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Khyati Undavia Explains Compounded Medication (and Why It’s Important)

Avatar photo Jeah Lorraine Adams on March 2, 2023

Khyati Undavia is a licensed pharmacist and holds the role of pharmacist in charge. Her specialty is compounding medications. Today, she explains what compounded medications are and why they are necessary. 

What is Compounding? 

Compounding refers to the process of creating customized medications tailored to meet the unique needs of individual patients. When a commercially available product cannot provide the desired therapeutic effect, compounding may be used to prepare medication that is specially formulated and dosed for the patient’s requirements. The U.S. Pharmacopia Convention (USP) defines compounding as the preparation, mixing, assembling, altering, packaging, and labeling of drugs, drug-delivery devices, or devices in accordance with a licensed practitioner’s prescription, medication order, or initiative based on the practitioner-patient-pharmacist-compounder relationship in the course of professional practice.

There are two types of compounding: traditional compounding and medically optional compounding. Traditional compounding is used when a patient’s medical needs cannot be met by commercially available products, and the preparation of customized medication is deemed medically necessary. Medically optional compounding, on the other hand, may be undertaken to accommodate a patient’s dietary preferences or to improve the taste of medication.

Compounding can be utilized to prepare medications in various forms, including intravenous, topical, or oral administration. The process of compounding ensures that patients receive medication that is personalized to their unique requirements, thereby promoting optimal therapeutic outcomes.

Why is Compounding Done?

Compounding is done for a variety of reasons, according to Khyati Undavia.

Changing Delivery Method 

One reason is to change the delivery method of the medication. For example, a tablet can be converted to liquid if the patient can’t swallow a pill. It can also be changed to a topical cream, which can be absorbed by the skin, rather than ingested. Medications can also be converted to a suppository form. 

Allergy or Intolerance to an Ingredient 

Another reason for compounding is to address allergies or intolerances to inactive ingredients, which can be removed from the medication. If a patient can’t tolerate an inactive ingredient, compounding can deliver the medication without the ingredient. 

Medications often include inactive ingredients to create stability or to create tablets. Inactive ingredients can also be used to change a medication’s color, texture, or flavor. In some cases, particularly pain medication, specific ingredients are used to make the medication tamper resistant. 

In some cases, it’s a preference rather than an allergy. Someone who wants to avoid gluten, for example, may request gluten free medication. 

Customized Strength or Dosage 

Compounding also allows the strength or dosage of the medication to be customized for the individual based on the doctor’s prescription. 

Change in Flavor or Texture 

Additionally, medications can be compounded to improve their taste and texture, particularly for children or pets who may be unwilling to take medication that tastes bad. While adults may be willing to endure unpleasant medication for the sake of their health, young patients may require a medication that tastes good to ensure compliance. 

Compounding vs. Drug Manufacturing

While both compounding and drug manufacturing involve the production of medications, there are significant differences between the two processes. Drug manufacturing refers to the large-scale production of FDA-approved drugs, while compounding is typically done on a smaller, individual basis.

Compounded medications are prepared for individual patients with a valid prescription and are dispensed directly to them. In contrast, manufactured drugs are typically distributed to hospitals, pharmacies, and other healthcare facilities for further distribution to patients.

Compounding Pharmacies 

According to Khyati Undavia, while most pharmacies are equipped to perform basic compounding using tools such as a mortar and pestle for grinding ingredients and graduated cylinders for measuring liquids, only a few specialize in compounding. Pharmacists are trained in making compounds as part of their education, and scales and ointment slabs are used to weigh and mix ingredients. However, of the approximately 56,000 community pharmacies in the U.S., only 7,500 specialize in compounding medications.

Sterile and Non-sterile Compounding 

Most pharmacies can perform non-sterile compounding. This typically involves compounding topical creams, suspension liquids, and tablets or capsules. 

Sterile compounds are introduced directly into the body. These include eye drops, injectable medications, and IV infusions. Sterile preparations require a higher level of expertise and knowledge than non-sterile compounds. 

Compounding Pharmacy Oversight and Regulations 

The Food and Drug Administration (FDA) is responsible for regulating the safety and efficacy of food and drugs in the United States. Before prescription drugs can be marketed, the FDA must approve their manufacture. The FDA evaluates medications for their quality, safety, and effectiveness.

However, most compounding pharmacies are exempt from FDA regulations. While the FDA oversees the active ingredients used in compounded medications, they do not oversee the compounded preparation itself. The Drug Enforcement Administration (DEA) also provides oversight for compounded medications that contain controlled substances. State authorities are responsible for overseeing compounding pharmacies as well.

