There are many patient groups that can benefit from the services of a compounding pharmacy. For pediatric patients there are different delivery methods to avoid needing to swallow a pill and flavors that can be added to medications to make them more palatable. Some of the same benefits can apply for geriatric compounding services – especially the ability to have alternatives to oral medications. Seniors account for about 14.5% of the US population and they all have unique needs. A compounding pharmacy can develop treatments that are best suited to the needs of geriatric patients.
Problems with Oral Medication
Dysphagia (trouble swallowing) is a serious problem among the elderly. When a patient has difficulty swallowing they are not able to get the medications they need. A compounding pharmacy can make medications into alternative delivery methods that don’t require a patient to swallow a pill. Troches and sublinguals can be used that dissolve in the mouth or a liquid solution can be made that is easier to swallow. Transdermal creams and gels can allow medication to be administered on the skin. A healthcare provider can work with a compounding pharmacy to find the right medication delivery method for their patients.
Oral medications are also more likely to cause gastrointestinal problems and interact with other medications. Elderly patients often are prescribed many medications to take on a daily basis and side effects can result from interactions between drugs. Different kinds of oral medications can also cause gastrointestinal problems, which can be exacerbated in geriatric patients. Non-steroidal anti-inflammatory drugs (NSAIDS), for example, can cause gastrointestinal problems when taken orally in patients of any age. However they can be useful in reducing pain and inflammation from arthritis. A good solution is to make a topical cream with an NSAID and other ingredients that can be applied directly to the area of pain. This avoids metabolism in the gastrointestinal tract while providing effective pain relief.
Changes in Pharmacokinetics and Pharmacodynamics
With age comes a change in many of the body’s essential systems. Metabolism and absorption of drugs (pharmacokinetics) may not be the same for geriatric patients. How the drugs affect a geriatric patient (pharmacodynamics) may also be different than when the patient was younger. When multiple drugs are being taken at the same time these problems can be made worse. The average long-term care facility resident uses about 7 to 8 different prescriptions each month. A compounding pharmacy can provide medications in dosages and forms that are better suited to geriatric patients. If it is possible to use a topical medication, for example, this may reduce problematic drug interactions.
Geriatric Compounding by Healthcare Practitioners
Sometimes at nursing facilities, a healthcare practitioner will alter a medication for a patient. This might involve breaking up a pill so that it can be more easily digested or dissolving medication in a solution. While this is technically a kind of compounding, it is inexact and can cause problems. A compounding pharmacy uses exact measurements and standards for each formulation. Dosages vary between delivery methods and can not be translated directly from one to the other without conversions. Contamination is also a possibility if compounding is done at a facility that lacks proper precautions for making medications. If altering a medication to change dosage or delivery method is necessary, an accredited compounding pharmacy should always be used.
Commercial Availability and Discontinued Medication
For various reasons, drugs are sometimes discontinued and become unavailable commercially. A patient may still need these drugs but can not obtain them the same way. A compounding pharmacy is able to provide these discontinued medications. All medications produced by a compounding pharmacy are not FDA-approved because each prescription is made individually. Since each medication is custom-made for an individual patient, compounding pharmacies are exempt from the approval process that is required of drug manufacturers.
Personalized Geriatric Compounding Services
Commercially available medications that are manufactured in large quantities are obtained from a retail pharmacy. Because of the large volume of prescriptions that go through many retail pharmacies, there is not a lot of time for pharmacy staff to spend talking to healthcare providers and patients. Since the drugs available are manufactured dosages, there are not many options for how to prepare the medication. A compounding pharmacy is often able to provide more personalized service and individualized treatment. When obtaining a compounded medication, the pharmacist on staff will spend time understanding the patient’s needs and can offer alternative solutions. At Woodland Hills Pharmacy there is always a pharmacist available to speak with healthcare practitioners about their geriatric patients’ unique needs.