Bupivacaine and Compounding Pharmacies

Local anesthetics, among them bupivacaine, are a drug class usually administered by injection to relieve pain in patient. Pain can also be managed with bupivacaine compounding pharmacies, which are very important especially in the field of surgery medicine. Definition of compounding pharmacies would read as follows: those are customized drugs made by a professional pharmacist or a physician to fit the unique needs of an individual patient. There is a wide-range of reasons why to use compounding medicines, varying from possibility to change state of aggregation, excluding a non-essential allergic ingredient, to possibility to obtain a strictly dosed medicine which has less adverse effects.

Many different kinds of medications can be designed and prepared by a professional compounding pharmacist, from just about any area of medicine. These personalized medications represent the new era of medicine. Commercial medications cannot meet unique needs of millions of people. That is when the compounded, personalized medications come into game, they allow those people to achieve their desired health care outcome. Many categories of people are in a need of these compounding medicines, including elderly, persons with multiple health care issues, hypersensitive and allergy-prone persons, hospitalized patients etc.

Many different pharmaceutical formulations can be made as compounding medications, from sterile intrathecal preparations for pain management, dermatological preparations, sterile ophthalmics and injectables, preservative-free and hypoallergenic preparations, hormonal preparations, pallatable pediatric preparations, wound care preparations, to transdermal medications etc.

Origins of compounding pharmacies reach far back in the history of the pharmacy itself, with a consistent and intensive evolution in recent decades. New modern technologies and science methods allow pharmacists and physicians to properly assess and meet patient’s needs. Compounding medications in the early 1930’s and 1940’s participated by 60% in the overall amount of medications available, but today’s estimations speak about 1% of these compounding medications on the market.

Comparing commercial with the compounding medications allows us to witness many advantages and strengths of the latter ones. Many distinct disorders i.e. swallowing disorders lower the quality of life for the persons suffering from them, and compounding medications enable them to be treated rightly and accurately. A pharmacist can change the delivery format for those patients, instead of swallowing tablets they can receive the same medication in the different dosage form, like a liquid solution or a suppository.

Medications which are no longer manufactured or have a limited production are also a potential problem for persons who are in a need of those drugs and compounding pharmacy can help them also. It is only necessary to obtain required chemical compounds for the mixture and the medication can be made and patient can be treated. Some medications have bad-taste because of some ingredient, that is non-essential for the treatment itself, and by customized compound mixing those ingredients can be easily eliminated and substituted with a pleasant new flavor.

Allergy-prone people who are hypersensitive to some specific compound in the medication also benefit from compounding pharmacies as these allergy-causing ingredients can be removed from the mixture when compounding a personalized medication.

Natural occurring unpleasant sensation of pain is also a field where compounding medications play an important role. Both of two main types of pain, acute and chronic, can be treated with compounding medicines. Chronic type is by far more difficult to treat as it requires multidisciplinary approach and creation of specific protocols to suit the individual needs of each patient.

Tailor-made and personalized medications for every patient, constructed and designed by his physician and implemented by a professional pharmacist, cause less side-effects and act more directly and efficiently.

Almost any pharmaceutical formulation can be utilized in compounding pharmacy, ranging from creams, gels, sprays, capsules, tablets, injections etc. Having all these dosage forms at his disposal, a physician can accurately fight the underlying cause of his patient’s disorders.

Bupivacaine is a local anesthetic which acts as a nerve impulse blocker, it increases the threshold for excitation in the nerves, by negatively affecting the impulse propagation velocity and a rise rate of an action potential. After bupivacaine starts his action, nerves lose pain sensitivity in a very short-term period, followed by loss of temperature and touch sensations.

Bupivacaine carries a risk of potential adverse events if it reaches systemic circulation. Especially susceptible to bupivacaine’s harm effects are cardiovascular and central nervous system. If its concentration is within therapeutical window, side-effects are minimal. However, a bupivacaine overdose can cause serious damages on cardiac tissue, its excitability and conduction, which may lead to severe heart disorders like atrioventricular block, ventricular arrhythmias or even a cardiac arrest. These adverse effects are followed by a consequent decreased heart output and hypotension.

Bupivacaine’s effects on the CNS are of a paradoxical nature, it produces stimulating effect followed by a depression phase.

Similar to the other local anesthetic drugs, bupivacaine has a rapid onset (starts to work in less than a minute) and a long-lasting effect (6-8 hours). Highly perfused organs – liver, lungs, heart and brain are found to have higher concentrations of bupivacaine, although it enters to some extent to all body parts and tissues.

Bupivacaine is metabolized in the liver, enzymes of liver conjugate it with glucuronic acid and, mostly in this form, it is being excreted by kidneys via urine.

Bupivacaine compound pharmacies also allow patients to receive medications via more pleasant administration route. Instead of painful and irritating injections, pharmacists can prepare gels, ointments and creams that can be easily applied to the inflicted area.

Active drug percentage can be manipulated within the mixture; an accurate amount suitable for a specific patient is adjustable and allows a precise and proper treatment of a patient. All the positive aspects of the medication remain untouched, and possibility of an adverse event is decreased to the minimum.

Bupivacaine compounding pharmacies can contain bupivacaine combined with other drugs that are compatible with it. This way, pharmacists reduce the concentration of every individual ingredient in the mixture and by doing so, they also reduce the possibility of a side-effect, which can be exacerbated by some of those components in higher concentrations.

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