F: What made you decide to blog about water on
In my early years in pharmacy, we compounded a lot more things than we did when I left the field. We did it because it wasn’t available commercially or because it saved us operating costs.
Compounding had its lighter moments. I still think of K, with whom I worked with for many years. Our pharmacy department had a standard cream preparation that we dispensed so often that one of us would have to spend a couple of hours, every couple of weeks, making a 2 kg batch, which would then be put into forty, 50 mL jars. Others in the department would use the Kitchen Maid electric mixing bowl to make the cream, but K and I preferred using spatula and slab because it was easier to cleanup at the end.
When K was the one to make the batch, it would always end up as a 2 dimensional “K slab work of art” before being broken up to fill the jars. If it was Thanksgiving, she’d shape it into a turkey; if it was Easter… you get my drift.
I have three compounding anecdotes that came into my mind, yesterday. I am going to tell one now and maybe save the others for other blogs. They may not seem funny as I guess they are the” you had to be there” kind of funny”, so bear with me because I think they are funny and this is my blog.
Vanity, Thy Name is Sludge
About twenty five years ago, a blood pressure medication came onto the market, which, as it was discovered, had a side effect of causing hair growth. Today, a topical solution with said ingredient is available, over the counter, for those men and women who are follicularly challenged. In the days of this tale, it wasn’t. However, some doctors weren’t adverse in prescribing the solution anyways.
One evening, a young man came into the pharmacy with a prescription. The prescription was for a topical solution containing X% of said drug. He was to apply the solution topically, to the bald area , daily. We looked at the man, who was evidently self-conscious about the situation, and blinked. We had never seen such a prescription before and were quickly trying to think of what to tell him. We knew that he was expecting us to just pull a bottle off the shelf and hand it to him - fast in and fast out.
Pharm: Sir, this product isn't available on the market, yet. We’ll have to make it from scratch and currently we don't have the ingredients to prepare it. Would you like to come back in a couple of days? It will take that long to get the ingredients and compound this prescription.
Long story short…
We figured out how many tablets of the medication (we had to use the tablets as nothing else was available) we were going to need to yield the solution strength the doctor had asked for. Luckily, looking up the solubility factor of the drug in our Big Book of Knowledge, we found that the drug was totally soluble in alcohol (pharmaceutical proof stuff).
To easy~ grind the tablets into a powder, add the required amount of alcohol, mix and let it all sit for a period of time in order to leach the medication from all the fillers used to make the tablets, and then filter into an applicator bottle. Voila, done!
Wrong!!!
Problem 1. We needed 200 tablets. This was going to cost the fellow $200 (new drug = expensive).
Problem 2. Expediently grinding 200 HARD tablets into a really fine powder was taking forever and the sound of doing it with a mortar and pestle was like fingernails on a chalkboard.
Problem 3. After adding the alcohol:
Me: Hey Pharm, this is looking really sludgy; really, really, really sludgy. I think we are going to have a BIG problem filtering this.
Pharm: Let’s give it a go.
Me: How long do we let this sit before we filter it?
Pharm: the Big Book of Knowledge didn’t say. Let’s try an hour.
Problem 4.
Me: This isn’t filtering at all. It might though, if we left it all for a hundred years. But by then the alcohol would totally evaporate and we’ll be back to where we started, but this time with ONE HUGE HARD tablet.
Pharm: Let’s just put the whole mess in the applicator bottle and see if he wants to take it as is.
The young fellow came in and we gave him his prescription. We explained that it was expensive because of the cost of the ingredients. However, because it was so expensive, we were not charging for compounding time or our dispensing fee.
Then we explained the “sludge factor”.
We gave him that “moment” to say he didn’t want to take it. But he took his prescription, paid for it, and left.
We never saw him again, which was a shame because the doctor wrote to allow him 11 re-fills.
2 comments:
I wonder if he never returned to your pharm because he couldn't manage to comb all the hair he grew or because he was embarassed because the alcohol had evaporated and he was left with what looked like a golf ball embedded in his bald scalp!
ROFLMAO :)
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