Commercial drugs are made by machines in huge batches under strict federal regulations. By contrast, compounded drugs are made by hand in smaller quantities, and regulations vary by state. These variables can increase the risk of contamination and error. Some drug recipes call for non-sterile ingredients, which raises the risk even more, but this represents only a small percentage of U.S. compounding. Here are basic steps a compounder could follow using non-sterile powder to make cardioplegia solution, a drug used in open-heart surgery. Read related article.