Missouri Now Using Compounding Pharmacies for Lethal Injection Drugs

In response to complaints and requests from drug manufacturers, particular those located in the European Union, Missouri has announced that it will be turning to undisclosed compounding pharmacies for its lethal injection drugs, a statement from the Missouri Department of Correction read. It was reported that the state government has an agreement with a compounding pharmacy to begin using pentobarbital in its executions.

According to the United States Food and Drug Administration (FDA):
“Pharmacy compounding is a practice in which a licensed pharmacist combines, mixes, or alters ingredients in response to a prescription to create a medication tailored to the medical needs of an individual patient.”

David Owen, the department spokesperson, would not reveal the name of the compounding pharmacy. This has angered the American Civil Liberties Union (ACLU) and prompted them to issue a statement on the matter:

“The state has retaliated by now making it illegal to name anyone who supplies the drugs. This is not the open and transparent government that Missourians deserve,” the organization stated.

Pentobarbital, which is usually consumed for sedative and pre-anesthetic purposes, is currently used in more than a dozen states for executions. Some of these states have also turned to compounding pharmacies to manufacture the drug. Richard Dieter, Death Penalty Information Center director, told Al Jazeera that those compounding pharmacies have the capacity to create single doses from raw ingredients.

Dieter added: “It’s critical that the dosage be potent and pure. You don’t want a very lengthy process.”

Health professionals concur that when pharmacy compounding is completed correctly it can become an important public health remedy for patients that cannot be treated and healed with a standard, FDA-approved medication.

The Show-Me State announced earlier in October that it would be returning its supply of propofol from a U.S. distributor after the European drug maker expressed its concerns over the state’s execution practices.

Elizabeth Carlyle, a Kansas City attorney, told the same news network that the new measure does provide them with some concerns but wouldn’t elaborate on what they were because it still requires consultation from their experts and more research.

At the present time, drugs generated by compounding pharmacies are not regulated by the FDA, which has various public health organizations and opponents of the death penalty concerned about the safety of its usage. Furthermore, once the names of compounding pharmacies are revealed, they risk facing public outrage, such as one pharmacy did when it received hate mail and negative publicity from local media outlets.

Maya Foa, director of Reprieve’s death penalty team, said compounding pharmacies are in the industry of improving the health and lives of patients rather than becoming the “henchman” for state governments.

“Why should compounders be forced to now play henchman to the ever-hungry executioner,” said Foa. “Good compounders want to improve the lives and health of patients; they don’t wish to be mired in execution drug controversies, forced to mix drugs to kill prisoners in dangerous and experimental executions.”

The next execution is scheduled for Nov. 20 and will be for Joseph Paul Franklin, who was recently sentenced to death for the murder of Gerald Gordon in St. Louis that took place nearly four decades ago. Pentobarbital will be used.

Tobacco Could Provide Anthrax Vaccine

In a Reuters report that sounds too good to be true it has been reported that a molecular biologist, Professor Henry Daniell of the University of Central Florida, has developed a method of using genetically engineered tobacco to grow anthrax vaccine.

The anthrax vaccine gene is injected into the chloroplast genome of tobacco cells. The plant then grows seeds — roughly a million seeds per plant — which contain the vaccine.

According to Daniell this technology produces anthrax vaccine that is free of the anthrax toxin contamination that plagues traditionally fermented vaccines. The process could also be used for growing treatments for diabetes, hepatitis C, plague and cholera.

But don’t go putting tobacco into the back forty just yet. Seeds are so plentiful in the tobacco plant that if this process works, one acre of tobacco would produce enough vaccine to supply the entire U.S.

Websites Selling TamiFlu Vaccine Identified by British Authorities

According to an AFX report, 18 websites worldwide have been identified as claiming to sell Tamiflu online. Seven sites were in the US, three in the UK, and two in Canada. Sting operatings have been mounted to track down and catch the would-be drug suppliers.

Tamiflu is made by Roche Pharmaceuticals of Switzerland, and is condidered the most effective treatment against the much-publicized H5N1 strain of bird flu.

