Laboratory Exercises to Teach Clinically Relevant Chemistry of Antibiotics

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INTRODUCTION

The switch to the all doctor of pharmacy (PharmD) curriculum enforced more emphasis on pharmaceutical sciences teaching in the context of applications to pharmacy practice and clinical pharmacy. (1,2) The Accreditation Council for Pharmacy Education (ACPE) Guidelines for 2011 state in Standard 11 that the college of pharmacy must integrate teaching and learning methods that foster the development and maturation of critical thinking and problem-solving skills. (2) Additionally, the Educational Outcomes for Medicinal Chemistry issued by the Center for the Advancement of Pharmaceutical Education reinforce the concept of comprehending, analyzing, and evaluating information about the chemical structure of drugs in order to implement, monitor, and evaluate pharmaceutical care plans that are patient-specific and evidence based. Clinical pharmacy entails the clinical application of knowledge of drug chemistry across pharmacological classes. (3) In fulfilling the University of Louisiana at Monroe School of Pharmacy's goal to integrate teaching and learning methods, an integrated laboratory class involving active-learning strategies focusing on Medicinal Chemistry and Clinical Pharmacy of antibiotics was developed.

Medicinal chemistry offers pharmacy students the foundational concepts of drug mechanisms of action, structure-activity relationships, acid-base/physicochemical properties, and absorption, distribution, metabolism, excretion, and toxicity profiles. (4-6) Understanding chemical and structural information enables pharmacists to rationally justify drug actions, interactions, routes of administration, and best indications. Therefore, medicinal chemistry knowledge provides pharmacy students with critical thinking and evidence-based problem-solving skills for appropriate clinical and therapeutic decisions. (6-8) Medicinal chemistry's indispensable role in pharmacy education is best illustrated in the area of infectious diseases. (9) Pharmacy students can justify the specific indications, spectrum of activity, route of administration, drug-antibiotic and food-antibiotic interactions, stability, and other clinically relevant information based on medicinal chemistry knowledge of antibiotics. An example of clinical importance of chemistry knowledge is in the area of [beta]-lactam antibiotics where the student should be able to identify oral or parenteral use, [beta]-lactamases resistance or sensitivity, potency and spectrum of activity, bioavailability, and duration of activity by carefully looking at the chemical structure.

Several models have been published that highlight the clinical relevance and application of medicinal chemistry to pharmacy education. (4-8) An example of these is the incorporation of cognitive and affective learning and case studies using representative drug classes through collaboration between experienced pharmacy faculty scholars. (5) The instructional model used integration of Bloom's cognitive and Krathwohl's affective taxonomies, which significantly improved student performance compared to that in prior years. (6) This model also improved overall student enthusiasm and offered better understanding of the value of medicinal chemistry to clinical pharmacy practice. Another relevant model attempted the integration of process-oriented guided-inquiry learning and team-based activities to a single-semester medicinal chemistry course. (8) The implementation of self-selected teams with guided-inquiry exercises significantly improved students' examination scores, grade distribution, and the classroom environment, and offered prompt feedback to the instructor concerning student-knowledge deficiencies compared with traditional teacher-centered lectures. Another model used problem-based learning in which precourse and post-course examinations were given to 2 groups of students: before and after conducting problem-based learning and before and after receiving classroom instruction. …