The company, Optimal Pain Control, or OPC, is the brainchild of pharmacist Robert Gussenhoven and harkens back to the day when pharmacists made the compounds doctors prescribed.

“Compound pharmacies” are becoming increasingly popular. they range from adding flavoring to cough syrups to combining off-the-shelf, federally approved medicines to produce customized therapies for patients.

OPC focuses on pain medications that are smeared — known as topicals — rather than swallowed that pharmacists say have no risk of addiction and few side effects.

Drugs delivered through the skin generated an estimated $5.6 billion in 2009, according to a report from Market Research News, an independent research firm.

“Innovative technologies that are able to deliver drugs with a broader spectrum of characteristics are poised to revolutionize the transdermal drug delivery market and drive significant growth,” the report states.

Unlike drug companies that invest millions into developing new brand-name drugs, compound pharmacies such as OPC capitalize on the thousands of available drugs that have already been tried and tested.

Until the mid-1940s, pharmacists only created prescriptions through compounding. The end of World War II ushered in the era of big science and compounding fell out of favor, said David Miller, executive vice president with the International Academy of Compounding Pharmacists, a trade organization.

Compounding made a resurgence in the mid-1990s at a time when big pharmacies started to inundate consumers with direct advertising and realized the aging population metabolized drugs differently than the general population.

“At the time, consumers started asking for things from their pharmacists such as ‘is this right for me?’ ” Miller said.

The compounding industry now makes up an estimated 1 to 3 percent of the U.S. prescription market, which is worth $300 billion overall. of the 56,000 pharmacies, approximately 7,500 specialize in compounding, an expensive proposition because of specialized equipment costs.

In rare cases, the popularity of a drug can indirectly cause its price to skyrocket in compounds. In March, KV Pharmaceutical got FDA approval for a drug, hydroxyprogesterone, to prevent pre-term labor.

The drug already had been used by compounders and cost about $15 per injection, but with FDA approval, the pharmaceutical company could charge $1,500 per injection.

“Drug companies are picking up on these old drugs that are being compounded and putting them through the FDA approval process,” Miller said. “they set up their pricing at a level that is substantially higher than when it was compounded.

“We really want to foster innovation, and we really want to stimulate research, but if we’re granting approval of drugs that have not involved innovation research, are we doing our health care service a disservice?”

Hydroxyprogesterone is just one of many compounded drugs that has skyrocketed in value, Miller said, but it still represents a rarity.

Alabama has five compound pharmacies accredited through the Pharmacy Compounding Accreditation Board. OPC is not accredited, but officials say they are seeking the seal of approval.

Compound pharmacies are limited in that they can’t make an exact medical claim because the compound hasn’t gone through clinical trials.

“The idea of topicals for pain relief is not new — our formulations is what’s novel,” said Ashley Morrow, director of marketing and human resources with Optimal Pain Control.

With thousands of formulations available and new pain drugs constantly becoming available, however, the competition is intense.

“In a year from now, the topicals we do will be obsolete,” Morrow said. “having these competitors validates our market, but if you don’t advance the formulas, you’ll bite the dust.

“if we find something better,” Morrow said, and then snapped her fingers, “We can change the formula overnight.”

During a lab tour, lab supervisor Jeremy Sherrill talks through an obligatory face mask. three technicians overlook the production that resembles a high-tech kitchen.

The cream includes 15 to 22 proprietary ingredients the pharmacists say helps drive medicines from the skin’s surface to the inside.

Down the hall, Morrow shows a “brag wall” where customers attest to the use of the topical pain medications personalized for their symptoms.

Larry Alton, a family and sports medical doctor in Montrose, Mich., not only uses the compound medicine in his practice, but is a patient himself.

Alton had several surgeries on his back and a damaged nerve in his leg. He worked four days a week. By the end of the week, Alton said he could barely stand up.

“I don’t take pain pills because of what I do for a living; I pretty much had to suck it up and do nothing,” Alton said.

“I tried the cream as directed and was a bit skeptical only because I’ve tried other topicals before and non-prescription topicals,” Alton said. “within about 12-15 minutes, I experienced probably more than 50 percent relief and the relief lasted eight to nine hours.”

Now Alton works a full five-day schedule and sings in a band.

Tim Aaron, chronic pain consultant and co-owner, said with pain-relief creams spread on the skin — also known as transdermals — “there’s no playbook out there — we’ve done a lot of learning by mistakes and errors.”

Trevor Stokes can be reached at 256-740-5728 or .