US, Austrian and Dutch authorities have traced counterfeit pills back to producers in Asia. Online sales of counterfeit copies of hard-to-get drugs are widely feared to pose serious risks to public health.

Women Still Live Longer, but Men Are Closing the Gap

The current “Longevity Index” put out by Credit Suisse First Boston indicates that the longevity gap between men and women is gradually decreasing. Women (in the U.S.) now live to be an average of 82.6 years, and men 78.1 years.

The average annual improvement rate for the last 10 years has been 2% per year for men, and only 1% per year for women. So the gap is slowly closing.

The reasons, according to researchers, are that men are smoking less (less lung cancer), and learning better how to avoid heart disease. Women, on the other hand are smoking more (relatively speaking), and living more stressful lives, and are therefore more susceptible to more heart disease.

Pharmacists set to Challenge Contraception Law

An Illinois law passed in August, requires pharmacies to fill prescriptions for emergency birth control “without delay” if they have the prescribed contraception medications in stock. If the medications are not in stock, they must either get it or transfer the patient to another pharmacy that has it.

Some pharmacists object to this law on moral and religious grounds claiming their opposition to specific kinds of contraception. But the law does not make exception for these pharmacists. Abby Ottenhoff, a spokesperson for the Illinois governor said, “If a pharmacist objects (to the rule), he or she is free to work in a pharmacy that doesn’t stock and dispense” emergency contraception.

A group of pharmacisits who object to dispensing contraceptives is challenging this law in U.S. District Court in Springfield, Illinois. The group is funded by evangelist Pat Robertson’s organization, American Center for Law and Justice.

Finding a College in Chicago

If you live in the city of Chicago, you can earn a college degree from one of many available institutions. Below are three reputable Chicago colleges and the choices that they offer.

University of Illinois at Chicago

The University of Illinois at Chicago is an open campus that is not marked by a fence at its boundaries. There are houses, apartments and shops inside the campus itself. UIC is located in the heart of downtown and is split into two parts: the East campus (engineering, liberal arts and sciences) and the West campus (medicine, nursing, pharmacy). There is also a South campus which has a large recreation center and dorms.

UIC offers programs in Applied Health Sciences, Business Administration, Dentistry, Education, Engineering, Liberal Arts & Sciences, Medicine, Nursing, Pharmacy, Public Health, Social Work, and Urban Planning & Public Affairs. Depending on the program, UIC offers Associate, Bachelor’s and Master’s degree programs along with doctoral degrees.

Columbia College Chicago

Columbia College Chicago is located in the heart of Chicago’s South Loop, where you can also find the Art Institute, Chicago Symphony and the Museum Campus. CCC is one of the most diverse private arts and media colleges in the country, with nearly 12,500 students and more than 120 academic programs.

The College offers Bachelor of Fine Arts programs in majors and minors such as Acting (B.F.A., Minor), Dance, Graphic Design, Directing-Theater, and Fashion Design as well as a general Fine Arts degree, among others. CCC also offers Bachelor of Arts programs in other programs that include Art & Design, Art History, Digital Media Technology, Early Childhood Education, Film/Video, Music Composition and Journalism.

Westwood College – Chicago Loop

Westwood College is located in the heart of downtown Chicago and is near a variety of captivating Chicago attractions such as the Theater District and Millennium Park. This Chicago college is easily accessible by the Metro transit system and the Chicago Transit Authority, which makes getting to school from home or work much smoother than suburban campuses. Sears Tower is close by and Lake Michigan also offers recreational options for those who want a break from their daily grinds.

The Chicago Loop campus offers degree programs among four schools in Westwood College. The School of Design provides degrees in Animation, Game Art, Computer-Aided Design/Architectural Drafting, Graphic Design & Multimedia, and Visual Communications. The Criminal Justice degree can be earned from the School of Justice. The School of Technology can prepare students with a degree in Information Technology that can be specialized in Network Management or Systems Security. Westwood’s School of Business offers Business Administration degrees in Accounting and Financial Management, Healthcare Management, Marketing Management and Construction Management.

