Athletes, coaches, “weekend warriors”, trainers, team physicians, and physical therapists strive to stay at the top of their game. These athletes are faced with problems that can lead to injury, pain and infection if proper care of their bodies is neglected. Tailoring treatment to the patient’s age and lifestyle is important in order to promote prompt healing and decrease the chances of repeat injury. Personalized medicine combines an ageless art with the latest medical knowledge and technology to enable pharmacist to prepare customized dosage forms to meet the unique needs of athletes.
Topical and transdermal therapy can help relieve pain, reduce inflammation, and relax muscles while significantly reducing the risk of side effects, such as drowsiness, that can be detrimental to athletic performance. Topical NSAID (Non-Steroidal Anti-Inflammatory Drug) application offers the advantage of local delivery to painful sites with a reduced incidence of gastrointestinal adverse effects compared to the same drugs when taken orally.1 Research has shown that topically applied ketoprofen provides a high concentration of drug below the site of application, but decreases systemic exposure and significantly reduces gastrointestinal upset and bleeding. A 100-fold greater concentration of ketoprofen was found at the application site (knee) compared to the rest of the body. 2,3,4
Excessive sweating is a concern for many athletes that can be physically and emotionally distressing. Oral medications like 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 treatment for certain patients, but many agents that have proven useful in clinical trials are not commercially available. For example, a patient experiencing excessive facial sweating was prescribed a daily topical application of a glycopyrrolate solution for the face and forehead and had a significant reduction in facial sweating after the first treatment, without any discomfort to the skin.5,6
Anti-fungal therapy may be needed for athletes suffering from recurrent athlete’s foot, jock itch, and fungal nail. Personalized therapy involves the use of a combination of compatible medications that are synergistic in effect. Amphotericin, terbinafine, itraconazole, and ketoconazole are a few of the anti-fungal ingredients that can be utilized. Ibuprofen has been shown to be useful in addressing candidiasis topically due to the drug’s anti-fungal and anti-inflammatory benefits.7 Topical ibuprofen would make for an ideal add-on to a patient’s anti-fungal formula. These medications can be designed for improved absorption at the affected area with the use of penetration enhancers such as USP medical grade DMSO. This can be particularly useful when preparing anti-fungal medications for nail application.
Our goal as personalized medicine pharmacists is to provide practitioners with therapy options that meet the unique needs of those they care for.
References available upon request.
By Juan Lopez, PharmD
Juan Lopez, PharmD is a personalized medicine pharmacist with Pharmacy Specialists Compounding Pharmacy in Altamonte Springs, FL. Pharmacy Specialists is proud to be Central Florida’s only nationally inspected and accredited compounding pharmacy. For more information on how personalized medicine can help you please call 407-260-7002, email Juan@MakeRx.com, or visit www.MakeRx.com.