Pharmacies are regulated by state boards of pharmacies, which may choose to adopt USP standards. Individual institutions or institutional accrediting bodies may also adopt or endorse USP quality standards for nonsterile compounding.
III. Nonsterile Compounding Equipment
A. Prescription balance or scale for weighing ingredients
- All pharmacies must have a prescription balance to weigh small quantities of ingredients.
- To control quality and ensure accuracy, pharmacies should regularly calibrate equipment used for measuring or compounding, such as prescription balances. Pharmacy departments have policies and procedures that describe calibration methods and schedules to follow to ensure that equipment gets maintained on a routine basis.
B. Graduated cylinder or other containers for measuring liquids accurately
- Size – the liquid you will measure should fill at least 20% of the graduated cylinder. For example, to measure a volume of 3 mL, you would use a 10 mL graduated cylinder instead of a 100 mL graduated cylinder.
C. Compounding equipment, such as:
- Mortars and pestles (both glass and wood)
- Metal spatulas for mixing powders into ointments or creams
- Ointment slab, ointment papers, or pill tiles as a work surface for mixing ingredients
- Funnels, filter paper, beakers, glass stirring rods, and a heat source
D. Preventing and treating unintended exposure to hazardous substances
- Nonsterile compounding may require handling of hazardous drugs or other substances. In these cases, the compounding equipment should include supplies and information appropriate for managing hazardous substances (e.g., eyewash kit, spill kit, Material Safety Data Sheets). Chapter 13 contains more information on storage, handling, and disposal of hazardous drug substances.
IV. Nonsterile Compounding Processes
A. At the pharmacist’s direction, technicians may need to assist in the compounding function. Compounds are generally prepared according to a written prescription or an existing formula. Section VII discusses the calculations related to compounding preparations.
B. Techniques commonly used to mix ingredients together in the nonsterile compounding process include:
- Trituration: using a mortar and pestle to grind a drug solid to reduce particle size, or to mix two or more solids together.
- Levigation: dispersing a drug solid in a small amount of mineral oil, glycerin, or other liquid before incorporating it into a compounding base, such as an ointment.
- Geometric dilution: method for mixing a small amount of a potent drug with a large amount of a nonpotent or inactive compound.
C. Bulk compounding
- Many commercially unavailable compounds are prescribed and dispensed on a regular basis.
To save time, many pharmacies prepare or bulk compound
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