A Spoon Full of Sugar – How to Save on Prescription Drugs in Texas

With the cost of prescription drugs continuing to skyrocket, you need to stay savvy regarding the use of money-saving strategies. According to the Employee Benefit Research Institute, prescription drug expenditures, in Texas as well as throughout the U.S., grew at double-digit rates during almost every year since 1980. Senior citizens who depend on Medicare, which doesn’t cover outpatient prescriptions, shell out the most. But even people whose health insurance pays for medications sometimes find they have hefty co-payments or deductibles. The prescription drug costs of private insurers are rising even faster than the overall total costs. The following are tips to help you stretch your prescription-drug dollar:

First, and most importantly, if you get your prescriptions from a variety of sources, remember to provide a complete list of ALL your medications — including over-the-counter — you’re taking to each pharmacist. This allows them to check for possible dangerous drug interactions.

Make Sure Your Doctor Knows. If you pay for prescriptions out of your own pocket, make sure your doctor knows. In many cases, there are less expensive medications that can be used to treat the same condition, and your doctor should be able to prescribe the most economical ones.

Go Generic. Instead of brand name medications, ask your doctor if he or she will prescribe generic equivalents. You can save between 30% to 50% or even more. Also inquire about over-the-counter medications that might be able to meet your needs.

Know Your Plan. Before signing up for an individual health insurance plan, check your co-payments for prescription drugs, as well as the maximum amount the plan pays annually. Also find out whether your health plan has a formulary — a list of drugs they’ll cover. A health insurance plan with a closed formulary pays only for certain pre-approved drugs. If the one you need is not on the list, you pay the entire cost of the drug. Open formularies offer most drugs, but the prices may vary. If your plan has a closed formulary, you may be able to request an exception by having your doctor fill out a form. But with HMOs, you may have to go through an appeals process.

Compare Prices. Shop around for a pharmacy that offers the best prices on prescription drugs. For example, some pharmacies offer cheaper prices but no extra services, such as home delivery or pharmacist consultations. It may also be worthwhile to compare prices on a prescription-by-prescription basis, since stores sometimes offer specials on popular drugs. In addition, your pharmacist may match the lower price, if you find a cheaper price on-line.

Bulk Up! If you’re prescribed a drug for a month or longer, ask your physician if you can order it in a bulk supply. It’ll cost less than buying the prescription weekly. Bulk purchases work to your benefit if you are insured. Most insurers charge the same co-pay whether you buy a 10 day or 30 day supply of a medicine. Furthermore, the co-pay for a 90 day supply, particularly if you order by mail from the insurer’s mail order drug supplier, is usually less than three times a 30 day supply.

Order Online or by Snail Mail. According to the Pharmaceutical Care Management Association, mail-order pharmacies now make up 10 to 12 percent of the total prescription market. Ordering by mail can lower your co-pays if you are insured or can save you 10% to 15% of the total cost if you are uninsured. It’s perfect for patients who take medication regularly and can place orders in advance. If you are insured, ask your insurance company for mail order information. Otherwise, some resources that offer discounted mail-order drugs are: Medi-Mail, 800-331-1458; and the American Association of Retired Persons (AARP), 800-456-2279.

While you can save money by purchasing online, be careful. Many web sites are not reputable and are selling medications without any authorization. And avoid pharmacies outside the U.S. — you may not get the proper formulation of the drug or the drugs you need. Also, some shady Internet pharmacies are set up overseas to avoid U.S. law. The National Association of Boards of Pharmacy (NABP) developed a system to verify licensure of Internet Pharmacies — the Verified Internet Pharmacy Practice SiteTM (VIPPS) certification. NABP is located in Park Ridge, Illinois. The organization can be reached at (847) 698-6227. For more information, check out The Food and Drug Administration’s site on buying medical products online, http://www.fda.gov/buyonline.

Split the Difference. You can get certain prescriptions at double their appropriate dose and then split the tablets in half. This can result in a 50% savings. It’s no wonder some health care providers ask or even require their patients do it. To find out if pill splitting is right for you, ask your doctor or pharmacist. Some drugs are in a time-release formulation, so they should not be split because you might get a full dose all at once. Also, since pill splitting can often result in uneven dosages, your doctor may not like the idea, especially if you need a very precise dose. But once you’re given the okay, you can purchase a pill splitter to help make the cutting easier and more accurate.