To ensure high-quality standards for compounding, the United States Pharmacopeia (USP), a private not-for-profit organization, issues standards for compounding. These standards apply to medications, dietary supplements, herbs, and food ingredients commonly used for compounding.

Compounding pharmacies may also seek accreditation through the Pharmacy Compounding Accreditation Board (PCAB). While this accreditation is not required, it reflects a commitment to high-quality standards and quality assurance.

Compounding Pharmacist Training 

Pharmacists are trained in compounding during pharmacy school. Most states require a pharmacist to pass tests on compounding before receiving their license. 

 However, pharmacies that specialize in compounding can seek additional education. There are no state or federal regulations that require additional training. 

Active pharmaceutical ingredient, or API, manufacturers typically offer compounding training. 

Compounding Pharmacy Benefits 

Depending on your specific needs, there are multiple advantages to selecting a compounding pharmacy. These types of pharmacies prioritize individuals, collaborating with both doctors and patients to create personalized medications.

In some cases, a doctor may prescribe a medication dose that is not available through the manufacturer. Alternatively, a patient may require a different route of administration or a modification of an inactive ingredient due to allergies or other sensitivities.

By working with a compounding pharmacy, patients can receive the precise medication that meets their unique requirements in a timely manner. Rather than simply dispensing standard medications, compounding pharmacies offer a tailored approach that can result in improved outcomes and a better overall healthcare experience.

Drugs That are Commonly Compounded

Many medications can be compounded, but certain types are compounded more frequently than others. Pain medications, particularly opiates, are commonly compounded, as the pharmacist may adjust the medication’s strength or provide it in a non-standard form, such as liquid or lollipops, to suit the patient’s needs. Hormone replacement therapy (HRT) medications are also frequently compounded because the dosage is personalized to the individual patient. Transdermal creams are a common type of HRT medication that is compounded in pharmacies. Additionally, dermatology medications are regularly compounded to customize the medication to the patient’s specific skin type and dermatological requirements.

Khyati Undavia

Khyati Undavia, originally from Bombay, India, developed a passion for life, art, and her cultural heritage, earning several accolades for her dancing skills. At the age of 15, she moved to the United States.

After earning her B.S. in pharmacy and completing her residency, Undavia worked at Medco before taking a bold risk on a struggling pharmacy. Undavia seized the opportunity to purchase the business, using her expertise to transform it into a thriving enterprise. Her efforts paid off, and she succeeded in building a successful pharmacy from the ground up.

 

Alexander Rekeda Takes a Look at How Businesses Are Embracing Cryptocurrencies

Avatar photo Jeah Lorraine Adams on March 2, 2023

Hoboken, NJ – (Date) – Although the value of digital currencies tends to fluctuate wildly, many businesses seem undeterred by the volatility. Alexander Rekeda, a seasoned crypto investor, recently indicated that tens of thousands of companies accept Bitcoin payments, resulting in an ever-increasing number of daily transactions in the United States alone.

Small and large enterprises use cryptos for transactional and operational purposes. This trend has left many people wondering what it’s in it for businesses.

Rekeda believes that companies understand the need to manage the risks that come with volatility. When handled correctly, cryptos’ volatility can become a source of huge profits. The likes of PayPal, Mastercard, Starbucks, AT&T, Microsoft, Tesla, and other notable entities have embraced cryptocurrencies. They’re demonstrating that the corporate world can work with digital currencies sustainably.

How can businesses benefit

Alexander Rekeda weighed in on the benefits of cryptos for companies by outlining some potential advantages of embracing the currencies. One of the key benefits he singled out is increasing the number of customers. Over one billion people own varying amounts of digital currencies. This figure creates a viable business case for opening up to new possibilities.

Another key reason for corporates to join the crusade is that cryptos have shorter payment settlement cycles than other payment methods. In addition, the transaction fees are much lower. On the other hand, Rekeda says adopting digital money is a practical way to attract affluent customers. It’s no secret that high-net-worth individuals invest in cryptos in huge numbers. Some wealthy people owe their success to Bitcoin and Ethereum.

Meanwhile, people looking for transparent payment options prefer dealing with companies accepting digital currencies. Alexander also noted that accepting cryptos makes it easier for companies to attract customers under 50. This demographic group is more open to digital money than people over 50. Enthusiasm for cryptocurrencies is strongest in the 18 to 35 age group. So, Rekeda says it makes sense to offer new payment methods if a company targets this demographic.

