Pharmacy Questions

Factual Questions
1

Why my mind has turned to pharmacies, I don’t know.

How common are compounding pharmacies nowadays? Does a person need special training to work in one? Does a regular pharmacy degree still cover compounding?

What do you call an old-fashioned non-compounding pharmacy anyway?

Is there much call for ginning up medications in the back room nowadays? Why? Freshness? Are some routine, well-known, medications usually compounded?

In a regular old commercial pharmacy in Devon or Davenport, do they stock any really interesting (deadly or dangerous) drugs? Perhaps you need a special license to stock some drugs?

Finally, does being a pharmacist pay well? It always seemed like a well-paid, inside sort of job to me. (Not that at my age, I have any real interest.)

2

I am not an expert but I thought of being a pharmacist at one time.

I always thought that pharmacists are very over educated for much of their work. When I say that they are over-educated for much of their work, I don’t mean that as a slam. I mean that they have a whole lot of knowledge that is underutilized most of the time. Pharmacists are usually required to have a doctorate (PharmD) degree. All pharmacies have to have pharmacists in management and supervisory roles even though the people actually filling the meds may be techs with much less pay and medication. Pharmacists are experts on the effects, side-effects, and interactions of the drugs themselves. Their education and day-to-day responsibility means that that they usually know more about the drugs they dispense than the doctors that write the prescriptions.

The drugs that are commonly not stocked in pharmacies, are drugs of abuse like Oxycontin. This isn’t because the pharmacies aren’t allowed to stock it, it is because they are concerned for safety. Addicts and thieves are less likely to rob pharmacies if the good stuff isn’t there. Pharmacies typically fill these types of prescriptions by special ordering it as needed.

All pharmacists are trained on some types of compounding and all pharmacies do at least the simple kinds. Simple compounding would be making children’s medicine in solution. More complex compounding is most commonly done at hospitals. This would involve things like making custom IV solutions. Pharmacies don’t whip up most types of pills. They are manufactured already.

3

I should amend the above slightly. There are practicing pharmacists with only a BS but that depends on the state.

Income for a pharmacist is usually pretty good. The average is around $80,000 for a PharmD pharmacist. Some that do complicated compounding in hospitals can make more. Because of the nature of the work, pharmacists often have to work under retail hours and conditions including some in 24 hour settings.

4

I was under the impression that pharmacies stocked plenty of heavy hitter meds like that but that most doctors don’t like to prescribe them for use outside of a hospital setting because of the potential for resale.

Any pharmacy is going to have tons of product with a hefty street value. Heck if I was gonna rob a pharmacy, hit the viagra, still going for what $5-$10 per pill and easily resold to alot of folks who might be interested in trying it just out of curiosity.

5

Compounding pharmacies also create custom medicines for people with certain allergies or other needs to abstain from particular substances. For example, I have a good friend with celiac disease; she can’t have anything containing wheat or gluten. The binders in some common OTC meds have vague “food starch” binders, which may or may not contain wheat. One of her options is to have a personally-made version in which the binding material is some other starch. It’s very expensive, though.

6

I didn’t write that part clearly and I didn’t mean it like that. I meant that pharmacies stock the vast majority of drugs but, if they don’t stock one for some reason, it is because it is a drug that is being commonly targeted for theft. In my area, Oxycontin is the major high-profile drug that attracts pharmacy robberies. You are right. Pharmacies usually have plenty of drugs that are attractive for theft and abuse.

7

Who does the compounding varies from state to state. In Illinois, we have what are called Licensed Pharmacy Technicians who assist in the filling of prescriptions. Job requirements: an ability to speak English, do basic arithmetic, pass a background check and urine test, and pony up the $40 licensing fee.

Now, if that Pharmacy Tech then goes on to take a certain 3-hour proficiency test, which costs $150 and involves a LOT of math, converting teaspoons to grams and back again and whatnot, that makes him/her a Certified Pharmacy Tech.

And in Illinois, CPTs are allowed to make up compounds, under the direct supervision of the pharmacist.

And at the Walgreens where I work, the CPTs are expected to be the ones to make up compounds, the pharmacist’s time being deemed too valuable for mundane tasks like that.

However, there’s an enormous 3-ring binder that gives the correct recipes for hundreds of compounds, so you need have no fear that the 16-year-old who is making up your acne cream is going to get it wrong. It’s not rocket science, just “cooking”.

Compounds are relatively uncommon at the Walgreens where I work. At our store they mainly consist of things like progesterone suppositories, which are made up in batches ahead of time and kept in the fridge, and special skin creams and lotions–dermatologists seem to have the most requirements for things that we can’t just get off the shelf. But we still don’t do a lot of them; basically everything comes from the warehouse already made up.

We don’t get a lot of requests for special syrups for children, probably because pretty much everything you could want to give a child is already packaged in a rootin’-tootin’ fruit-flavor. But we do get the occasional request for a medicine to be put into a flavored syrup, going by the child’s body weight, and in those cases my observation has been that the pharmacist does that personally.

It depends on the pharmacy, and it probably directly correlates to how much demand there is for the drug, rather than to any fears of being robbed. Statistically speaking, employee theft accounts for a LOT more of the controlled substances that go missing, rather than heist-type armed robbery.

There’s no sense in some small-town pharmacy keeping a bottle of Oxycontin around if there’s no demand for it. So it’s just more economical for the Taylorville Walgreens, with their 25 scrips a day, not to keep it around, and to order it in for those patients who are going to need it. And if they need Oxycontin today, they can always drive to Decatur to get it.

At our pharmacy, the things we do not stock are Schedule I substances like heroin, Ecstacy, and LSD, because Schedule I substances are not considered to be prescription medications, but there are plenty of Schedule II substances that we do routinely stock, like morphine, Oxycontin, and Adderall.