Hudacko's Pharmacy

Caring for a loved one in a hospice environment can be challenging. You, the physician, and a compounding pharmacist can provide personalized symptom control and pain relief.

The need for hospice compounding is growing. As the elderly population grows, the need for compassionate hospice care becomes more and more relevant. At the heart of hospice care is the belief that each person has the right to die pain free and with dignity. In many cases the care is provided in the patient’s home with a loved one serving as primary caregiver.

Compounding offers options for unique drug combinations that can be prepared to allow patients to continue to live normally within their pain threshold. Many hospice patients have trouble taking their medications. Transdermal gels, flavored troches (placed between the cheek and gum), suppositories, oral suspensions or even lollipops are some of the many alternatives to traditional dosage forms. Relief can be tailored to a patient’s specific needs.

Common symptoms experienced in end-of-life care such as pain, nausea/vomiting, constipation, diarrhea, bedsores, and anxiety can be dealt with through compounding. Hospice care focuses on pain management.

The goal is to relieve as much pain as possible without causing sedation or adverse side effects. Since patients vary in size, tolerance and needs, commercially available medications often do not provide the appropriate strength or method of administration.

Through compounding, a physician and a compounding pharmacist can design a specific medication to the exact needs of the patient.

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Managing pain can be a challenging and frustrating experience. Many pain medications, when given in doses that provide pain relief, can cause debilitating side effects. These side effects may include drowsiness and can often prevent people from working or driving a vehicle. Also, many types of pain do not respond well to traditional therapy.

This is where a compounding pharmacist can help. Many oral pain medications can actually be applied topically, right where it hurts!

Topical pain cocktails can work well, especially for the following conditions:

• Muscle pain from injury or soreness/tightness
• Nerve pain from injury or painful conditions such as post-shingles pain
• Joint pain such as that from arthritis or sprains
• Bone pain
• Other types of pain

You may call us with questions about the medication you are currently using for your pain, or you may ask your doctor about using topical compounded pain medication. If your doctor has questions, the doctor is welcome to call us as well.

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Dermatological prescriptions frequently need to be compounded. Often, this can be simply the addition of an active drug to a topical cream or lotion or it may require a complex formulation to meet a patient’s specific needs.

Commonly compounded dermatological prescriptions include medications for acne, psoriasis, warts, fungal infections, rosaceae, hyper pigmentation, miscellaneous skin infections and hyperkeratosis among others.

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When athletes need help in recovering from injuries or muscle pain, their treatment should be as individualized as they are. At Hudacko’s Pharmacy, we customize medications for anything from tennis elbow and carpal tunnel to muscle spasms, fibromyalgia, and peripheral neuropathies. Our pharmacists can customize medications to fit the weight and body type of any athlete, as well as offer topical gels and pain sticks which can be applied directly to the problem area.

We can provide help with:

• Blisters – Flexible collodion preparations
• Fever Blisters – Lip balms with or without sun block
• Rehydration – Sports drink formulas
• Athlete’s Foot – Topical Antifungals
• Muscle Aches – Topical Gels, Pain Sticks
• Muscle Cramps – Speed Gels, Topicals
• Wounds – Polyox bandages, gels, ointments
• Carpal Tunnel – Transdermal Gels
• Nail Fungus – Antifungal solutions
• Hemorrhoids – Rectal Rocket Suppositories
• Sprains – Transdermal Gels
• Trigger Point – Transdermal Gels

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While the location of many oral disease states would allow for ready topical treatment, often the necessary medication is not available in a topical form. However, such medication formats frequently can be provided to the dental medicine professional by a compounding pharmacy.

For example, corticosteroids can be incorporated into a mouth wash for the treatment of canker sores, lichen planus, cicatricial pemphigoid and pemphigus. Further, the pain associated with these conditions can be relieved with the use of a prescription analgesic agent that is compounded with a mucoadhesive agent.

Troches containing an anti-fungal agent for the treatment of thrush and alcohol-free microbicidal mouth rinses helpful in the management of gingivitis and periodontitis also can be compounded.

Our pharmacists can provide the practitioner of dental medicine with a variety of “custom-made” prescription compounded medications that can be helpful in the management of a number of dental disease states.

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Bedsores or pressure sores are caused by impaired blood supply and tissue nutrition that result from prolonged pressure over bony body prominences. Similarly, skin ulcers can occur in diabetic patients. The ulcers, usually located on the feet, are the result of a combination of nerve damage and impaired blood circulation that are frequently associated with chronic diabetes.

The management of such wounds can be difficult. Obviously, the initial approach to treating such wounds must be to address the underlying causes and to correct them as much as possible.

Our compounding pharmacists can prepare a variety of prescription medications that can be helpful in the total management of such skin conditions. Additionally, prescription antiseptic medications are available for use in the management of septic wounds.

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A wide variety of diseases can affect the ears, nose and throat (ENT). Most commonly, they are infectious or allergic in origin and are usually effectively treated with antibiotics or antihistamines.

However, commercial medications often are not available in a form that would best suit the management of a particular disease state or which would allow for easier administration to the patient.

The primary role of the Compounding Pharmacist in the management of ENT disorders is that of providing physician-indicated medications in a variety of forms, such as lozenges, mouth rinses, nasal drops, troches etc. that are better suited for a patient’s particular needs.

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Alternative dosage forms, flavored medicine and strength variations are some of the main reasons your child’s pediatrician may wish to contact a compounding pharmacist.

Many children have difficulty swallowing capsules or tablets, especially when it involves more than one medication during the day. Pediatricians and compounding pharmacists can work together to find alternative dosage forms for your child. These include lollipops, syrups, freezer pops, lozenges, and other forms, even pacifiers for infants.

All of the previous examples along with others can be produced in any number of flavors that your child won’t mind taking.

A child’s weight can also be a problem. Drug strengths frequently need to be scaled-down in order to provide the proper dose of the drug for the child. Breaking a tablet into some fractional size is not only often difficult; it can result in giving the child a dose of medicine that could be either too high or too low. Fractionating the dose of a drug contained in a capsule at home is fraught with danger

The compounding pharmacist can easily prepare the exact dose of a drug for a child.

New drug delivery systems are being developed for children. For example, antiemetics for the management of motion sickness and nausea and vomiting can be compounded in the form of a transdermal gel that is dispensed in a graduated syringe and applied to the child’s wrist thus providing easy administration with the elimination of undesirable side-effects.

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Our ultimate goal through compounding here at Hudacko’s Pharmacy is to improve patient compliance. Of all of the hospitalizations in the elderly population, 25% of them are related to non-compliance. When patients don’t take their medication properly diseases progress or go out of control and that is what happens. Patients don’t take medication correctly for many reasons: side effects, difficulty with available dosage forms, multiple medications, forgetfulness, cost, taste, etc. Many of these problems can be eliminated through compounding. Each patient is unique and should be treated that way.

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The symptoms of hormone imbalance are all too familiar for the millions of women who suffer from hot flashes, depression, night sweats, insomnia, mood swings, and loss of libido on a daily basis. In the past, hormone replacement therapy has relied on synthetic hormones or animal-derived hormone products that come only in one-size-fits-all doses. While this therapy has worked for some women, many others have found that it has no effect at all, or worse—it causes a host of unpleasant side effects. This should be of no surprise, since every woman’s hormonal profile and needs are uniquely her own.

Our approach to hormone replacement therapy uses simple, personalized hormone-level assessment and monitoring combined with customized doses of natural hormones that are identical to those your body makes. We also recognize the important contribution of healthy lifestyle choices and proper nutritional supplementation to hormone balance.

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