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Compound Interest


Pharmacists, Lauren Driebe, left, and Karen Lieb stand at a work bench in the new compounding pharmacy Mortar & Pestle located on North Fourth Street. (Jake Bacon/Arizona Daily Sun)

By KAT NICHOLS Sun Staff Reporter
Posted: Saturday, August 15, 2009 10:00 pm

Most people get their medication prescriptions filled by regular pharmacists with manufactured drugs.

However, some patients need specialized medication, compounded immediately at the doctor's request.

This is where Mortar & Pestle comes in, the newest addition to Flagstaff pharmacies.

"It's old pharmacy, making the medicines from scratch," said Lauren Driebe, RPh, co-owner and one of two pharmacists of Mortar & Pestle.

Driebe is a third-generation pharmacist, with a degree from the college of pharmacy at Auburn University in 1987. After owning a business in Georgia, she moved to Arizona, where she worked for a chain pharmacy and then a local Flagstaff pharmacy.

At the local pharmacy, she met Karen Lieb, RPh, who got her degree in 1986 from the University of Montana. The pair decided to open a compounding pharmacy in Flagstaff to fill a medicinal niche. Their business on North Fourth Street opened its doors on July 22 and has been busy filling prescriptions ever since.

Lieb said the business handles prescriptions from all kinds of physicians, including pediatricians and oncologists. Dentists have been their most frequent business thus far.

They also handle prescriptions for companion pets. These are primarily dogs and cats, but they can handle all animals, from tarantulas and snakes to exotics.

Lieb says there are some specific advantages to using a local compounding pharmacy over a chain pharmacy.
"With pre-made drugs, you're limited to that strength," Driebe said. "With compounding, the doctor can say, 'Well, my patient only needs this strength, or I want to try this strength with something else mixed into it that you can't get commercially.' That's kind of the main draw of compounding — you can adjust the dose specifically to the patient's needs."

The duo said there are three elements that set Mortar & Pestle apart from other pharmacies. The first of these is technology. To mix the medicines, they use state-of-the-art equipment.

The second is that they take the time to speak to the patients and do follow-ups on their medication. Within a few days of receiving a prescription, both Lieb and Driebe know if it is working or not and if they have to make adjustments.

"The main thing is you want the patient to be compliant," Driebe said. "If they don't like what they're taking, if they can't swallow it or it doesn't taste good, that's where we come in to meet that need. If they can't swallow it, we can change it to a liquid, or if they are so sick that they can't swallow, we can make a suppository or a transdermal gel to get the drug in."

The third element is continuing education. Although both women have degrees in pharmacy, they acknowledge that the world of medicine is always changing. They attend seminars during the year and are linked via computer to the Professional Compounding Centers of America, which they use as a resource for any problems that arise or if they need a recipe they can't find elsewhere.

"I went through this same primary training about 12 years ago and then Karen and I went again this year and it had changed," Driebe said. "You can't assume that nothing's changed, that there's nothing new out."

The continuing education also extends to the patients they treat. Both women take the time to sit down and talk to the patients, making sure they completely understand what to expect from their medication.

"It's real individualized, I mean we take the time to talk to them, especially Lauren, that's kind of her forte," Lieb said. "Talking to people, listening without being rushed. Other pharmacies are just hurry, hurry, hurry, and here we have time to talk to the people."

They also offer consulting for hormone replacement therapy. Driebe specializes in HRT for both men and women. She will sit down and consult a patient for up to an hour, figuring out the exact dosage and treatment on an individualized basis. Doctors occasionally send patients to Mortar & Pestle for that specific reason.

Driebe and Lieb both hope that their business will continue to thrive, branching out to help hospices and sports teams in the future. They are hoping that next year they will be able to work with the Arizona Cardinals, a prospect that, according to Lieb, head athletic trainer Tom Reed showed interest in.

They will also be offering once-a-month seminars in their store on different topics, primarily focusing on hormone replacement therapies. They believe that once the citizens of Flagstaff know they're in town, they'll be interested in using their compounding services.

"The providers have been extremely positive and receptive," Driebe said. "A lot of people here in Flagstaff, they know what compounding is, and I think they will be open to it."

Mortar & Pestle: Professional Compounding Pharmacy
2708 N. Fourth St., Suite C-2
(928) 526-2446
HOURS: 9 a.m. - 5:30 p.m., Monday to Friday; weekends and after hours by appointment only