Manufacturer Aid. Many major drug companies now have programs to cover patients who can’t afford medications they need. Program details vary widely depending on the manufacturer, but all of them require that your doctor put the application in for you. If your primary care physician is unfamiliar with these kinds of programs, he/she should call the Pharmaceutical Manufacturers Association (202-835-3400) and ask for a program guide. You will not be able to get this information on your own.

If you’re looking ways to lower your prescription bill in Dallas, Houston or anywhere in Texas, why not go with an individual health insurance plan that will cover the majority of your prescription drugs, with no deductible? Take a look at the revolutionary comprehensive individual health insurance solutions created by Precedent specifically for young, healthy individuals. For more information, visit us at our website, [http://www.precedent.com]. We offer a unique and innovative suite of individual health insurance solutions, including highly competitive HSA-qualified plans, and an unparalleled “real time” application and acceptance experience.

What Is Olympics Cupping Therapy?

Through Olympics cupping, designed for athletes you cannot only enhance your blood flow but at the same time reduce muscle tension and promote the cell repair. It is even beneficial for connective tissues and aids in the formation of new blood vessels present within them. Athletes make use of cupping services by sports physiotherapy center to heal a host of conditions and aliments.

Different Types of Cupping
In the ancient era, cupping was performed with the help of animal horns. Later different cups made up of ceramic and bamboo evolved. Effective suction through these cups was possible with the use of heat, the cups were first heated in fire and then applied. Once they were cooled, they drew the skin due to pressure difference.

Modern cupping utilize cups that are crafted from glass and are rounded like balls. The two main types of cupping include:

  • Wet Cupping
  • Dry Cupping

In wet cupping a combination of medicines and suction is used to treat the patient, while for dry cupping only the suction method is implemented. Your preferences, present condition and the problems that you are going through help you choose the appropriate one.

What To Expect From Olympics Cupping Treatment
During the treatment, a specialized cup is placed on the skin and the vacuum sucks the muscle upwards. This creates a pressure onto the vessels, allowing the muscle to relax and relieves tension. The cups are usually allowed to settle for a period of 5 – 10 minutes after which they are removed and placed at another part of the skin. The process continues until a particular segment of the body has been rejuvenated by the cupping session.

To help athletes make the most of it, practitioners combine the power of cupping along with acupuncture to treat skin issues, digestions and other associated problems.

Cupping is able to cure a wide range of conditions that athletes often suffer at some point or the other and these include:

  • Facial Paralysis
  • Lumbar disc herniation
  • Herpes Zoster
  • Cervical spondylosis

The best part about this therapy is that it has zero side-effects or risks, allowing you to attain a perfect body without any complications.

But, before you begin with your cupping session do make sure that you consult with qualified practitioners about your conditions, past medical records and your expectations from the treatment. Because this ancient integrative medicine requires the support of both practitioners and patients in order to achieve successful results.

Can You Mix Inalienable Rights With the Business of Medicine?

Actually, we think our work is done, simply by asking the question. Thomas Jefferson tossed the wrench into the process by suggesting in the Declaration of Independence that Americans should have inalienable rights including life, liberty and the pursuit of happiness.

Setting liberty and the pursuit of happiness aside, for now, generally, we divide rights into those which are natural versus legal. Clearly, we have some rights simply because they are allowed and supported by our highly malleable laws and legal system. Other rights are considered essentially independent of law, current acceptable social manner, contemporary political correctness, and leanings of the present government. These rights are seen as expected or natural. And, that which is natural or universal comes to be seen as inalienable.

Rights define our senses of behavioral freedom and sense of entitlement. They circumscribe our expectations of our behavior, that of others, and that expected of corporate entities which are often referred to as if sentient. In our civilization, a body of people of shared civil manners and rights are the bricks and mortar forming the infrastructure of morality, law, and governance we share.

