Preparation of extemporaneous drugs

***

Preparation of extemporaneous drugs - a comparative analysis through Europe (Working Group C - BEAM Summit Aspects of compounding)

G. Sailer, G. Caravella, E. Garvey, M. Helin-Tanninen, L. Horváth, H. Ovesen, P. Nydert

Hospital Hietzing, Pharmacy, Vienna, Austria; A.O. Melegnano Hospital Vizzolo P., Pharmacy, Vimodrone, Italy; Midland Regional Hospital, Pharmacy, Tullamore, Ireland (Rep.); Kuopio University Hospital, Pharmacy, Kuopio, Finland; University of Debrecen Medical and Health Science Centre, Pharmacy, Debrecen, Hungary; Trondheim Hospital, Pharmacy, Trondheim, Norway; Karolinska University Hospital, Pharmacy, Stockholm, Sweden

Background: The need for extemporaneously prepared drugs in Europe is usually provided through small scale compounding. The European Pharmacopoeia gives a base for this work but local guidelines for small scale compounding can vary. Hence we wanted to examine the differences in seven European countries with examples of small scale compounding.

Materials and Methods: The European Association of Hospital Pharmacists has an ongoing project to interact with its members through several summit sessions focusing on important areas of hospital pharmacy. In September 2010 a summit with regard to aspects of compounding took place in The Hague, The Netherlands. Our working group was formed during this summit under the topic - small scale compounding. During this session we started by comparing our small scale compounding practices with regard to types of spironolactone preparations and the shelf life of an oral liquid of clonidine hydrochloride for children.

Results & Discussion: Seven hospitals serving in total more than 7500 (250-2000)beds in Austria, Finland, Hungary, Ireland, Italy, Norway and Sweden were included in the analysis. All hospitals undertake small scale compounding during week days. For the provision of spironolactone different practices were recorded including capsules, sachets and suspensions. As for the preparation of an oral liquid of clonidine hydrochloride the shelf life varied between the participating countries depending on local practices and type of preservation methods. Although not all participating hospitals carry out these preparations at present, we discussed our approach to solve the difficulties by way of these two substances.

Conclusion: Critically, many products are not standardized and little data to their
compatibility and stability are available. Therefore, this survey highlights the need for a European database for preparations in small scale compounding. The database suggested should not strive to contain all drugs, rather give a format based on the principles of Wikipedia where all participating nations can collect,
compare and share their methods of compounding.

References: 16th Congress of EAHP. 30 March - 01 April 2011. Viena. Austria