Pharmacogenomics Concierge Service as an Opportunity for Pharmacist Reimbursement and Practice-based Learning.

Objective: To assess the feasibility of a pilot pharmacogenomics concierge service that incorporates student practice-based learning opportunities and a survey to determine the patients' interest and willingness to pay.

Methods: Participants in the pilot study (n = 34) completed a survey to determine their willingness to pay for concierge services. Six participants indicating the highest level of interest were selected to participate in the program free of charge.

Report of the 2023-2024 AACP Research and Graduate Affairs Committee.

The 2023-2024 American Association of Colleges of Pharmacy Research and Graduate Affairs Committee ("the Committee") was charged with developing programs focused on career and professional development for researchers, new faculty, and graduate students in colleges and schools of pharmacy. After reviewing exiting resources available to pharmacy faculty for grant writing, the Committee recognized a need for more comprehensive, diverse, and tailored resources for pharmacy faculty. The Committee, therefore, focused its effort on creating an intensive grant writing course intended for independent pharmacy researchers without previous major grant awards that would support writing for career development and research grant applications and cater to faculty in translational, clinical sciences, and pharmacy practice, along with fellows and residents.

Technology Personalities in the Classroom: A New Classification System of TechTypes from Expert to Techy Turtle.

The incorporation of technology in higher education has increased rapidly in recent years to allow for remote work and to promote active learning. Technology use could align with personality type and adopter status as defined by the diffusion of innovations theory. A review of the literature was conducted using PubMed with 106 articles found, and 2 articles meeting the inclusion criteria of the study.

Pharmacogenomics elective focused on advanced lab techniques, game-based learning, and business plan development.

Background And Purpose: Many medications contain labeling information related to pharmacogenomics. Effective education in this area is critical to ensure that future healthcare professionals are equipped with the skills needed to optimize patient therapy based on genetic testing results. This study focused on a novel elective course designed to educate students in pharmacogenomics.

A novel game to review pharmacoeconomic content in a pharmacy program.

Background And Purpose: This study reports on the development of a new game designed specifically for a pharmacoeconomics course to meet three objectives: (1) identify four main types of pharmacoeconomic analyses, (2) understand different outcomes for each analysis, and (3) interpret findings of pharmacoeconomic analyses.

Educational Activity And Setting: The game simulated real-world applicability of pharmacoeconomic analyses in a classroom setting using a candy theme. Groups of pharmacy students (N = 62) competed by building formularies that incorporated a minimum number of medications (candies) from each outcome category and at least two specialty services.

Delivery of interprofessional education through a co-curricular journal reviewing medical literature.

Background: This study's objective was to determine if student participation in a co-curricular drug information journal would increase interprofessional education (IPE) competency as measured by a validated survey tool.

Interprofessional Education Activity: To encourage interprofessional collaboration, students from diverse professional backgrounds were split into groups to conduct a literature review, draft an article on a topic of their choice, obtain revisions through formal review, and publish their article in a student-led journal, The ARxCH (The Annual Review of Changes in Healthcare). To measure IPE competency, students completed the validated Interprofessional Collaborative Competencies Attainment Survey (ICCAS) at the beginning and end of the study to measure changes in IPE competency scores.

Digital Storytelling Review in a Pharmacy Self-Care Course.

Digital storytelling is a type of active learning that allows instructors to simulate real-life situations through a series of connected videos. While this technique has been used in other healthcare education disciplines, its use in pharmacy has not been well documented. A digital storytelling model was incorporated in a required self-care pharmacy course to assess if the technique was helpful to improve the knowledge, confidence, and satisfaction of students.

Game-Based Learning in Pharmacy Education.

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.

Grant deadline: An escape room to simulate grant submissions.

Background And Purpose: Previous lectures for graduate trainees did not convey the urgency, complexity, and challenges of a successful grant submission. To increase engagement, instructors applied gamification principles to create an educational escape room. Serious games used in other settings engage participants to solve problems, build teamwork, and improve communication skills.

Clinical Application and Educational Training for Pharmacogenomics.

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.

Impact of a high-fat meal on assessment of clopidogrel-induced platelet inhibition in healthy subjects.

Background: Ideal conditions for platelet reactivity testing are critical for optimal selection of a P2Y12 inhibitor. Data are inconsistent regarding the impact of high-fat meals on test assessment.

Methods: Participants included 12 healthy subjects not taking antiplatelet drugs after a 12-hour fast.

Ticagrelor: pharmacokinetics, pharmacodynamics, clinical efficacy, and safety.

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.

Cangrelor for treatment during percutaneous coronary intervention.

Dual antiplatelet therapy consisting of aspirin and a P2Y12-receptor antagonist is important for preventing major adverse cardiovascular events in patients managed with percutaneous coronary intervention (PCI). The current P2Y12-receptor antagonists are only available for oral administration and exhibit a delayed onset of action. Furthermore, several days are required for platelet function to return to normal following cessation of therapy.

Prevalence of CYP2C19 variant alleles and pharmacodynamic variability of aspirin and clopidogrel in Native Americans.

Background: The prevalence of variant alleles of the CYP2C19 gene has been determined for most population groups, but not Native Americans. Furthermore, the overall effectiveness of clopidogrel and aspirin has not been well studied in Native Americans, although this group has high mortality rates for cardiovascular disease and diabetes.

Methods: We recruited 50 volunteers from the Oglala Sioux Tribe with coronary artery disease taking aspirin and clopidogrel.