From this point, you work backward. Considering government to be the arbiter, the issues pertinent to unalienable rights are then based upon the society’s decisions defining our morality. Morality is an essential element because inalienable rights generally address the “good,” by necessity defining the bad, right, wrong, and so on. Of course, different religious/spiritual groups, Atheists, legalism and the undecided regarding a source of ultimate moral authority never all agree on the “good”. Even inalienable rights are always a socially dynamic issue, including the definitions and rights pertaining to “life”.

If in the U.S. there is such an entity as an inalienable right to life, then such encompasses the inalienable right to that which keeps you alive. That is, you cannot live without attending to the needs for food, water and all that which protects you from, or is applied in response to the adverse effects of living in our world (AAOL). We do not all have access to ideal food and water, but we shall also be put that aside for now. However, what is society’s responsibility to address the AAOL on people’s well-being? If the effects of AAOL are physical and mental illness, injury, disease, and disability, then it would appear that comprehensive medical care for our citizens is the appropriate response to addressing this inalienable right.

Presume that everyone both empowered and relevant to considering the above arguments drew comparable conclusions. In that case, they would agree that every citizen should have access to comparable medical care. The challenges then become 1) access as primarily defined by the distribution of care facilities, appropriate service providers, and products, and 2) management of quality and cost of products/services delivery.

The cost of all contemporary medical products, services, and related insurance rises much faster, year over year than personal incomes and net revenue growth of the average business. So, most Americans and their employers are not prepared to handle the costs of medical care purchase directly or via insurance. Issues of access and distribution aside, government intervention to address medical care as an inalienable right then means either 1) marked cost capping and controlling consumer fees, 2) subsidizing patient payments, or 3) a combination. Capping and controlling costs would cause an evolution in the business of medicine. All participants (pharmaceutical companies, medical instruments and soft goods manufacturers, sales/distribution organizations, clinicians, insurers, IT services and others) in the industry would need to reconsider their margins, as well as their ability and willingness to remain in the medical industry. However, our government needs to control the sometimes markedly excessive and inflationary medical billing practices. Capping and controlling costs should ideally be tackled first, addressing runaway fees associated with hospital services, pharmaceutical products, surgical procedures, medical hardware, other medical technologies and insurance coverage. All components of the medical system will resist capping and controlling fee schedules.

Providing patient fee subsidies will always be fraught with inflationary excesses, deductibles and patient portions of bills would need to be eliminated. Even nominal point of service charges could always be a challenge unless the net annual out of pocket personal expenditures do not exceed the price of a visit to a fast food venue eliminate them. Otherwise, the middle and lower economic strata and their [potential] employers would continue to be obliged to choose between eating, acquisition of other necessities, employment and offering benefits. Additionally, service providers should not be allowed to bill in excess of fee schedules, writing off the excesses as tax deductions.

There are many products and services people should not expect to purchase if they have not financially successful in life to the extent of their more affluent neighbors. As such, nobody would suggest that all have the inalienable right to own a brand new luxury automobile, yacht or personal jet. However, if as a society we state that life, including full, high-quality medical care is an inalienable right of American citizens, then we should deliver it, without burdening others. But, there is “no free lunch” even regarding medical care. So what does “full, high-quality medical care for all citizens, without burdening others” actually mean? It may need to be defined in two ways: 1) products and services price caps, and 2) society attitude adjustment.

Regarding society attitude adjustment, as an example, we already provide military services to protect the entire nation without attempting to provide some stratified, sliding scale, itemized bill to each citizen. Medical services could be addressed in a similar manner. If medical businesses were all conscripted, essentially indefinitely subcontracted, to deliver care in a uniform manner (e.g., blend of active military care and preferred provider organization models), with a central payer and QA provider, maybe we could do it.

However, unlike changes in health measures, per capita, government spending on healthcare is a poor indicator of the effectiveness of U.S. medical care. Neither is ACA enrollment a measure of care delivery or effective care (e.g., see if holding a season ticket is a measure of NFL game attendance this year). Throwing taxpayer money at a series of poorly cobbled strategies is not an effective national medical care solution. Inalienable right or not, we cannot deliver broad-based high-quality medical care to all citizens via current medical business models.

