At Mike's Pharmacy in Carson City, compounding pharmacists are busy making custom medications ordered by doctors for their patients.
“They call it the Triad-physician-patient-patient-pharmacy. So that Triad has to be kept for compounding. Manufacturing is no longer a Triad,” says Mike Hauterkeet owner and pharmacist at Mike's.
Compounding pharmacies are becoming more popular with patients and doctors.
Each prescription is custom made and are more exact than those manufactured on a mass level.
But these pharmacies are coming under the watchful eye of congress all because of a nationwide meningitis outbreak last year.
The drugs which caused that outbreak were made by a specialty pharmacy called the New England Compounding Center.
"She was probably infected with the 1st injection and from that day. The course had been set,” said Marsha Martin, whose mother was infected in the outbreak.
The tragedy led to an investigation into states and their regulation of such pharmacies.
The congressional report released this week's shows most states do not track or routinely inspect compounding pharmacies.
Nevada is not one of them.
This state by all accounts has some of the most stringent regulations regarding compounding pharmacies.
Including yearly checks, licensing and a register of specific problems--things that most states currently do not have.
Nevada's Pharmacy Board says it is ahead of the game because of an incident similar to Massachusetts occurred in Walnut Creek California back in 2001.
It prompted the board to look at Nevada's regulations, and update them accordingly.
While most compounding is is done for human patients.
Many compounding pharmacies also work with veterinarians and animals.
Medications are compounded for dogs and cats and can be flavored with tuna, beef or chicken so that animals will happily take the medicine.