathophysiology to improve patient care.

Edwin Leigh Newcomb 1882-1950: Pharmacy's many-sided man

It is common for drugs to be sold by vendors in markets throughout Tanzania; however, these drugs are often counterfeit, mimicking the size, shape, and packaging of genuine drugs without offering the desired efficacious effect. This poses a major problem. These counterfeit drugs waste resources, put individuals at risk of continued illness, and discourage individuals from purchasing genuine and life-saving medications. With the research being conducted by this global development team (GDT) for project partners at the Kilimanjaro School of Pharmacy (KSP), our goal is to develop a universal method for distinguishing between counterfeit and noncounterfeit drugs in Tanzania. The team will also develop training materials for the project to implement at KSP. High-performance liquid chromatography (HPLC) is used to compare samples of drugs with standards to test for the presence of the active pharmaceutical ingredient (API) of each drug. Various solvent and buffer solutions were researched and chosen with the hopes of simplifying the method and easing the implementation in Tanzania while still allowing for the testing of many drugs. Using the pure component of each drug obtained from the United States Pharmacopeia (USP), chromatograms have been collected from HPLC experiments used as standards for the project. So far, this research has allowed the team to test the possibility of using HPLC to distinguish between counterfeit and the genuine drugs and to develop preliminary methods for extraction and analysis of five commonly used and commonly counterfeit medications in Tanzania. Current methods to combat the counterfeit drug problem are selective to the pharmaceutical ingredient being tested and not universal. Continued research will be completed to further simplify the methods and make this project even more comprehensive for a variety of commonly counterfeited medications.

Provider status: Speaking with one voice