Indigestion, also known as dyspepsia describes the feeling of fullness or pressure like discomfort that many people feel after eating a meal.  it may or may not be accompanied by heartburn or a burning pain in the upper stomach or esophagus region.

Indigestion can affect people of any age or sex.  There can be many things that cause indigestion.  Many people only experience indigestion with increase stress or times of extreme emotion. the risk sometimes increases with alcohol intake or medications that may irritate the lining of the stomach and digestive system.

Medical conditions which may cause indigestion include stomach ulcers, GERD, Irritable bowel syndrome, thyroid disease, infections of the stomach and several others.  some medications which can irritate the digestive tract are pain medications, especially those containing aspirin, steroids, some antibiotics, thyroid medications and some hormones.  Cigarette smoking, alcohol, eating too much or too fast and increased stress or fatigue can also contribute to indigestion symptoms.

The symptoms of indigestion include:

• A feeling of fullness or bloating after meals
• Belching and gas
• Noises from your stomach, such as gurgling or growling
• Nausea and vomiting
• Upper abdominal pain
• Acidic taste in your mouth or throat
• Sometimes accompanied by heartburn, or burning feelings in the upper stomach or esophagus which is caused by stomach acid flowing up into the esophagus.

If you are experiencing these symptoms frequently you should speak to your doctor about them.  they may increase in times of increased stress, anxiety or with depression.

If indigestion is not usual for you and is combined with shortness of breath, increased sweating or pain in your arm, neck, upper back or jaw you should seek immediate medical attention.  These are symptoms of a heart attack which are often confused with indigestion.

Other symptoms that you should notify your doctor that you are experiencing with indigestion include:

• Severe pain in the right upper abdomen
• If you notice blood in your vomit, or if it resembles coffee grounds
• Loss of appetite
• Blood noted in your stools or tarry stools that are dark in color
• Loss of weight that is unintentional or unwarranted
• Repeated discomforts of indigestion that are not related to meal consumption

Indigestion is a symptom of many illnesses and conditions.  If your indigestion is becoming increasingly frequent and impairing your ability to nourish yourself of causing you discomfort each day you should see your physician to determine the cause.

Related Posts shyley. May 13th, 2010 no comments

How to reduce stress and suspicion when seeking chronic pain medications.

You’re a chronic pain patient who takes several prescription narcotics to control your symptoms. Then one weekend, excruciating pain lands you in the emergency room. there, a doctor grills you about your medications, in part to make sure that you’re a legitimate pain patient, not someone seeking drugs. What can you do to help the ER doctor to believe you?

It’s not always easy to tell chronic pain patients from drug-seeking patients, says Howard Blumstein, MD, FAAEM, president of the American Academy of Emergency Medicine and medical director of the North Carolina Baptist Hospital emergency room.

Patients with chronic pain visit the ER for various complaints, he says. “Some of these patients have demonstrable disease, like sickle cell disease or chronic pancreatitis. I think that physicians are more likely to give them the benefit of the doubt when they come in and say they have pain.”

“Other patients are prone to have problems that you can never objectively demonstrate, like chronic back pain and chronic headaches,” he says. “We just have to take their word for it. You can’t look into anything and tell whether or not they’re actually having pain.”

Regardless of which group patients fall into, Blumstein says, “there are some patients who, because of their behavior or their frequent visits, still get labeled as being addicted to drugs or abusing drugs.”

What type of behavior raises suspicions? “Patients will come in and be very demanding, get into fights with doctors and nurses because they don’t think they’re getting enough pain medicine, and that causes the health-care providers to become suspicious of the patient’s motives,” he says. or the patient may ask for a specific narcotic like Demerol, or say they’re allergic to non-narcotic pain relievers.

Understanding Suspicion in the Emergency Room

“In most cases, it’s probably unfair to the patient,” Blumstein says. but emergency room doctors have strong motivations to carefully screen out drug seekers. they want to thwart drug abuse and any chance that narcotics will be diverted, for example, sold to strangers, or exchanged for illegal substances. “They have a high street value,” Blumstein says.

ER doctors have one useful tool, though. Currently, 34 states have prescription drug monitoring programs that allow doctors to check a patient’s prescription history online. “I can look up a patient and see all the prescriptions that have been filled for controlled substances,” says Blumstein, who practices in North Carolina. Doctors can use the database to corroborate a patient’s story. or they might see patterns that warn them to probe further for drug abuse, for example, prescriptions from numerous physicians that have been filled at multiple pharmacies.

“It is an unbelievably great tool for physicians,” says Eduardo Fraifeld, MD, president of the American Academy of Pain Medicine.