Spicy Furry PharmD

0 dubai chocolate ingested

0 labubus bought

Some of the rabbis at work were having a discussion about the prohibition of taking "unnecessary" medication on the sabbath because of the fear that you might come to grind it up yourself (nowadays most rabbis rule than you can find a reason to allow most medications on the sabbath, even if they're not strictly "necessary"). This particular prohibition doesn't apply to cutting tablets in half, mixing fluids, measuring powder, etc. just crushing.

Anyway, one of them said that despite the mortar and pestle on retail pharmacy signs, he doesn't think anyone is grinding medications anymore, except the drug companies that produce them, but I'm really curious to hear if that's true!

I have no idea how long this ask has been in my box. But overall, you’re right! It’s not part of most prescriptions, and you’d know it ahead of time if it were part of yours. Most of the time we’re able to use drugs as prepared by the drug manufacturers.

Not all of the time, though! Every pharmacy that I’ve worked at, inpatient or outpatient, has had to do at least a little compounding from scratch. I have a couple of patients who have to use feeding tubes and it’s easier for them if their specialized meds come in liquid form. I have to take out the old mortar and pestle and I get to feel like a Real Pharmacist for a minute and I’ll tell you what, it’s kind of sweaty work and I don’t know why?

I think pharmacies that do a lot of non-sterile compounding like where @gochugarulionboy works have specialized machines for this stuff, but we normal folks still go at it with mortars, pestles, beakers, etc.

Trituration at its core is the mixing of powders. Using a mortar and pestle is key to ensure even mixture of powders without having to buy $20k+ machinery for single prescription things. But it’s only useful when you use the principle of geometric dilution.

Start with a small amount of powder and by sight add an equivalent portion then mix, add an equivalent portion more than mix, repeat and repeat until all portions are used. That way you’re mixing powders and diluting it by around 1/2 with each step you go. According to a source from the USP, that’s the gold standard for reliable and even mixture of powders.

But to the crushing question, we rarely crush tablets unless the API isn’t available or isn’t to USP standards. It’s probably done maybe once or twice a week. Opening capsules is another thing we use from commercial products and we sometimes use them to dilute into smaller doses or turn into suspensions.

That leads me to one more use of mortars and pestles: creating suspensions from pastes. We mix the powders, create the paste and pour into dispensing bottle, then rinse the mortar with the base and “mix” it around to pick up more of the API. We do that a couple times then QS to the final calibrated volume.

There’s so much more to nonsterile compounding and I’d be happy to talk more off tumblr (because I was dragged here kicking and screaming by @pharmdup but no matter). And I’d be completely oblivious on how the act of compounding relates to the rules of the Sabbath given my Greek Orthodox background, but I hope that this helped a little.