Fueling new business opportunities

As analysts expect the digital currency market to reach $2.2 billion by 2026, companies can tap into wide-ranging opportunities that come with this growth. The most progressive businesses are already coming up with innovative offerings. Doing so lets companies stake a substantial claim in the burgeoning market.

Although there’s a need to bring the right talent and tools to take advantage of crypto business opportunities, Alexander believes the rewards can be sweet and worthwhile. Businesses should navigate technology complexities, consumer paranoia, and compliance matters.

The opportunities extend to the hospitality industry. Because of this, some hotels like Pavilions accept Ethereum, Bitcoins, and other cryptos. Guests can book accommodation with a currency of their choice, depending on location. Rekeda believes this approach provides a practical way for hoteliers to tap into crossover markets. Many big spenders are active in the digital currency market.

About Alexander Rekeda

As an experienced crypto investor at a New Jersey firm, Rekeda understands the importance of cryptos in some business sectors. He’s also heavily involved in humanitarian work. In his spare time, he explores different destinations globally.

The Happiest Man in America – Helping People Achieve Happiness in their Lives

Avatar photo Jeah Lorraine Adams on March 2, 2023

In the most basic terms, happiness is a psychological state encompassing several positive emotions or feelings, including contentment, satisfaction, fulfillment, well-being, and euphoria. Pursuing happiness or being happy is a fundamental human right, and people strive to be happy by making several efforts. Almost all human activities, efforts, and endeavors revolve around achieving happiness through well-being, success, wealth, relationships, peace, and other social or personal elements. Although the definition or meaning of happiness may differ for various socioeconomic groups, every individual wants to remain happy by recognizing the underlying meaning. Thousands of websites, blogs, articles, and books focus on how people can achieve happiness or stay happy. However, happiness seems to elude most people due to a lack of awareness regarding the true meaning of happiness or the approach to finding happiness.

People strive for happiness but fail because they are unaware of what makes them happy. Happiness stems from numerous factors and typically changes with people’s contexts and circumstances. However, sustainable happiness is usually unachievable because people associate happiness with the wrong aspects or elements. There are several ways of achieving happiness by focusing on activities and elements that make a person happy. However, most people fail to remain happy for extended periods because they do not understand the true meaning or technique for achieving happiness. One primary way to achieve happiness is to examine and evaluate a happy individual’s behavior, activities, lifestyle, and actions. People can also seek advice or guidance from people who are happy and content in their lives. Alvin Wong is the best person to help people understand the meaning of happiness and the path to achieve it because he is the happiest person in the United States.

Alvin Wong is a Chinese-American from Honolulu, HI, in his late sixties and married with children. He earns over $120,000 annually and is a retired hospital and group healthcare practice administrator with over 40 years of experience in the healthcare industry. Wong worked for over 25 years as a physician recruiter and hospital administrator and 15 years as an administrator for two group practices comprising 20 physicians. He is the perfect source for understanding and achieving happiness because a survey conducted by Gallup at the request of the New York Times nominated him as the happiest person in America. Wong is a Kosher-observant jew who perfectly matches the profile of the happiest person in America due to his lifestyle and outlook on life. 

Wong gave hundreds of interviews after he was nominated as the happiest person in America. The common theme among all interviews was the secret behind his happiness. Everyone wanted to know the secret behind his happiness and what made him the happiest person in America. Wong also wanted to share his formula for happiness with everyone and help people understand the true meaning of happiness and how to stay happy. He wrote a book entitled The Happiest Man in America to share his secret and help people achieve happiness. The book is unique because it shares the first-person account of the happiest person regarding the true meaning of happiness and how to achieve happiness regardless of the adversities, circumstances, and contexts. The Happiest Man in America highlights Wong’s journey from childhood to being selected as the happiest person, encompassing all elements that contributed to his happiness.

The book “The Happiest Man in America” chronicles Alvin Wong’s philosophy of achieving and maintaining happiness. The book highlights that keeping life simple, focusing on small elements of happiness, and making others happy are some primary aspects of sustainable happiness. The author explains that being humble, making every day count, and not taking things or life seriously are the perfect ingredients for a happy and fulfilling life. The book informs readers that happiness lies in some of the smallest things people take for granted, prioritizing others’ happiness rather than concentrating on self-contentment. The Happiest Man in America offers a unique perspective on the right to pursue happiness in the Declaration of Independence. Wong illustrates in the book that although pursuing happiness is a fundamental right, people still need to try to achieve happiness.

