This Profile in Personalized Medicine highlights Ashley Nolan, BSc, CPhT, a co-owner of Martin's Wellness & Compounding at Lamar Plaza Drug Store in Austin, Texas. They have been proud PCCA members since 2010.

How long have you been compounding?

I have worked in pharmacy for 23 years and spent the last 18 years as a compounder.

Did you always want to work in the field of pharmacy?

Yes. You could say pharmacy runs in my family. I grew up helping out at my mom's pharmacy in Sherman, Texas. She had a long-term care pharmacy at the time and often would be the on-call pharmacist. There were weekends where she would put me to work pulling all the medications and packing the orders. Then I would hop out of the car and deliver to the nurses’ stations at the local long-term care facilities.

It was an exciting time for me as a 10-year-old. Mom made it a family affair. As children, my brother and I always attended pharmacy conferences in exciting places — sort of like a vacation! I met many of the pioneers in Texas pharmacy and beyond. I learned about pharmacy operations before I even knew that was what I was doing. I enjoyed meeting the brightest and most influential people in the profession, and those relationships have led to great resources and provided me mentors during my career.

When did you learn about compounding?
I moved to Austin, Texas, in 2002 and started working for a local, independent compounding pharmacy. I was interested in learning the art of making customized medications, so they moved me into the compounding lab to begin training. I remember my first day: I made nothing but slow-release progesterone capsules all day long. I think the trainer wanted to make sure that I never forgot how to put together a capsule machine.

What do you find most fulfilling about compounding?

The most amazing part of my job is the joy of helping others — learning the latest developments, investigating and then creating a preparation that improves a patient’s quality of life. It's pretty incredible to be a part of a patient’s health care journey and help in their recovery or healing or maintaining better health.

“The most amazing part of my job is the joy of helping others — learning the latest developments, investigating and then creating a preparation that improves a patient’s quality of life.”

What are some of your favorite PCCA formulas?

Tetracaine popsicles using MucoLox^™ (PCCA Formula #11430) is a favorite formula of mine. Patients are typically prescribed these to use at home, between pain medication. We have also made this formulation into a MucoLox oral spray for adult use.

Another formula that I like is amitriptyline topical cream with Lipoderm ^® (PCCA Formula #9342). Some of my local veterinarians prescribe amitriptyline for felines needing pain management. I had one four-legged patient in particular who really couldn't tolerate oral amitriptyline because of the bitter flavor. This cat was not having it. He would stay up nights, meowing in pain, causing an issue with his owners. His pet-dad wasn't getting any sleep before long days at work, and kitty's mom was pleading. If we couldn't get kitty some relief, then her husband was going to have him put down.

I talked to George in Clinical Services at PCCA, and he recommended preparing it topically using a permeation-enhancing base. The veterinarian agreed, and the cat’s mom was on board. I checked with her the following day, and kitty slept all through the night.

What are some of your compounding pharmacy success stories?

We had a concerned parent reach out to us. Her 3-year-old had a neurological condition that caused his facial muscles not to work well, so he was constantly drooling, which was causing a rash. We worked with the child’s doctor and PCCA Clinical Services to create an oral paste with glycopyrrolate and flavored it so that it tasted like icing. The patient responded well and liked that taste so much that when his dad applied the medicine to his gums, Mom was happy, and the 3-year-old felt better.

Additionally, we have filled prescriptions for a patient for many years who suffered a terrible back injury more than 30 years ago. She is on multiple pain medications and suffered side effects like dizziness, which eventually caused a fall and broken collarbone. Her doctor wanted her off of the oral meds because of that. Working with the doctor, we came up with something that fit her perfectly. She is now off her former medication and using a lesser dose of narcotic with the application of a combination pain cream made with Lipoderm.

What advice would you give to a new compounder?

I have a few:

• Always ask questions.
• Take your time. It’s better to get it done right than right now.
• Get to know your customers. People like to do business with people they like.
• Cultivate relationships with your doctors and their office staff. They will rely on you to help their patients and them when prescribing compounds.