BROOKSVILLE — Not all patients are created equal. Thus, not all experience the same results from medications, whether over-the-counter or prescribed medications produced by pharmaceutical manufacturers.
Enter the compounding pharmacist.
Jenny Bridges is one of them.
At Sunshine Wellness Center, a fully stocked retail and compounding pharmacy just west of downtown Brooksville, owner and registered pharmacist Bridges specializes in what she calls "a unique way to get medication without using commercially available products. The great thing about compounding is you can make exactly what the patient needs."
The pharmacy is one of a very few in Hernando County qualified to formulate medications on the premises.
Specially compounded formulations can be required for patients, for instance, who can't abide any sugars or carbohydrates, who are allergic to particular dyes, who require minute formulations of hormones or who have an unusually low or high tolerance to a particular drug, Bridges said.
"That's where dosing is really important," she stressed. "Compounding is completely patient-specific."
In another example, Bridges noted that infants with heart issues, even with a gastric tube, require doses that aren't commercially available. "So, compounding their medications is crucial to their life."
And then there are cats, particular among pets and livestock because they are highly finicky, plus their scratches and bites at resisting medication can impart infections to humans. Dosing them orally is problematic.
Whether the patient is a human or another animal, a prescription from a medical doctor or veterinarian is required for a compounded medication. Such orders at Sunshine Wellness are about equally divided between MDs and VMDs.
The cat issue is perhaps the most readily solved. Bridges concocts the prescribed compounds into a lotion or paste to rub on the cat's ear.
"They think you're just petting them," she said with a smile.
For humans, Bridges formulates compounds for oral, dermal or suppository application, according to a doctor's prescription.
As required by the federal Food and Drug Administration, Sunshine Wellness is outfitted with a pharmaceutical compounding laboratory. Its shelves hold "hundreds," Bridges estimates, of chemical compounds and bioidenticals, the latter exact replicas of what the human body produces naturally. Special equipment includes scales, under glass, that measure to a thousandth of a milligram.
During compounding, Bridges wears a disposable gown, mask and gloves to ensure product purity and to protect herself.
Often, specialized containers are required for compounded medications to guarantee proper dosage delivery. She demonstrated a lotion container that, with a dedicated twist, oozes out the precise amount for a single application.
To gain certification as a compounding pharmacist, Bridges, 39, completed studies beyond her pharmacy degree from the University of Florida. She took classes through the Accreditation Council for Pharmacy Education. For questions she might have in the field, the Professional Compounding Centers of America provides on-call specialists to advise on formulations.
Rounding out Sunshine's offerings, with two pharmacy technicians and two office staffers, Bridges pointed out, "We do carry some things a lot of pharmacies don't." S.S.S. is an old-time tonic containing iron and vitamin B. Neon Nits is a lice identifier that turns nits florescent so they're more visible for comb removal. Bag Balm is a traditional chap cream for livestock udders that humans use for extremely weathered hands.
Bridges said she anticipated spending her career in a chain pharmacy. But her uncle, compounding pharmacist and Sunshine Wellness founder Kenneth Norfleet, announced his retirement in 2006 and offered her the business.
"The fun part of it," Bridges said, "is it's not just counting pills. It's helping a group of people who were struggling with what was commonly available. Helping that group of people is extremely gratifying."
Contact Beth Gray at firstname.lastname@example.org.
This story has revised to reflect the following correction: Sunshine Wellness Center, a compounding pharmacy at 90 Ponce de Leon Blvd., Brooksville, is not licensed to formulate injectable medications or any form of sterile compounding. A story on Oct. 20 was incorrect on that point. The address of the center was also incorrect.