Don't Let Your Body Hold You Back
Athletes, coaches, trainers, team physicians, physical therapists, and even the “weekend warrior” are faced with problems including inflammation and muscle spasms. We work together with these individuals and health care professionals to customize medications which help ease these painful symptoms. At Genesis, our compounding specialists can help to solve medication problems using customized preparations that contain the most appropriate ingredients in the best vehicle to most efficiently provide the needed drug to the affected area.
EXCESSIVE PERSPIRATION
Hyperhidrosis therapy
Excessive perspiration is a concern for many athletes, as well as members of dance teams and marching bands. Numerous topical treatment options exist.
Primary hyperhidrosis (excessive perspiration) is a physically and emotionally distressing condition which involves mainly the palms, soles, and axillae. Oral anticholinergic agents and beta-blockers may be effective for controlling or reducing profuse sweating, but also carry significant side effects. Topical therapies may be the most practical and most common treatment for hyperhidrosis, but many agents that have proven useful in clinical trials are not commercially available.
Placebo-controlled trials have shown that topically applied 20% aluminum chloride hexahydrate significantly reduces the symptoms of hyperhidrosis in 60%-100% of patients. Skin irritation can be minimized with 1% hydrocortisone cream or by compounding 20% aluminum chloride in a 4% salicylic acid gel base, instead of in anhydrous alcohol base (as is the commercial product Drysol®).
Luh and Blackwell of the Dept. of Internal Medicine, University of Texas Medical Branch at Galveston describe a healthy, active 27-year-old male resident physician who had excessive facial sweating with minimal exertion or stress. The sweating was especially pronounced on the forehead, nose, and upper lip. Daily topical application of a 0.5% glycopyrrolate solution to the face and forehead significantly reduced facial sweating after the first treatment, without any discomfort to the skin. No loss of efficacy was seen after multiple face washings. Facial hyperhidrosis recurred after withdrawal of the glycopyrrolate for 2 days, confirming its therapeutic effect. Two years later, he continues to use glycopyrrolate as needed.
HEMMORRHOIDS (Ouch!)
Hemorrhoids are particularly problematic for catchers, coaches, and others who are regularly in a squatting position. Treatment often involves use of a novel dosage form known as the "rectal rocket", a suppository that permits simultaneous internal and external application of anti-inflammatories, anesthetics, antibiotics, or other medications.
PREGAME RUBS
Pregame rubs can be compounded to contain substances such as emu oil and anti-spasmodic drugs. Emu oil is a moisturizer that can improve healing of injured skin.
IONTOPHORESIS & PHONOPHORESIS
To avoid the risks of COX-2 inhibitors, our pharmacy can compound topically applied NSAIDs such as ibuprofen and ketoprofen. Topical NSAIDs have a safety profile which is superior to oral formulations. Topical NSAID administration offers the advantage of local, enhanced delivery to painful sites with a reduced incidence of systemic adverse effects.
Topical preparations can be customized to contain a combination of medications to meet the specific needs of each patient.
Topical NSAIDs for Acute Pain
“Topical non-steroidal anti-inflammatory drugs have a lower incidence of gastrointestinal adverse effects than the same drugs when they are taken orally. The low incidence of systemic adverse effects for topical NSAIDs probably results from the much lower plasma concentration from similar doses applied topically to those administered orally. Topical application of ibuprofen resulted in measurable tissue concentrations in deep tissue compartments, more than enough to inhibit inflammatory enzymes.”1 Topical NSAIDs have not been associated with renal failure.
“Topical non-steroidal anti-inflammatory drugs are effective in relieving pain in acute and chronic conditions.”
“The systemic concentrations of ketoprofen have also been found to be 100 fold lower compared to tissue concentrations below the application site in patients undergoing knee joint surgery. Topically applied ketoprofen thus provides high local concentration below the site of application but lower systemic exposure.”
"following topical application in a patch, ketoprofen shows rapid and sustained delivery to the underlying tissues without a significant increase of the plasma drug concentration."
Reduction of spontaneous pain and pain on active movement in the topical ketoprofen spray group was significantly greater than in the oral ketoprofen treatment group, irrespective of sprain severity. Regarding mobility impairment and ankle swelling, topically-applied ketoprofen treatment turned out to be significantly superior to orally administered ketoprofen treatment. Additionally, the topical preparation was well tolerated, whereas ketoprofen tablets caused gastrointestinal side effects in some patients.
Topical NSAIDs have a safety profile which is superior to oral formulations. Topical NSAID administration offers the advantage of local, enhanced delivery to painful sites with higher tissue levels beneath the site of application and a reduced incidence of systemic (such as gastrointestinal) adverse effects.
This study concluded that topical NSAIDs, when used for treatment of pain resulting from strains, sprains or sports or overuse-type injuries, can provide good levels of pain relief without the systemic adverse events associated with oral NSAIDs.
Topical Anesthetics
To avoid the risks of COX-2 inhibitors, our pharmacy can compound topically applied NSAIDs such as ibuprofen and ketoprofen. Topical NSAIDs have a safety profile which is superior to oral formulations. Topical NSAID administration offers the advantage of local, enhanced delivery to painful sites with a reduced incidence of systemic adverse effects.
Topical preparations can be customized to contain a combination of medications to meet the specific needs of each patient.