The Happiest Man in America illustrates how regulating behavior and seeking small episodes of happiness from within can lead to overall happiness in life. Alvin Wong shares his unique insights regarding how to lead a happy life without making excessive efforts or sacrificing a considerable amount of time. Wong highlights how he became the happiest man in America and the various aspects of happiness that are typically obscure from people’s views despite their proximity. The book helps people achieve happiness by focusing on the little things, alleviating seriousness, and striving to keep others happy.

Severance agreement change, how it affects employees and employers

Avatar photo Brandon Foster on March 2, 2023

Severance – Parting with an employee, whether by mutual consent or not, is never easy.

Regardless of how the decision was reached, employers usually offer severance pay to terminated employees.

It is a critical practice that softens the blow of an involuntary termination.

Furthermore, it is a strategy used to prevent future lawsuits wherein the employee signs a release for severance.

However, the National Labor Relations Board recently came up with a decision that prevents employers from requiring released workers from signing agreements.

The decision prohibits them from signing certain non-disparagement and confidentiality clauses in exchange for the severance packages.

The news

Last week, the NLRB alerted employers, saying they can no longer keep laid-off employees from sharing information in two specific ways that violate employees’ rights.

Employers are prohibited from attaching a confidentiality clause that requires the laid-off worker from sharing the terms of their severance agreement.

In addition, they cannot include non-disparagement clauses prohibiting them from discussing the terms and conditions of their employment.

“A severance agreement is unlawful if it preludes an employee from assisting coworkers with workplace issues concerning their employer, and from communicating with others, including a union, and the Board, about his employment,” the board wrote.

Who does the change apply to?

Although the change is significant, it doesn’t affect every company across various industries.

The majority of US private sector employers fall under the new rules’ umbrella as they are subject to the NLRB’s authority.

As a result, private sector employers must follow the latest decision.

Furthermore, it will apply to the employers’ union and non-union workers.

Andrew Herman of law firm Blank Rome LLP discussed the decision, saying:

“This board is signaling and reminding employers that the NLRB applies to employers regardless of whether workers are unionized.”

The exemption

While US private sector employers must abide by the NLRB’s decision, a few groups aren’t subject to their authority.

The exemptions include federal, state, and local government agencies, such as:

  • Public schools
  • Libraries
  • Parks
  • Railways
  • Airlines

The NLRB enforces the National Labor Relations Act, which means that some groups of workers are unlikely to be covered by the ban.

Read also: Job cuts and hiring creates headache for US market

Those excluded from the Act include:

  • Supervisors and managers who are authorized to hire, fire, set pay, and discipline employees
  • Independent contractors
  • Agricultural workers
  • Domestic workers
  • People employed by a parent or spouse

Influence on past legislations

Andrew Herman underlined how the decision doesn’t say if the ruling is retroactive, noting that the decision was hard to pin definitively.

According to Michael Healey of Wagner, Falconer & Judd Ltd, NLRB decisions can be presumed retroactive.

However, it is only exempted if it results in an injustice or is unfair to the employer.

He added that it’s fairly possible it isn’t retroactive because employers have offered severance agreements in the past few years following a 2020 NLRB decision overturned by the latest ruling.

According to some lawyers, it’s possible the labor board might consider making it retroactive if an employee files a charge for an alleged labor violation referring to a severance agreement signed or enforced in the past six months.

There is usually a six-month window similar to a statute of limitations to bring alleged violations to the board’s attention.

The new severance agreement condition

The NLRB’s new rule raises an important question: are employers prohibited from requiring workers to stay silent about the company in exchange for severance?

Although the rule makes it seem they can’t, employers can include the condition in certain situations.

Herman noted that they can still require leaving employees not to reveal trade secrets and confidential information to protect business interests.

In addition, employers can still ask employees to waive their right to make future claims or file lawsuits against them.

Impact on future severance decision

Regarding the impact on future severance decisions, employers have no legal requirements to offer a severance agreement.

However, most employers still make severance offers to maintain amity with employees and the surrounding community, which could economically impact the business’ workforce.

Employees offer severance to prevent getting sued, receiving bad word-of-mouth reviews and preventing future employees from applying or having their secrets shared.

Jon Hyman, a management-side attorney who doubles as the chair of the employment and labor practice at Wickens Herzer Panza, explained his severance offer, saying:

“I’m doing it because I want to get something from the employee in return. I’m buying finality [in having to deal with that employee].”

However, he noted that without the clause, an employer’s protection is reduced.

Hyman suggested that employers might want to pay less for it.

“There’s a real risk to employees that the case will have a negative impact on the size of severance packages going forward,” Hyman elaborated.

Image source: Hammer Smith Endocrinology

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