1. Hospital Pharmacy Compounding Virginia R. Leland R.Ph. Clinical Pharmacist Drug Services virginia@u.washington.edu

2. Objectives Review training for pharmacy compounding Discuss products made in a hospital pharmacy setting Discuss changing standards for pharmacy compounding

3. Pharmacy Background B.S UW School of Pharmacy 1969 University of Washington Medical Center 1974-present PCCA Primary Compounding Course 1996 Certificate in Comprehensive Compounding 2003 Certificate in Aseptic Technique and Risk Level III 2003

4. Access to Compounding Training School of Pharmacy On the job Vendor-PCCA Certificate Programs Board Certification as a specialty???

5. Drug Services Compounds for the UW Medicine system pharmacies Purchases pharmaceuticals for researchers within UW Medicine Drug Services info share page https://eres.lib.washington.edu/course page.asp?cid=1805&page=01https://eres.lib.washington.edu/course page.asp?cid=1805&page=01

6. History of Compounding Pharmacy Compounding in the Bible 19 th century many prescriptions compounded Post 1950, pharmaceutical companies manufacture a large percentage of drug products

7. Compounding Today Increasing numbers of discontinued products Patients that benefit from new drug or new drug applications Patient special needs Increasing drug shortages

8. Hospital Compounding Non-Sterile Compounding

9. Suspensions

10. Solutions

11. Cream

12. Hospital Compounding Sterile Products

13. Antibiotic Beads

14. LET Gel

15. Hospital Compounding Clinical Trials

17. New Practice Standards Deaths have occurred from some pharmacy prepared sterile products United States Pharmacopoeia 2004 Chapter 797

18. References Loyd V. Allen, The Art, Science and Technology of Pharmaceutical Compounding, Second Edition, 2002 United States Pharmacopoeia 2004 www.usp.org International Journal of Pharmaceutical Compounding, Loyd V. Allen editor, www.ijpc.com

19. References Lawrence A. Trissel, Stability of Compounded Formulations, 2 nd Edition, 2000 Lawrence A. Trissel, Handbook on Injectable Drugs, 12 th Edition, 2003 USP Pharmacists’ Pharmacopeia 2005

20. Reference Compounding Book The Art, Science and Technology of Pharmaceutical Compounding Loyd V. Allen, Second Edition 2002

21. Reference Journal International Journal of Pharmaceutical Compounding Loyd V. Allen, Editor

22. Reference Compounding Book Stability of Compounded Formulations Lawrence A. Trissel, Second Edition, 2000

23. Reference for Sterile Products Handbook on Injectable Drugs Lawrence A. Trissel Twelfth Edition, 2003 The Tenth Edition is pictured.

24. Questions? http://courses.washington.edu/pharm304/