Topical NSAIDs for Acute Pain
“Topical non-steroidal anti-inflammatory drugs have a lower incidence of gastrointestinal adverse effects than the same drugs when they are taken orally. The low incidence of systemic adverse effects for topical NSAIDs probably results from the much lower plasma concentration from similar doses applied topically to those administered orally. Topical application of ibuprofen resulted in measurable tissue concentrations in deep tissue compartments, more than enough to inhibit inflammatory enzymes.”1 Topical NSAIDs have not been associated with renal failure.
“Topical non-steroidal anti-inflammatory drugs are effective in relieving pain in acute and chronic conditions.”
“The systemic concentrations of ketoprofen have also been found to be 100 fold lower compared to tissue concentrations below the application site in patients undergoing knee joint surgery. Topically applied ketoprofen thus provides high local concentration below the site of application but lower systemic exposure.”
"following topical application in a patch, ketoprofen shows rapid and sustained delivery to the underlying tissues without a significant increase of the plasma drug concentration."
Reduction of spontaneous pain and pain on active movement in the topical ketoprofen spray group was significantly greater than in the oral ketoprofen treatment group, irrespective of sprain severity. Regarding mobility impairment and ankle swelling, topically-applied ketoprofen treatment turned out to be significantly superior to orally administered ketoprofen treatment. Additionally, the topical preparation was well tolerated, whereas ketoprofen tablets caused gastrointestinal side effects in some patients.
Topical NSAIDs have a safety profile which is superior to oral formulations. Topical NSAID administration offers the advantage of local, enhanced delivery to painful sites with higher tissue levels beneath the site of application and a reduced incidence of systemic (such as gastrointestinal) adverse effects.
This study concluded that topical NSAIDs, when used for treatment of pain resulting from strains, sprains or sports or overuse-type injuries, can provide good levels of pain relief without the systemic adverse events associated with oral NSAIDs.
BENEFITS OF TRANSDERMAL NSAIDs
To avoid the risks of COX-2 inhibitors, our pharmacy can compound topically applied NSAIDs such as ibuprofen and ketoprofen. Topical NSAIDs have a safety profile which is superior to oral formulations. Topical NSAID administration offers the advantage of local, enhanced delivery to painful sites with a reduced incidence of systemic adverse effects.
Topical preparations can be customized to contain a combination of medications to meet the specific needs of each patient.
Topical NSAIDs for Acute Pain
“Topical non-steroidal anti-inflammatory drugs have a lower incidence of gastrointestinal adverse effects than the same drugs when they are taken orally. The low incidence of systemic adverse effects for topical NSAIDs probably results from the much lower plasma concentration from similar doses applied topically to those administered orally. Topical application of ibuprofen resulted in measurable tissue concentrations in deep tissue compartments, more than enough to inhibit inflammatory enzymes.” Topical NSAIDs have not been associated with renal failure.
“Topical non-steroidal anti-inflammatory drugs are effective in relieving pain in acute and chronic conditions.”
“The systemic concentrations of ketoprofen have also been found to be 100 fold lower compared to tissue concentrations below the application site in patients undergoing knee joint surgery. Topically applied ketoprofen thus provides high local concentration below the site of application but lower systemic exposure.”
"following topical application in a patch, ketoprofen shows rapid and sustained delivery to the underlying tissues without a significant increase of the plasma drug concentration."
Reduction of spontaneous pain and pain on active movement in the topical ketoprofen spray group was significantly greater than in the oral ketoprofen treatment group, irrespective of sprain severity. Regarding mobility impairment and ankle swelling, topically-applied ketoprofen treatment turned out to be significantly superior to orally administered ketoprofen treatment. Additionally, the topical preparation was well tolerated, whereas ketoprofen tablets caused gastrointestinal side effects in some patients.
Topical NSAIDs have a safety profile which is superior to oral formulations. Topical NSAID administration offers the advantage of local, enhanced delivery to painful sites with higher tissue levels beneath the site of application and a reduced incidence of systemic (such as gastrointestinal) adverse effects.
Topical NSAIDs, when used for treatment of pain resulting from strains, sprains or sports or overuse-type injuries, can provide good levels of pain relief without the systemic adverse events associated with oral NSAIDs.
TOPICAL & TRANSDERMAL THERAPIES
Athletes, coaches, trainers, team physicians, physical therapists, and even the “weekend warrior” are faced with problems including inflammation and muscle spasms. We work together with these individuals and other health care professionals to customize medications which meet specific needs. Our compounding specialists can help to solve medication problems using customized preparations that contain the most appropriate ingredients in the best vehicle to most efficiently provide the needed drug to the affected area.
EXAMPLES OF COMPOUNDED MEDICATIONS
The following list is just a few of the preparations that we can compound for sports medicine. All formulations are customized to meet the unique needs of each individual; therefore, we can consider the athlete’s lifestyle and environmental factors when formulating medications. Our compounding professionals can choose the best base to administer the active ingredients, or consult with the prescriber to determine the most appropriate route of administration to solve a specific problem.
- Clotrimazole in DMSO solution
- Cyclobenzaprine/Ketoprofen transdermal gel
- Dexamethasone iontophoresis solution
- Fluconazole/Ibuprofen topical gel
- Ketamine/Gabapentin transdermal gel
- Ketoprofen 10% transdermal gel
- LAT topical gel
- Lidocaine/Hydrocortisone "rectal rocket" suppository
- Nutritional Supplements
- Rehydration Drinks