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June 2012
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Customized medicines

By LAUREN P. DUNCANlduncan@paducahsun.com

While advertisements pushing big name prescription medications remain common, some local pharmacies are encouraging patients to try unique treatments catered especially to them.

Prescription pharmacies began as places where local pharmacists compounded most medicines, but the growth of pharmaceutical manufacturers led some local shops to become a place of doling out pills. In recent years, with the help of technology available to pharmacies, the field of compounding and creating specialized treatments has returned.

One local compounding pharmacy, Lone Oak Pharmacy, has been doing compounding since 2000. Owner Michelle Lowe said the pharmacy was one of the first in the area to begin compounding. Its specialty area started as bio-identical hormone replacement therapy, and she said that remains its area of focus today.

Lowe said when hormone replacement therapy began some people were skeptical, referring to it as voodoo. Since then, the practice has become more widely accepted.

While the pharmacy has been able to see hormone replacement compounding grow, it's also had to stay in front of new trends. One of the latest new areas of treatment, she said, is scar and wound therapy. She said many patients are unaware that pain creams are available to treat wounds as an alternative to typical pain pills.

"A lot of patients are unaware you can compound things for those problems," she said.

Lowe said the pharmacy has received feedback from patients on the new wound therapies and the staff members are hearing good things.

"That's what we want to do, we want to help people solve their problems," she said.

The ability to address a patient's problems directly is not only a unique aspect to compounding pharmacies, Lowe said, but it's becoming a necessity for local pharmacies. Since Lone Oak Pharmacy began compounding in 2000, she said, its local customer base has grown.

"We're happy to have the volume that we do. It's definitely grown over the last 14 years," she said. "I was asked a couple weeks ago: 'Can you still make money in compounding?' If you get the right training, have the right equipment and have the right staff and technicians, it can be rewarding financially and personally. We're just grateful for the community support."

"For an independent pharmacy, (compounding) is almost a necessity if you really want to establish yourself as a problem-solver in the community," she added.

Not all pain management solutions are for people. Compounding centers have also been creating solutions for animals. Because there are limited products available for veterinarians, Lowe said, customized medications have become increasingly popular. Does your cat scratch when receiving medicine orally? Compounding pharmacies can turn it into a topical treatment for the ear.

The most interesting patients Lowe said she's helped were pythons. The pharmacy compounded a special oral liquid with a unique delivery service to get the medicine far down the snakes' throats.

"I don't like snakes, but the owners were extremely gratified," she said.

Other special treatments the pharmacy can help with include care for children, who can be picky when it comes to medicine. She said they've transformed medicine into the form of a lollipop, oral liquids or once she even made ADHD medicine in the form of a gummy bear.

Lone Oak Pharmacy isn't alone in its compounding services. At Strawberry Hills Pharmacy, where personally mixed essential oils are becoming popular, the pharmacy has treated ADHD with an essential oil.

The pharmacy, which compounds its own diet pill as well, creates catered treatments in the form of creams, supplements and amino acids, can mix essential oils to treat anything from sleep disorders to wrinkles. More doctors are recommending the oils and no prescription is required, according to Staci Overby, compounding specialist at Strawberry Hills Pharmacy.

Overby has been in pharmacy for 24 years. In the three years since Strawberry Hills opened, she said a large amount of compounding orders have also centered around hormone treatment.

Another new trend is saliva testing. Overby explained the difference between saliva and blood testing is that saliva tests directly at the tissue site, while blood tests the entire spectrum of the blood stream. She compared it to looking for someone at a location, when all a blood tests does is drive up and down the street while saliva tests go directly to the site. Because receptors are at the tissue site, that's the information physicians and pharmacists need to find out what a patient needs.

Saliva tests don't just make it easier on the pharmacists; they can be more convenient for patients too. They can take the tests at home and do a test four times a day at different hours to detect different levels in sync with different symptoms.

"We are driven by symptoms but guided by labs," Overby said.


Many of the ailments Overby sees today involve inflammation, which can often occur as a result of poor health habits and stress. Thus, she said, she encourages good diet and exercise habits as a part of a treatment option rather than just handing people medicine.

"Compounding is a customized medicine, but we also take it as an approach to wellness," she said.

Overby said pharmacies would be even more effective if people measured their health levels when they are well, so that pharmacy staff can work on prevention treatments.

Overby said that people today too often wait until they're sick to receive treatment. If people focused on keeping themselves well with vitamins, minerals, supplements, exercise and keeping a watch on their hormone and thyroid levels, it would be easier to treat when problems do arise.

"It's good to have labs done whenever you're feeling good so, when you feel bad, we know what's wrong," she said.

While some women may wait until they're older to test for hormone levels, she said it's best to do it when women are young or at their healthiest.

Pharmacy is becoming more of a consulting field than counting pills. At Strawberry Hills, the group takes the triad approach to treating patients, which involves allowing both the doctor and patient to consult with the pharmacy on the best treatment.

"It lets the patient have a say too," she said.

Overby gave an example of a success story. A 19-year-old male struggling with depression and fatigue was tested for neurotransmitters, cortisol and stomach problems, and the pharmacists went to figure out what was going on. He was prescribed amino acids, a supplement, and cortisol, which boosted his adrenal glands.

"When a parent comes in and they're at their wits' end ... we can work with that child or person," she said. "We've had a lot of that."

The 19-year-old has been doing well since treatment and the clients thanked Strawberry Hills for the help, Overby said.

Contact Lauren Duncan, a Paducah Sun staff writer, at 270-575-8692 or follow @laurenpduncan on Twitter.

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