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| Sterile Preparation |
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Safely customizing your medications to fit your needs...
The pharmacists at Medical Center Pharmacy are frequently called on to prepare sterile products when a suitable sterile product is not available from a licensed manufacturer. While pharmaceutical manufacturers prepare a wide variety of medications, on occasion, sterile customized medications are needed to treat various medical conditions. Physicians may be faced with patients with medical situations where treatment solutions are not available in the form of a commercially manufactured drug product or the commerical product requires a final sterile preparation procedure prior to administration. Some pharmaceuticals may be available to treat medical conditions in a particular dosage form, but not as a sterile preparation. Other treatments may be available in other countries as manufactured items, but not yet manufactured in the U.S. In these situations, a customized medication prepared by a compounding pharmacy with the capability to prepare sterile dosage forms may be a useful resource. These services are provided for both human and veterinary patients.
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The preparation of sterile medications for individual patient use is called sterile pharmaceutical compounding. The standards set for a pharmacy to prepare a sterile compound are established by the U.S. Pharmacopeia, a not-for-profit organization of leading healthcare professionals who volunteer to provide state-of-the-art standards for medicine preparation. The specific USP standard for sterile pharmaceutical compound is USP <797>.
Medical Center Pharmacy maintains standard operating procedures, a hepa filter clean room facility, equipment, and pharmacist/pharmacy technician aseptic training that meets USP <797> standards. These are services, training, and standards that are not available at most community pharmacies.
Preparing a sterile medication requires specialized equipment and training in aseptic technique. Considerations in preparing sterile solutions include tonicity, pH/buffers, sterility, preservatives and viscosity enhancers. A laminar airflow hood is essential in providing a sterile environment in preparing customized preparations. During this procedure, the product must be sterilized by using standardized methods of aseptic technique, such as micron filtering or autoclaving, to ensure quality control.
Working in a sterile hood using aseptic techniques is a standard procedure at Medical Center Pharmacy. Compounding pharmacists Henry Herring and Beverly Clark have received specialized aseptic training and are available to prepare customized sterile preparations. By being affiliated with Professional Compounding Centers of America, the pharmacy staff has access to various customized formulas and the expertise of pharmacy consultants. The staff of Medical Center Pharmacy encourages physicians and patients to consult with them to discuss sterile customized treatment options. Please give the pharmacy staff a call for assistance with “problem solving” sterile drug therapies.
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Types of sterile products that can be prepared include:
- Injectables
- Ophthalmics
- Irrigations
- Inhalation Therapy
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| Ophthalmic Sterile Products |
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Avastin (bevacizumab)- Used by retinal ophthalmologists for the treatment of wet AMD (wet macular degeneration). Sterile unit dose preloaded syringes are prepared for intraocular office injection.
Fortified Antibiotic Drops- Some more serious or refractory eye infections can require preparation of antibiotic ophthalmic drops that are not commercially available or that require higher concentrations than are produced commercially. Antibiotics for bacterial infections include:
- Fortified Tobramycin Ophthalmic and Fortified Gentamicin Ophthalmic Drops
- Vancomycin Ophthalmic Drops
- Cefazolin Ophthalmic Drops
- Penicillin G Ophthalmic Drops
Antifungal Drops include:
- Voriconazole Ophthalmic Drops
- Amphotericin B Ophthalmic Drops
- Miconazole Ophthalmic Drops
Mitomycin Ophthalmic Drops- Used for surface ablation in eye surgery.
Dry Eye Ophthalmics:
- Autologous Serum Ophthalmic Drops
- Used for refractory dry eyes. This customized eye drop is prepared by using the patient's own blood serum.
- Cyclosporine Ophthalmic Drops
(oil based or aqueous)
- Tacrilomus Ophthalmic Drops
(oil based or aqueous)
Preservative Free Ophthalmics- Ocassionally preservatives in commercially available ophthalmics can result in allergic reactions for the patient that prohibits a successful therapeutic outcome. In these situations, preservative free sterile ophthalmics can be prepared for the patient. Examples include:
- Prednisone Acetate Ophthalmic Drops
- Methylprednisolone Ophthalmic Drops
- Timolol Ophthalmic Drops
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