| By :
Stephen Daniels
The word custom usually brings to mind high-end tailoring or hot rods. Another area where the product is fitted to the individual is in pain management. Doctors can order customized medications prepared by a compounding pharmacy to treat the pain. These specialized pharmacies differ from your neighborhood drug store in that they offer medications in formulations and dosages to suit each customer rather than just over the counter (OTC) or mass-produced prescription drugs. Pain from inflammation, injury, osteoarthritis, fibromyalgia, surgery or any other cause, is treated by three main classes of pain relievers, each with their accompanying side effects: * Opiates are narcotic pain medications that are appropriate for acute pain, such as that experienced after surgery. Their side effects are drowsiness, nausea, constipation, itching and breathing problems, not to mention addiction. * Cortico-steroids are steroid hormones that are prescribed to reduce inflammation by suppressing the immune system. Side effects include weight gain, upset stomach, headaches, mood changes and sleep disturbances and in some cases, impaired liver function. Therefore their use is closely monitored to achieve the desired result at the lowest dose and shortest duration possible. * Non-steroidal anti-inflammatory drugs or NSAIDS are available in over the counter drugs such as Alleve. Common side effects include stomach bleeding or ulcers, increased risk for heart attack, stroke or kidney problems. They can also be administered in topical gels directly on the affected area. Examples of over the counter topicals are Aspercreme and Ben-Gay. Topical NSAIDS are an emerging pain management technique because they avoid the gastrointestinal and cardiovascular side effects of oral delivery. Factors to consider are: * How much of the drug gets into the affected tissue? * How efficient is the drug's penetration? * Is the drug's effect strictly localized or does it have some systemic involvement? Here is where a sterile compounding pharmacy can provide a valuable service. Working with the patient's physician, a compounding pharmacy can customize a specific formulation for the individual's needs. A topical NSAIDs can start working on the pain in minutes without the systemic side effects of an oral medication. As well, the dosage can be more finely calibrated in this form, as it can be based specifically on body type, sensitivities, allergens, and level of pain being treated. It is important to monitor any patient sensitivity to the gel such as itching or rashes. Again, the pharmacist can work with the patient and the physician to modify the formulation as necessary. Working with a compounding pharmacy can provide an individualized drug delivery solution in a one-size-fits-all world.
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