FALLS CHURCH, Va. | When most people think of pharmacists, they imagine a local drug store or the pharmacy counter at their military treatment facility. Those are common locations to encounter pharmacists, but many people might not know that Air Force pharmacists also provide critical deployed medical support, offering their medication expertise in deployed theaters around the world.
“Filling prescriptions in the deployed environment is just as important in a deployed setting as it is back home,” said Col. Melissa Howard, pharmacy consultant to the Air Force Surgeon General. “Anything we do in garrison, we can be called on to do while deployed. That also includes supporting inpatient requirements, like making sterile intravenous products, or administering drugs when needed.”
One of the most important behind-the-scenes roles for deployed Air Force pharmacists is ensuring that their clinics have the right medication inventory. The logistics chain for delivering new prescription drugs to Baghdad or Bagram Air Base in Afghanistan is much longer and more complicated than for a U.S. pharmacy. If a clinic runs out of some drugs, or if they expire without a new supply, then they may not be able to treat patients.
“When I was deployed to a clinic in Baghdad, I had a time where without proper supply chain management, we wouldn’t have been able to perform surgeries,” said Howard. “There is a muscle-relaxing drug called Dantrolene that needs to be given in conjunction with anesthesia drugs. Without it, the patient can experience hyperthermia, or high body temperature, and die. It’s not a drug you use every day, but it’s life or death for some patients.”
Howard noticed that her clinic’s Dantrolene supply would soon expire, rendering the clinic unable to perform some types of surgeries.
“We couldn’t get a new supply shipped from the U.S. in time,” said Howard. “The logistics for getting drugs like that just take too long, so I was able to work with a colleague at another overseas clinic to get a temporary supply.”
Another critical area for pharmacists to support in the deployed setting is fatigue management for pilots. Capt. Josh Radel, an Air Force pharmacist who recently returned from a deployment at an air base in the Middle East, says this was a critical mission for him.
“Our base supported a variety of different aircraft types, including some with extremely long mission flight times,” said Radel. “It’s obviously critical for pilots to stay alert throughout their mission, and restore their sleep schedule when they return. One way to do that is with carefully monitored use of stimulants and sleep aids.”
Because these drugs have the potential to be dangerous or habit forming if not used appropriately, they require close supervision by a pharmacist.
“I monitor usage, ensure correct dosage, prepare time-release formulations, and ensure that our pilots stay in good health,” said Radel. “I even had to create liquid suspensions of some drugs for pilots with pressurized flight suits who can only intake medication through a drinking tube.”
Deployed pharmacists are responsible for every medication used in their clinic. That includes preparing medication kits for medics on patrol, helping prepare aeromedical evacuation patients, normal outpatient prescriptions, and in some locations, even snakebite antidotes.
“Pharmacists are a critical part of the Air Force deployed medical team, from treating seasonal allergies, sports related injuries, chronic disease management, or serious trauma situations,” said Howard. “Whether it’s a tiny forward operating base in an austere location, or a major air base, having a pharmacist on-station ensures that patients can get the medication therapy they need.”