The Currier and Ives image of the apothecary — you know the one, the wood-carved print of a shop on a cobblestone street in old London, a sign out front reading ‘Ye Olde Apothecary’ — has long passed away.

Today there are pharmacists, but even a pharmacist is not really an apothecary, even though they both are health professionals trained in the art of preparing and dispensing drugs. The apothecary gets down to the nitty-gritty, rolling up his sleeves, grinding, mixing and matching ingredients to deliver the specific remedy prescribed by a doctor.

Oh yes, the apothecary has changed his name. Today, he, or she, is called the compounding pharmacist — and they’re not found everywhere, but there is one in Calistoga.

“A pharmacist is not a compounding pharmacist,” said Mark LeRoy, one of the pharmacists at the Silverado Pharmacy in Calistoga, where he’s been mixing medicines for every ailment — from hemorrhoids to diabetes in dogs, from dry throats to topically applied hormonal creams — for the last two years.

“A pharmacist cannot do any compounding, or mixing of drugs at all,” said LeRoy. “A compounding pharmacist, on the other hand, can mix or create different ways to administer a physician’s prescription.”

A long historic slog / Looking back through time, early pharmacists of the compounding sort were herbalists, chemists and alchemists who experimented with every element of the natural world to develop medicinal remedies, prepare remedies for physicians and even create incense and perfumes.

They also, according to storytelling traditions, sometimes sought to create gold from various elements, or find the fountain of youth. Think of the medieval world of alchemists — think Merlin the magician, or someone from Harry Potter’s world of magic potions.

But those are just stories.

Baghdad might be known for its strife today, but according to some sources, it was the home of the first apothecary shops, or pharmacists, which grew out of ancient medicinal tradition around A.D. 785.

Things were probably pretty crude. Still though, much of what those ancient compounding pharmacists did lingers today. The real difference is the technology that today allows LeRoy and his colleagues to keep a close eye on quality.

Today, LeRoy, like other compounding pharmacists, is surrounded by modern mixers, not too different from mixers you might have in the kitchen, he said. They also have ointment mills and in some cases hoods where they can compound sterile preparations.

“As I mix the different medications, everything is tracked by bar codes and recorded on the computer,” LeRoy said. “A paper record is also kept on file so that if there is ever a question about the prescription, we can go back and refer to it.”

The difference in what LeRoy does today and the way things were done even 50 years ago can be realized in the quality of the medication.

“Even 50 years ago everything would have been mixed by hand in a mortar and pestle, or on an ointment plate,” he said. “I’m sure they did fine, since as far as I’m aware there weren’t any major issues with the medications or how they worked, but ointments might have felt a little gritty, or solutions might not have been as smooth as we can make them today.”

Even as a young pharmacist, LeRoy said if a child needed a pill medication in liquid form they’d grind it and put it into some kind of syrup.

“But that wasn’t very efficient, really, since some medications would settle to the bottom of the bottle,” he said. “That’s the beauty of what I do; the possibilities are endless. Whether I’m mixing a medication for a child, a topical ointment for someone who can’t take medicine orally, or mixing medication for an animal, we create medications that are more efficacious and easier to use.

“This is what I was called to do,” he said.

When he was young, LeRoy said he really considered becoming a dentist or an orthodontist, but while working for a pharmacist during school in the Los Angeles area, the pharmacist convinced him to consider pharmacology.

He went to pharmacology school and eventually earned a doctorate degree in pharmacology. He’s been a compounding pharmacist for more than 20 years.

How it works / Anyone who has difficulty taking any kind of medicine can approach a compounding pharmacist, LeRoy said.

“If they come to me, I’d contact their doctor on their behalf and we’d discuss a variety of delivery systems to prepare a solution, ointment or other preparation tailored specifically to the needs of that person.

“This is all about safety,” he said. “Physicians depend on the compounding pharmacists a lot to treat their patients.”

LeRoy works at the Silverado Pharmacy, and takes referrals to his own business, Quality First Compounding Pharmacy, from Silverado Pharmacy’s owners, who have also owned Smith’s Pharmacy in St. Helena for more than 15 years.

“Pharmacist Jeff Hansen and his wife Debbie and Bob Havens, the pharmacy’s owners and managers, have been very supportive of what I do here,” said LeRoy.

Print this story   |   Email this story | Browse today's articles in this category: Previous | Next