Understanding Molecular Medicine and Its Major Advantages

Molecular medicine is a broad concept and it incorporates the study of molecular structures, identifying genetic errors for the cause of a disease, use medical nanotechnology to correct them. The fundamental concept of molecular medicine is the distribution of medicine to the body cells and it is similar to the assimilation of oxygen by a healthy human being. The discipline (molecular medicine) is new. It combines medical studies of modern times with biochemistry. It offers a bridge between today’s medical science and biochemistry. The course of molecular biology includes disciplines like biochemistry, immunology, and biotechnology. Nanotechnology in medicine has many advantages like it leads to diminished costs of treatment, cost-effective and yet high quality drugs. Nanotechnology in medicines help in effective diagnosis and treatment of diseases, it will lead to modern treatment methods, treating complicated medical problems can become simplified.

Benefits of molecular medicine

Molecular medicines and nanotechnology in medicine have their own advantages. These include the following:

  • Molecular medicines can lead to the invention of elegant and cheap surgical/diagnostic tools.
  • Medical diagnosis and research can become effective and efficient.
  • Nano medical devices can be implanted permanently to treat specific medical conditions.
  • Many medical conditions can be prevented.
  • Unknown diseases can be treated effectively.
  • This can lead to semi-automated diagnosis and treatment.
  • The nanotechnology in medicines help to reduce mortality rate, improve health.
  • Using gene therapy or similar treatment methods, organs can be replaced easily.
  • The different biological systems in the body can be improved.

When nanotechnology is applied in medicine then it is known as Nano medicine. It caters to the improvement of human health using Nano tools (tools at the molecular level) of the human body. Such technology in medicine encompasses areas like drug delivery using nano-particles.

The human body comprises of molecules, the use of molecular nanotechnology enhances progress in the human medical services. The Nano medicine helps to understand the functioning of the biological machinery inside the living cells. This understanding helps medical professionals to cater to complicated medical conditions like AIDS, cancer, ageing. All these help to bring a significant improvement of the natural human biological structure. The understanding helps to reduce mortality rate, ensure proper functioning at the molecular level of the humans.

The understanding of the molecular medicine has resulted in developing Nano particles/molecules to help transfer medicine to each cell of the body. For a sick or unhealthy entity, such developments in molecular biology lead to effective treatment of complicated diseases. Using Nano medicine, malignant cells within a human body can be tracked and then treated. This entire process includes targeting of bacteria/viruses/tumors within the body by Nano particles, treating infections, diseases.

Molecular medicine advantages

Other advantages of using Nano medicines are given as follows:-

With Nano medicines, treatment is gentle and advanced. Most of such treatments are non-invasive. Powerful drugs may have side effects which cannot be ignored. By using molecular medicines, one can reduce the effects of the drugs. Since the use of Nano medicines does not involve surgery therefore it is less painful. Another important advantage of using Nano medicine is that it involves small yet highly sensitive diagnostic tools which accounts for better treatment of diseases. Treatments using Nano technology in medicines are cost effective. It is effective to treat complicated medical conditions like cancer.

Nano medicine disadvantages:

Nano-particles used as part of nanotechnology in medicines uses biochemical pathways, affect the different biological processes of the human body. Under such circumstances, a lack of knowledge about the effects of the nano-particles on the human body, it processes can be a disadvantage. The researchers who deal with design of the nano-particles remain concerned about their toxicity and characterization on their exposure to the biological pathways. If the nano-particles are toxic then they can pose severe threat to the humans and the environment. The researchers remain concerned as the people part of the society use the molecular medicine. In certain instances, researchers remain in doubt of the possible outcome of the use of certain Nano medicines.

Nanotechnology in medicines have revolutionized medical treatment. The doctors now see a ray of hope to treat medical conditions and diseases which were not treatable earlier. Nano medicines have their own advantages. However, researches are on to make the most of nanotechnology in the days to come.

Sterility in Medicine

We are lucky to live in this century, one where medicines have been developed to combat most ailments, where we can be sure that the medicines we have are safe and sterile when needed and if we need a surgery, that the tools and equipment needed is all safe, clean and germ free.

