Compounding is a useful and sometimes necessary option for ensuring appropriate care. Although many novel ways exist to alter drugs, compounding is nuanced and requires expertise and knowledge to ensure the safety and stability of the final product. Compounders (in a pharmacy or veterinary practice) in the United States rely on the United States Pharmacopeia (USP), an independent nonprofit organization, to provide minimum guidance on how to safely and effectively compound drugs. The USP focuses on patient safety for decision-making and is involved in chemical procurement, manufacturing, and employee training, as well as suggestion of maximum beyond-use dates (ie, date, or hour and date, after which a compounded sterile preparation [CSP] or compounded nonsterile preparation must not be used, stored, or transported) for compounded drugs in the absence of extended stability studies.
Many USP chapters have relevance in compounding. Chapters 795 (nonsterile compounding), 797 (sterile compounding), and 800 (hazardous drug handling) are of particular importance. Although these guidelines are not enforced on a federal level, many states have adopted part or all of the USP guidelines. Compounders should understand how this information relates to their practice.
To learn more about compounding, see these articles on:
Do’s and Don’ts of Compounding & Compounded Medication Administration
Take the Quiz
The following questions highlight current recommendations based on USP chapters 795 and 797 and how they can be applied to practical compounding.
Table: Summary of USP Chapter 797 Compounded Sterile Preparation Categories With Abbreviated Conditionsa
How to Help Clients Feel Confident About Giving Medication
When prescribing a medication, ask the client whether they feel comfortable and confident administering it. Ask about potential challenges, and create space for them to be honest and forthcoming. They may respond with:
I'm usually comfortable giving my dog pills, but I am unable to get down on the floor to give them medication.
I have a family member in the hospital and don't have time to pick up medication from the pharmacy.
I'm willing to try medication, but I never learned how to give pills to animals. I could use some help.
Once you know about and can help address concerns, administering medication may feel more manageable for the client and less likely to cause anxiety, missed doses, and treatment failure.