Sports Health Pharmacy

Pain and Inflammatory Relief

Healing the injured athlete is a common goal for both the athletic trainers and compounding pharmacist. Sports medicine strives to create a system of prevention, but when injuries do occur, medications are necessary in both immediate first aid and in progressive rehabilitation. Below is a list of compounded topical prescriptions that will enhance your powerful medical arsenal.

During physical activity, the body is exposed to extreme conditions and circumstances that have the ability to cause pain. The pain can occur due to chronic overuse and repetitive stress of exercising, muscle cramping, intense activity and traumatic injury. Often times this leads to chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs). Long term use of NSAIDs can lead to serious gastrointestinal side effects including peptic ulcers and bleeding. The use of topical gels for pain and inflammation avoids these types of side effects.

Below are common topical gels that can be compounded to treat pain and inflammation
Ketoprofen 20%
KICK	(Ketoprofen 10%, Ibuprofen 10%, Cyclobenzaprene 2%, Piroxicam 2%)
KICK ES	(Ketoprofen 15%, Ibuprofen 10%, Cyclobenzaprene 2%, Piroxicam 2%)

Medications also can be incorporated into gels that are applied to the skin where penetration is facilitated by phonophoresis or iontopheresis.

NSAIDs
Piroxicam 0.5%
Ketoprofen 2%

Steroids
Dexamethasone 0.4%
Hydrocortisone 10%

Anesthetics
Lidocaine 2-4%

Contusions (Bruises)
When the skin is not broken during a traumatic injury, bleeding can occur underneath the skin to produce a bruise. Vitamin K is essential for blood clotting and Vitamins A and E are antioxidants responsible for cleaning up harmful inflammatory byproducts. The Apothecary Shops can combine these ingredients into a cream or ointment that may help reduce the healing time of a bruise.

Example formulations:
Phytonadione (Vitamin K) 2% topical ointment
Phytonadione (Vitamin K) 1% / Vitamin E 1% topical cream

Cold Sores
Antiviral medications and sunscreen can be used to prevent or treat oral herpes (cold sores) reactivated by sun exposure or stress. The addition of anesthetic creams can provide pain relief during healing.

Example formulations:
Acyclovir 5-10% / Oxybenzone 6% / Dioxybenzone 3% (sunscreen)
Acyclovir 5-10% / Deoxy-D-glucose 2%
Aclycolvir 5% / Lidocaine 2% (anesthetic)

Wart Removers
Plantar and common warts are caused by a virus and are highly contagious in the locker- room setting. It is important warts be treated promptly to avoid spreading them to other teammates. There are several prescription-strength wart removers that can be compounded. Caution should be used when handling these products and applying them on the skin as irritation can occur to healthy skin exposed to these products.

Example formulations:
Salicylic acid 25% in flexible colloidion paste
Trichloroacetic acid 30% solution
Squaric acid 2% topical solution