Throughout history, they didn’t give much thought to keeping things clean and sterile, but luckily today we know that it is used to promote health and to eliminate the risk of contamination. What does being sterile mean though? Well, sterility is defined as the complete absence of any viable microorganism whether on a surgical tool, on equipment or in medicines themselves.

There are a few different ways that sterility is achieved in the medical and pharmaceutical fields. The first is using steam. This technique was actually invented back in the 1880’s by a man called Charles Chamberland. He came up with the autoclave, a steam sterilizer that used water to create steam to clean surgical tools and kill bacteria between patients. Today we still use this technique to clean glassware and surgical instruments.

What about things that can’t withstand high temperatures? In the case of sensitive electronic components, plastics and cardboard that need to be sterilized, the technique is EtO or EO, and it uses Ethylene Oxide gas as the sanitizing agent.

Another way to sanitize things is by the use of dry heat. This is used for things like needles and metal instruments that can get very hot with no worry that they will disintegrate.

But what about medicines themselves? They can’t be steamed, but they can go through the process known as aseptic processing. This takes a sterile medicine and packages it in a sterile container using flash heating. It is a task that also requires the use of clean rooms, bacteria retaining filters and dry heat. By using this technique however, drugs can be imported and exported anywhere in the world without the need for refrigeration and will be sterile when they arrive at the patient.

Sterile medicines, equipment and tools all help to provide the best care possible to us when we are sick. We don’t have to worry about contamination as the risks for it is low if all temperatures, gases, humidity and pressure levels have been accurately monitored throughout the sterilization process to ensure validity and effectiveness. Medicine has come a long way and the results are safer and more reliable than ever before.

Aseptic Processing

If you go back in time, hygienic practices weren’t even heard of let alone carried out. Medicines were made primarily of plants and whatever else was on hand and even, during the Victorian period when pharmaceuticals became more main stream, they weren’t very worried about how sterile the compounds were.

Today of course, pharmaceuticals are big business and having a product delivered to a patient sterile and ready to go is the norm. We’re talking eye drops, ear drops, inject, infusion products and the like, all things that have to remain sterile until ready to use.

By definition, something that is sterile has the absence of any viable microorganism, and the specification is unchanging and independent of the manufacturing process of the drug in the first place. To make a sterile product then, means filling and sealing the product containers under high quality environmental conditions, with care and with the same practices in place day after day.

When you are talking foods, beverages and medicines, keeping them sterile is a process called aseptic processing. This means that the sterile product is packaged in such a way as to keep its sterile rating. It is accomplished by flash heating which uses less energy than other techniques while (in the case of food) retains more nutrients. When you are talking pharmaceuticals, the ante is upped and the procedure also includes the use of clean rooms, bacteria retaining filters, and either dry or steam heat.

Some examples of food and drinks being in a sterile container include tetra juice boxes and drink pouches, but for medicines, they are stored in plastic or glass containers as these materials form a tight seal against microbiological organisms, contaminants, and degradation of the substance being carried. Using aseptic processing means you no longer need refrigeration and it makes worldwide import and export safe and economical.

Aseptic containers range in size from tiny ones that hold just a few ounces of medicine to ones that can hold eight million gallons in a tank on an ocean liner. Companies that package these medicines and the like can then send their product all over the world, knowing that once it reaches its destination, it is still a viable, sterilized product and will remain that way until it is used for a patient.

The next time you have a prescription for eye drops or have medicines administered by injection or drip, you can be sure those medicines are sterile, all thanks for aseptic processing.

Cosmetic Medicines Ordering, Storage, Supply and Incident Reporting

This article gives an overview of the systems and processes that must be followed by cosmetic clinics when supplying prescription medicines.

A prescription medicine or drug legally requires a qualified doctor, dentist, nurse or pharmacist to write a prescription for a named patient. The list of drugs and prescribing qualifications may vary in different countries.

A cosmetic clinic must ensure that all medicines are ordered, stored and supplied within the legislative and other relevant pharmaceutical guidelines available.

Therefore ordering, storage and supply of medicines for use within the practice must be undertaken according to appropriate procedures and guidelines to ensure all relevant legislation and pharmaceutical information is adhered to.

