An AGH Frontliner’s Alcohol Compounding

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Nowadays, alcohol is considered a scarce commodity. When the pandemic corona virus hit initially different parts of the world, there was a sort of pandemonium in supermarkets, drugstores and even convenience stores in buying Vitamin C, toilet papers, disinfectant sprays, and yes, alcohol. Demand was so high, causing them to be non-in-stock. If you are lucky to find where they are available, numbers of purchase are limited per customer and with extra cost.

There had been, and still ongoing, repetitive reminders, among others, to properly wash your hands with soap and water, and in their unavailability, use alcohol to disinfect the hands, etc. In our own Army General Hospital, someone stood to answer the call for availability of more alcohol if there is none in the commercial markets.

How the Compounding Started

Ms Angela Perpetua dela Cruz- Munarriz, a registered pharmacist at the AGH Pharmacy Section since 1991, received a request from Lt Col Erwin Comendador, Administrative Officer at the Office of the Commanding General, Philippine Army, for Vitamin C, masks and alcohol for use of OCG. It took a half-day wait at Mercury Drugstore to purchase said items, but to no avail.

This prompted the lady frontliner to put to good use her being a pharmacist. “It was probably my instinct as laboratory professor that I thought of compounding the alcohol myself,” she said in an interview with her via electronic mail. She added that she even told her chief: “Gawa na lang kaya ako sir, bili lang tayo ng raw materials,” which got the nod of her boss.

She asked for the assistance of Adamson College of Pharmacy laboratory coordinator, Ms Angeli Ann Rescober, to endorse her to the university’s supplier who in turn kindly accommodated her request for purchase the raw materials, that is, either 95% USP grade Ethyl alcohol or 99% Isopropyl alcohol, distilled water, beaker and a stirring rod “so I could make 70% alcohol which is used as a disinfectant.”

Since some of the equipment she would use, like the graduated cylinder and funnel, were available at her office, Gettie made use of them along with a pail which she disinfected first before using.

 Risks Involved

I did the compounding at the pharmacy lavatory but due to lack of containers, I had to compound by small batches only. With little additional cost, I added fragrance to some of those I compounded”, Gettie further said

Alcohol is a flammable compound which is highly explosive so there was a risk involved in what she was doing. “We cannot just compound anywhere. It has to be done in a well-ventilated area, without direct exposure to direct sunlight. Likewise, the mask that I was wearing was an ordinary mask and I did not have goggles during the first few days of compounding… alcohol dries the nasal cavity causing nasal congestion and causes reddening of the eyes as it dilates the blood vessels. Also, protective nitrile gloves which is chemical resistant must be worn, but I had to settle for the latex surgical gloves. Alcohol is highly volatile so that containers must be kept tightly closed. We need to take safety measures too so no harm would come our way,” Gettie further narrates.

She also reiterates that compounding chemicals should be done by an expert…either a pharmacist or a chemist as to ensure safety and that proper procedure is followed.

After complying with the requirements of OCG, Gettie further added that, “From there, I thought of posting on Facebook on what we have done to encourage my fellow hospital and industrial pharmacists to compound alcohol for their respective hospitals since there is already scarcity. What we did at Army General Hospital pharmacy is called extemporaneous compounding, a practice done by most hospitals with clinical pharmacy (not in AGH though).”

A Minor Effort but a Big Contribution in the Army’s Fight vs COVID-19

The act that I did is probably ‘something’ for people who needed the alcohol at that time. I never thought that it would create an impact because I know that it is my responsibility. I am used to the idea of thinking of a solution if there are problems encountered like if there are lacking of stocks in the pharmacy. As drug experts, the AGH pharmacists may not be out in the open, but are certainly ready to be of service to our patients. I am just so thankful that God allowed me once again to use the skills/talents He has given me for the good of others and for His Glory. We can only do so much if we care to share!” Gettie further said.

Team Pharmacy On the Move

Other AGH registered pharmacists who, in one way or another, assisted her in compounding, repacking and labeling are fellow frontliners that included: Ms. Ma. Rosario O. Cayetano, Ms. Marcilyn T. Pinili, Ms. Jean Hazel B. Labis, Ms Dulce C. Jardin and Ms. Sarah Joy E. Gaspar. It was also a collaborative effort involving the Pharmacy NCOIC Sgt Claire M Mayono who gave his all-out support to the task at hand; and Sgt Noel Plantilla who had three or more trips a day to buy the raw materials outside of the camp. Among the offices that benefited from the services rendered by these frontliners included the OCG, OCSPA, OG1, OG3, ASCOM, ASPA, OACS, AIR, NOLCOM, PGMC (GHQ). “We still hope to be of service to everyone and every office when needed. However, we are also alarmed of the risks we take in facing the patients,“ Gettie added.

Aside from compounding alcohol, the AGH pharmacy is open to dispense medicines to in-patients and outpatients. “We continue to purchase whatever the patients, especially those PUIs and PUM’s need. I am also in constant communication with Col Jose Rosel Reduble of OACS and Col Joel Enrico N Anastacio, our Commanding Officer, regarding the medicines we need to stock in preparation for any emergency, which we hope and pray will not happen. I believe that as a member of the healthcare team, pharmacists have a vital role in educating patients about the drugs that they take as well as we believe in the phrase: ‘Prevention is Better than Cure,” Gettie concluded.

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