Before 8-year-old “John” was referred to Shara Rudner, BSPharm, his inflammatory bowel disease landed him in the emergency department with severe diarrhea or cramps. John has many special needs; one is that he takes mesalamine for intestinal inflammation through a g-tube. Because mesalamine isn’t available in a form appropriate for a g-tube, John’s mother crushed adult-dosed tablets for him, but they often clogged the tube before reaching the boy’s inflamed intestines.
Then John’s pediatrician referred his mother to Rudner at Belvidere Pharmacy in Highland Park, NJ. As a compounding pharmacist, Rudner is able to start with mesalamine in a pure powder and prepare a liquid that is the perfect consistency for a g-tube and the perfect strength for John’s age, weight, and disease state. As John grows and changes, Rudner and John’s doctor work together to make necessary adjustments to his medication.
“We have a single mom who’s caring for a special needs child, who requires round-the-clock nursing care, and also has GI [gastrointestinal] issues. Having this medication in a liquid form for his g-tube has definitely changed their lives,” Rudner said.
Now 14 years old, his inflammatory bowel disease in control, John takes far fewer trips to the emergency department since coming to Rudner for his prescription. Also deaf, John does not communicate his gratitude with words, but thanks Rudner with hugs and kisses whenever she delivers the medication to his home.
“He makes me want to come to work every day to do what we do and help him and his mom,” Rudner said.
Rudner makes medication easier to swallow for many children. Crushing tablets into applesauce or cherry syrup isn’t a magic bullet. The bitterness of some tablets intended for adults, due to binders, fillers, and dyes, is just too strong to mask with sugar.
“The parents will say their kid was gagging and throwing up purely from the bitterness. I love to be able to tell them that we can help,” she said.
Starting with pure powder eliminates the bitterness and Rudner can compound the medication in the flavor of her young patients’ choosing. “We can allow them to be part of solving the problem of taking their medicine as opposed to fighting with them.”
Belvidere Pharmacy, which Rudner co-owns and operates with her husband Michael, was among the first 10 pharmacies in the country to earn Pharmacy Compounding Accreditation Board (PCAB) accreditation. “PCAB accreditation is an outside validation of all the things that we do from building our state-of-the-art facility to my staff training to quality assurance measures,” she said. “We can tell practitioners and patients about all the things that we do, but having accreditation is the proof.”