This Profile in Personalized Medicine highlights Joseph P. Navarra, RPh, FACA, owner of Town TOTAL Compounding Center in Woodbury, New York. He has been a proud PCCA member since 1994.

How did you start compounding? What led you to PCCA?

My experience in compounding started very early in my career. As a student in college, I would compound total parenteral nutrition (TPN) preparations and antibiotics for home-care patients. Shortly after graduation and as a new pharmacist in 1992, I compounded medications for children with pediatric HIV during a time when there were very few available pediatric dosage formulations. Providers asked for pharmacy collaboration to help with supporting patient adherence. So I would make gummies and lollipops and suspensions flavored and tailored to the needs of each patient. Basically, I would collaborate with the family and provider to help these children take their HIV medications. I then started doing some pediatric AIDS Clinical Trial Group studies with the National Institutes of Health and a local hospital, and that gave me the ability to come up with other formulations for the kids.

As part of my commitment to learn more about compounding, I attended a PCCA training in Houston during the early 90s after my father had met with PCCA’s Bill Letendre. I have been growing my compounding practice ever since.

What was one of your toughest patient problems? How did you solve it?

Solving problems is what I do, for patients and prescribers alike. One of the most challenging patient problems I can think of involved a patient with a diagnosis of shingles. This patient had numerous lesions covering a large surface area from the back of their head through their neck and extending down to their shoulder. They were on multiple oral meds that did not seem to help. Even sleeping was painful, and they had told me that that ice helped better than the medication. The patient’s provider made it clear to the patient that a topical treatment would not work given the severity of zoster lesions. I thought, maybe a compounded preparation just might. I worked with the prescriber and compounded a topical combination cream that resolved most of the pain in two or three days, and the patient was sleeping again with no problem. By day seven, the lesions were resolving and dried up, and by day 10, everything was clear. The only remaining visible sign of zoster was some red skin where the worst of the shingles had been.

What has been your most satisfying patient experience? What was their health challenge? How did you assist them?

This is another question where there are many possible answers. Yet I believe working with HIV-infected children was one of my most satisfying professional experiences. Pediatric antiretroviral medication was so new at the time, and these kids were taking many medications multiple times a day. It was difficult for them to adhere to medications and the schedule. To help support adherence, we did many flavored medications and dosage form conversions. Groups of children with HIV would make visits to the lab to watch us make their medications, and we even gave them the opportunity to pick their own flavor. Our goal was to give them a sense of autonomy and control over their illness and medication. Many of these children are now young adults and likely have children of their own, but I still remember their faces and names.

What was the moment you realized that joining PCCA was going to make a difference for your pharmacy?

Immediately, during a PCCA training in Houston back in 1994. And PCCA keeps making a difference for my pharmacy to this day.

What is your favorite PCCA base?

Currently, NataTroche^®. My favorite bases change depending on what PCCA comes out with, but right now, it is NataTroche. It is easy to work with, the patients like it and we are currently evaluating everything we make in a troche mold to see if we can switch them to this base.

What is your favorite PCCA event?

International Seminar, of course. It brings everyone together for a great networking event. And there are so many educational opportunities during this event, from CE to lectures and speakers and an informative exhibit hall.

When was the last time a patient thanked you, and why?

Last week and the week before. We get a lot of thank-yous, some in the form of emails, letters or phone calls. We even get food and drink! Most of these gestures are a way for patients to express how good of a job we did in helping them or that what we compounded for them worked better than anything else they have tried.

What do you wish you could tell new compounders?

Network, network, network. Surround yourself with people who know more than you. And never say no to a patient’s need for a solution. Always, always try to find the answer.

What is your favorite thing about your job right now?

Building and growing my practice by learning new things, solving new problems, and watching my employees grow into great compounders.

What is your personal motto or words to live by?

When one grows, we all grow.

What do you enjoy for fun?

Spending time with my wife and daughter, martial arts, car restoration and car shows, and the gym.

What are the best words to describe your life?

Satisfying and fulfilling.