Dual antiplatelet therapy, composed of aspirin plus a P2Y12‐receptor antagonist, is the cornerstone of treatment for patients with acute coronary syndrome (ACS). A number of U.S. Food and Drug Administration–approved P2Y12‐receptor antagonists are available for treating patients with ACS, including the thienopyridine compounds clopidogrel and prasugrel. Ticagrelor, the first of a new class of antiplatelet agents, is a noncompetitive, direct‐acting P2Y12‐receptor antagonist. Unlike the thienopyridine compounds, ticagrelor does not require metabolism for activity. Also, whereas clopidogrel and prasugrel are irreversible inhibitors of the P2Y12 receptor, ticagrelor binds reversibly to inhibit receptor signaling and subsequent platelet activation. In pharmacodynamic studies, ticagrelor demonstrated faster onset and more potent inhibition of platelet aggregation than clopidogrel. These properties of ticagrelor may contribute to reduced rates of thrombotic outcomes compared with clopidogrel, as demonstrated in a phase III clinical trial. However, in addition to bleeding, distinctive adverse effects of this new chemical entity have not been reported with the thienopyridine P2Y12‐receptor inhibitors. Although ticagrelor represents an advancement in P2Y12‐receptor inhibition therapy, a thorough understanding of this compound as an antiplatelet therapy remains to be elucidated.
1 January 2010 in The Journal of Clinical Pharmacology
Game-based learning (GBL) involves adding game elements to non-game activities to encourage engagement. Pharmacy curricula are required to incorporate active learning to meet accreditation standards. The literature supports that well-designed GBL holds the attention of students and improves knowledge in some instances. Furthermore, these adaptable experiences can be leveraged for a variety of content areas in pharmacy education. Some activities utilized by educators require large amounts of technological expertise, while others involve minimal use of technology. The incorporation of technology can create highly immersive experiences for learners; however, there are barriers (e.g., financial and technology prowess) to implementation compared to simpler designs. One area of GBL that is not well defined in the literature is how to adequately assess student learning outcomes. Most current studies describe subjective attitudes and confidence or assess content knowledge through objective pre- and post-tests. In the future, more defined and connected methods for assessment—such as active demonstrations within the game—will be needed to better incorporate GBL into pharmacy curricula. Based on the collective evidence in the literature, some GBL activities may serve as useful tools to improve pharmacy student engagement and learning.
Pharmacogenomics—defined as the study of how genes affect a person’s response to drugs—is growing in importance for clinical care. Many medications have evidence and drug labeling related to pharmacogenomics and patient care. New evidence supports the use of pharmacogenomics in clinical settings, and genetic testing may optimize medication selection and dosing. Despite these advantages, the integration of pharmacogenomics into clinical decisions remains variable and challenging in certain practice settings. To ensure consistent application across settings, sufficient education amongst current and future healthcare providers is necessary to further integrate pharmacogenomics into routine clinical practice. This review highlights current evidence supporting clinical application of medications with pharmacogenomic labeling. The secondary objective is to review current strategies for educating health professionals and student trainees. One national organization predicts that most regions in the United States will soon contain at least one healthcare system capable of applying pharmacogenomic information. Applying genotype-guided dosing to several FDA-approved medications may help produce beneficial changes in patient outcomes. Identifying best practices for educating health care professionals and trainees remains vitally important for continuing growth of pharmacogenomic services. As pharmacogenomics continues to expand into more areas of healthcare, current and future practitioners must pursue and maintain competence in pharmacogenomics to ensure better outcomes for patients.