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Zoe Stefanadis, RPh

Tamara Bowe, Pharmacy Technician

109 Conner Drive, Suite 1200
Wilshire I Building

Chapel Hill, NC 27514

Telephone: (919) 967-8805

Fax: (919) 967-8205

Trials and Benefits of Prescription Drugs

“Substance abuse levels have reached an all-time high in our country, with illicit drug use by nearly 25 million people over the age of 12, who are suffering from addiction,” notes Pharmacist Zoe Stefanadis, owner and chief proprietor at Chapel Hill Compounding.

Pharmacist Zoe Stefandadis, left, and Leslie Forsyth, a certified pharmacy technician, discuss every detail as a new medication is formulated for a client.

“Drug overdose,” she notes, “is the leading cause of accidental death in the U.S.—a sad commentary on the mental and emotional health of vast numbers of people.”

There is intensifying concern among pharmacists that a substantial and growing number of people are abusing the drug-delivery system by getting medications from multiple sources.

“State officials have said we have a crisis on our hands,” Ms. Stefanadis notes. “The death rate from opioid addiction has increased phenomenally in the last few years, with scores of people going to multiple doctors seeking prescriptions to feed their addiction.”

While there are safety practices in place, she notes, there are also serious challenges. “For example, there is a controlled substance reporting system, but it’s left to the practitioners to report drug use information. This can present another set of difficulties because of the time constraints imposed on practitioners within our health care system. Pharmacies are responsible for reporting any controlled substance prescription that is filled. Also, patients picking up certain medications have to show us an ID and sign a record book.

“However,” Ms. Stefanadis says, “we really don’t see as much of this in a compounding pharmacy. It’s much more common in a traditional retail setting, like the chain pharmacies.”

Life-long Interest

Compounding pharmacists also encounter less substance abuse issues because they develop a much closer relationship to both patient and doctor. Typically, clients are sent to them specifically by a doctor to help solve medication problems.

“Compounding is fascinating,” says Zoe Stefanadis. “It’s my passion. When I was little I used to play that I was a mad scientist. I would take all the ingredients out of my mom’s cabinet and put them on the table and mix and match.” The result of this passion is Chapel Hill Compounding, which she has owned and operated since 2006.

In a compounding pharmacy, there is no traditional dispensing from stock bottles off the shelf. Every prescription is formulated on the premises, the pills counted, the labels applied. And each prescription is a unique formula. “I love compounding because it’s problem solving,” says Ms. Stefanadis. “I tell people that we don’t invent the drugs, we just make them better.”

She says her job is to address issues that mass-produced drugs do not. “We see people who are looking for solutions when their traditional pain medications aren’t working for them. The answer may be to create a transdermal medication that can be applied directly to the skin. One thing we have to consider is the chemical side of the medication. How big is the molecule? Can it be transported through the skin, through the muscle, to the area where it’s needed? Is it an effective application? Transdermal delivery of medications has numerous benefits for all patients, especially for kids, who may have a fear of needles or issues about taste.

Compounding for Children: A Special Challenge

“Right now we have a lot of clients who are children,” says Ms. Stefanadis. “Children are not little adults, and the medications they take must be formulated in dosages appropriate for their developmental level. And children need medicines that can be taken easily. We serve a lot of children that have a feeding tube in place or have certain absorption issues that we have to address. And we’re not just treating the child, we’re helping the entire family. It’s important to reduce stress on the parent, who is the one having to administer the medication.

“We may, for example, increase the effectiveness of medications by lowering volume amounts, and tweaking taste and palatability. Dosages can be divided so that large pills don’t need to be administered. Medications can be flavored with tasty, child-pleasing flavorings. “There’s often a good deal of problem-solving involved to find the most effective way to offer a child needed medications. Each child is different. Medications—in terms of content and delivery—are designed to need the specific individual needs of each child.”

When serving the needs of children, Ms. Stefanadis always tells parents to feel free to call her at any time, day or night, if there are drug delivery issues of any kind.

The Aging Population

Notes Ms. Stefanadis, the geriatric population also often needs a highly individualized approached in the preparation and administration of prescription drugs. “Older clients absorb medications differently. In the past decade, we have come to realize that our seniors also have individualized needs when it comes to drug prescription support. Often we need to determine if an older individual is a fast- or slow-metabolizer of medications. Is the individual dehydrated? What other medication is the individual taking that could potentially interfere with a new medication? All of this and more is part of the drug prescription approach before we formulate the requested prescription.”

When working with hospice patients, attention to the smallest details may help a person reduce pain and create more comfort, Ms. Stefanadis explains. “For example, we can use transdermal medications instead of pills when swallowing is too difficult for the patient. There are other routes of administration as well, whether suppository or transdermal. We can get systemic absorptions through venous areas of the wrist or the bottom of the feet. It’s all about the passage.”

Ms. Stefanadis admits to dreaming of formulations in her spare time. “I often think about how can I make a medication better? I refuse to admit that there isn’t an answer to every problem. It may not be what you’re expecting, but there’s always an answer.”