Effect of genetic variation in P2Y12 on TRAP-stimulated platelet response in healthy subjects.

In platelets, thrombin receptor signaling depends upon the release of adenosine diphosphate and subsequent activation at purinergic subtype Y (P2Y) receptors. The purpose of this study is to evaluate the influence of specific P2Y12 polymorphisms on platelet reactivity in healthy subjects mediated by thrombin receptor activating peptide (TRAP). We recruited a total of 29 healthy volunteers who had been previously genotyped for two polymorphisms of the P2Y12 receptor: the H2 haplotype (rs2046934) and 34C>T (rs6785930).

Pharmacodynamic interplay of the P2Y(1), P2Y(12), and TxA(2) pathways in platelets: the potential of triple antiplatelet therapy with P2Y(1) receptor antagonism.

Introduction: Previous work suggests that the extent of platelet inhibition by P2Y(1) receptor antagonism may be underappreciated, particularly in the context of dual antiplatelet therapy with aspirin and clopidogrel.

Materials And Methods: Using P2Y(1), P2Y(12), and TxA(2) receptor antagonists individually and in combination, we assessed the incremental changes from baseline platelet reactivity in blood collected from healthy volunteers.

Results: The P2Y(1) receptor antagonist further inhibited platelet activation and aggregation in several assay conditions ex vivo when combined with P2Y(12) and/or TxA(2) receptor blockers.

Novel direct-acting anticoagulants for risk reduction in ACS.

Acute coronary syndrome (ACS) is a devastating adverse cardiovascular event with a massive burden on patient morbility and mortality, as well as the economy. Approximately 1.2 million people are hospitalized annually for ACS in the United States, with direct medical costs estimated at $150 billion in 2009.

Traumatic brain injury: central and peripheral role of α7 nicotinic acetylcholine receptors.

Traumatic brain injury (TBI) is a significant public health concern worldwide for which there is no cure. Once trauma has occurred, multiple biochemical pathways are set into motion that leads to a chronic, neurodegenerative condition. Two of the most widely studied pathological pathways are excitotoxicity and inflammation, processes that are influenced by α7 nicotinic acetylcholine receptors (nAChR).

Progress of antiplatelet pharmacogenomics.

Numerous genetic variants have been studied in the context of antiplatelet responsiveness, particularly for aspirin and clopidogrel. The majority of these variants have failed to demonstrate any measurable level of clinical validity with the exception of the CYP2C19*2 allele. Several studies have identified a link between CYP2C19*2 carriers and decreased clopidogrel responsiveness as assessed by platelet reactivity testing and clinical outcomes.

Elinogrel, a reversible P2Y12 receptor antagonist for the treatment of acute coronary syndrome and prevention of secondary thrombotic events.

P2Y purinergic receptor subtypes are expressed on the surface of platelets and are vitally important for platelet function. Elinogrel (PRT-060128), a novel, direct-acting and reversible platelet P2Y12 receptor (P2Y12R) antagonist, is being developed by Portola Pharmaceuticals Inc and Novartis AG for the intravenous and oral treatment of acute coronary syndrome and prevention of secondary thrombotic events. In phase I clinical trials, elinogrel demonstrated a rapid and potent inhibition of ADP-mediated platelet response, even in patients with coronary artery disease who were deemed non-responsive to clopidogrel, the current standard-of-care therapy.

Impact of genetic polymorphisms on clinical response to antithrombotics.

Antithrombotic therapy, including anticoagulants as well as antiplatelet drugs, is an important component in the treatment of cardiovascular disease. Variability in response to such medications, of which pharmacogenetic response is a major source, can decrease or enhance the benefits expected. This review is a comprehensive assessment of the literature published to date on the effects of genetic polymorphisms on the actions of a variety of antithrombotic medications, including warfarin, clopidogrel, prasugrel, and aspirin.

Pharmacokinetics and pharmacodynamics of a bolus and infusion of cangrelor: a direct, parenteral P2Y12 receptor antagonist.

The purpose of this study is to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of cangrelor administered as an intravenous bolus plus a continuous infusion in healthy volunteers. Twenty-two healthy volunteers are randomized to receive 1 of 2 intravenous cangrelor dosing regimens: a 15-microg/kg bolus followed by a 2-microg/kg/min infusion or a 30-microg/kg bolus followed by a 4-microg/kg/min infusion. The infusion is continued for 60 minutes, and serial blood samples are obtained for evaluation of pharmacokinetic and pharmacodynamic parameters.

Considerable variability in platelet activity among patients with coronary artery disease in response to an increased maintenance dose of clopidogrel.

Background: Variable platelet response to clopidogrel has been widely observed. Studies have shown that the mean aggregation response to clopidogrel can be changed by a higher maintenance dose. However, these studies have not focused on individual changes.

Cangrelor in percutaneous coronary intervention.

Cangrelor is a novel, intravenous P2Y12 receptor antagonist in development for use in percutaneous coronary intervention. Currently in Phase III testing, the reversible platelet inhibitor provides several inherent advantages over other P2Y12 receptor antagonists in this setting for the prevention of adverse cardiac events. Unlike the class of thienopyridines (ticlopidine, clopidogrel and potentially soon to be available, prasugrel), cangrelor has nearly immediate onset after a bolus dose and a short half-life, and achieves maximal inhibition of ADP-mediated platelet function.