Compounding pharmacy prepares vital drugs in short supply

Urgent care drug supply relies on compounding pharmacists

Former hospital pharmacist Denise Burnham, BSPharm, knows it’s crucial to always have sodium bicarbonate injections on hand in any intensive care unit. When tissue is dying – for reasons ranging from a major accident to a surgery from which a patient is not recovering well – the body becomes highly acidotic. Sodium bicarbonate alkalinizes the body so the cells can continue to function normally.

But the simple solution of baking soda and water seems to always be in short supply.

“With my hospital background, I couldn’t believe that sodium bicarbonate would be on back order for such a long time.  It’s such a vital ingredient for so many things,” Burnham said. “A lot of places really guard their supply and carefully monitor their use. You have to really be in need to get it. If there are other ways to handle the situation, they try to do that instead.”

When commercially available drugs are in short supply, compounding pharmacies help meet the demand. Through a shared services agreement that authorizes compounding pharmacies in the state of Oregon to supply hospitals with otherwise unavailable drugs, Burnham’s Creative Compounds pharmacy compounds sodium bicarbonate for Oregon Health Sciences University Medical Center and other area hospitals.

In the summer months, Burnham often sees a spike in traumatic accidents, such as boating and motorcycle accidents, that further stress and deplete supplies of sodium bicarbonate.

“I spent my labor day weekend driving an extra batch up to the hospital so that in case they had anybody come in that had been in a trauma, they wouldn’t be out. I know I wouldn’t want to be in that situation,” she said.

It’s important for Burnham to anticipate shortages of drugs that are used in the ICU or the ER because a compounding pharmacist cannot simply rush a drug to the hospital when an emergency arises. 

“With the kind of quality care that we put into our products, we can’t have a lot sitting around, so it’s a slower process.”

As owner of a PCAB-accredited pharmacy, Burnham carries out the quality control measures recommended by the Pharmacy Compounding Accreditation Board, but accreditation is not a legal requirement.  Burnham hopes, however, that the recent meningitis outbreak will change that. 

“It’s a horrible thing that happened, but hopefully it will reveal the importance of accreditation.”