Any medicines stored within a typical cosmetic clinic are those used for aesthetic purposes, this includes drugs such as Botox ® and Hyaluronidase. These must be stored according to manufacturer’s guidelines in a locked refrigerator or locked cabinet as appropriate. The temperature of the refrigerator should be monitored and documented daily. If the temperature is found to be outside the recommended range the pharmacy supplier must be informed as soon as possible and if necessary the medicines are returned to the supplier and a new supply obtained.

Supply of Medicines and Maintaining Patient Records for Cosmetic Clinics

The Medical Practitioner is responsible for maintaining a record of medicines obtained from the supplier for use during treatment. A copy of the prescription is retained in the patient’s notes and the following information is noted in the Medicines IN register. The Medical practitioner must include the following details:

– the name of the medicine (generic)

– the dose provided by the pharmacy

– the amount provided by the pharmacy

– the format of the medicine (oral I IM etc)

– the batch numbers and expiry dates

The Medical Practitioner is responsible for ensuring that details of the medicines administered are recorded in the patient notes, including:

– the name of the medicine (generic)

– the dose provided

– the route of administration

– the batch number and expiry date of the medicine

– the date and time of administration

The Medical Practitioner must also document in the Medicines OUT register the name of the patient the medicine was administered to and the date and time of administration. This will ensure an audit trail is available for each practitioner.

All medicines not used or expired must be returned to the pharmacy.

In conclusion only a medical professional should be accepted on a cosmetic training course. This will ensure all practitioners have experience with the use of prescription only medicines and record keeping. The medical practitioner who facilitates a cosmetic intervention should be a qualified doctor, dentist, nurse or pharmacist. These specialists have the prerequisite medical experience plus understand their legal and ethical requirements in prescribing, dispensing and administration of such drugs.

Any errors with the medication must be recorded and reported.

Reporting a Medication Incident

A cosmetic clinic must ensure that all medication incidents follow local legislative and other guidelines for your country of practice. The following is based on the UK CQC guidelines.

All practitioners involved with medication prescribing, dispensing or administration must be aware of the procedures to be followed in the event of a medication error or near miss.

Medication errors or near misses will occur despite having risk procedures in place, and all personnel involved in medication prescribing, dispensing or administration are at risk of being involved an error or a near miss. Because of this, comprehensive reporting of all medication incidents is crucial to enable the organization to learn from mistakes and improve practice wherever possible.

All incidents involving medication prescribing, dispensing or administration, ‘near misses’ and serious drug reactions must be documented on the Incident Report Form. A medication error is a preventable incident or omission that results in an increase in the risk of patient harm. A ‘near miss’ is a medication error that is discovered before it reaches the patient, thus preventing harm to the patient.

What to Report

The following are some of the issues that require an incident report:

– incorrect dose administered (both over and under dosing)

– incorrect route of administration

– incorrect rate of administration

– incorrect drug administered

– administration to the wrong patient

– failure to document administration in the patient’s medical notes

– administration of an expired drug

– prescribing errors

– incorrect labels

– allergies not recorded

– serious adverse effects including allergic reactions

Near Misses will also be recorded on the Incident Report form.

How to Report Medication errors

Medication errors involving administration to a patient will be documented in the patient’s notes. The Medical Practitioner should inform the patient.

The incident should be documented fully before the end of the day. This report form must be completed by the Medical Practitioner and given to the Practice Manager without delay.

Follow Up Procedures for Medication Errors

A follow-up is undertaken by the Medical Practitioner to ensure the safety of the patient. If necessary the patient must be referred to the nearest Emergency department for further review. The Practice Manager must undertake an investigation into the event ensuring a statement is taken from those involved.

The incident must be discussed at the next Clinical Governance meeting and an action plan developed to aim to prevent recurrence; this may include further training for the personnel involved.

Any severe medication incident must be reported to the within 24 hours of it occurring.

I hope you enjoyed the article. For more information about medicines and their regulations you can check with the Department of Health and MRHA in the UK. In the USA please refer to The Food and Drug Administration (FDA).