Defining and unpacking the core concepts of pharmacology education

Pharmacology education currently lacks a research-based consensus on which core concepts all graduates should know and understand, as well as a valid and reliable means to assess core conceptual learning. The Core Concepts in Pharmacology Expert Group (CC-PEG) from Australia and New Zealand recently identified a set of core concepts of pharmacology education as a first step toward developing a concept inventory—a valid and reliable tool to assess learner attainment of concepts. In the current study, CC-PEG used established methodologies to define each concept and then unpack its key components. Expert working groups of three to seven educators were formed to unpack concepts within specific conceptual groupings: what the body does to the drug (pharmacokinetics); what the drug does to the body (pharmacodynamics); and system integration and modification of drug–response. First, a one-sentence definition was developed for each core concept. Next, sub-concepts were established for each core concept. These twenty core concepts, along with their respective definitions and sub-concepts, can provide pharmacology educators with a resource to guide the development of new curricula and the evaluation of existing curricula. The unpacking and articulation of these core concepts will also inform the development of a pharmacology concept inventory. We anticipate that these resources will advance further collaboration across the international pharmacology education community to improve curricula, teaching, assessment, and learning.Marina Santiago, Elizabeth A. Davis, Tina Hinton, Thomas A. Angelo, Alison Shield, Anna-Marie Babey, Barbara Kemp-Harper, Gregg Maynard, Hesham S. Al-Sallami, Ian F. Musgrave, Lynette B. Fernandes, Suong N. T. Ngo, Arthur Christopoulos, Paul J. Whit

Defining and unpacking the core concepts of pharmacology education

Pharmacology education currently lacks a research-based consensus on which core concepts all graduates should know and understand, as well as a valid and reliable means to assess core conceptual learning. The Core Concepts in Pharmacology Expert Group (CC-PEG) from Australia and New Zealand recently identified a set of core concepts of pharmacology education as a first step toward developing a concept inventory—a valid and reliable tool to assess learner attainment of concepts. In the current study, CC-PEG used established methodologies to define each concept and then unpack its key components. Expert working groups of three to seven educators were formed to unpack concepts within specific conceptual groupings: what the body does to the drug (pharmacokinetics); what the drug does to the body (pharmacodynamics); and system integration and modification of drug–response. First, a one-sentence definition was developed for each core concept. Next, sub-concepts were established for each core concept. These twenty core concepts, along with their respective definitions and sub-concepts, can provide pharmacology educators with a resource to guide the development of new curricula and the evaluation of existing curricula. The unpacking and articulation of these core concepts will also inform the development of a pharmacology concept inventory. We anticipate that these resources will advance further collaboration across the international pharmacology education community to improve curricula, teaching, assessment, and learning

Generic substitution in the treatment of epilepsy: Patient attitudes and perceptions

There have been considerable debates about bioequivalence and generic substitution of certain critical care drugs. We aimed to understand patient attitudes and perceptions about generic substitution in the treatment of epilepsy. In this pilot study, a self-administered anonymous survey was completed by 47 patients with epilepsy. The response rate by postal mail was 6.7%. More than 70% of the patients were concerned about the effectiveness of generic antiepileptic drugs, and 68% of the patients were not comfortable receiving generics to treat their epilepsy. About 87% of the patients thought that their antiepileptic drug should only be substituted with a generic with their consent, and 64% of the patients believed that substitution should only take place with the consent of their doctor. Considerable concern exists among patients about generic substitution in the treatment of epilepsy. More data regarding whether generic antiepileptic drugs are bioequivalent in clinical situations would help to address patient concerns

Rosemary and cancer prevention : preclinical perspectives

Colorectal cancer is the second leading cause of cancer death in Australia. Nutrition, particularly intake of vegetables and certain plant components, has been reported to have a major role in cancer risk reduction. Recently, there has been a growing research interest in rosemary, a common household plant grown in many parts of the world. This study aims to review scientific evidence from all studies, published from 1996 to March 2010 that examined the protective effects of rosemary on colorectal cancer and other types of cancer. Literature evidence from animal and cell culture studies demonstrates the anticancer potential of rosemary extract, carnosol, carnosic acid, ursolic acid, and rosmarinic acid. No evidence for other rosemary constituents was found. The reported anticancer properties were found to arise through the molecular changes in the multiple-stage process of cancer development, which are dose related and not tissue or species specific. This is evidenced by the ability of rosemary to suppress the development of tumors in several organs including the colon, breast, liver, stomach, as well as melanoma and leukemia cells. The results suggested that the different molecular targets modulated by rosemary and its active constituents are useful indicators of success in clinical cancer chemo-prevention trials.

Appropriate use of non-prescription ibuprofen: a survey of patients' perceptions and understanding

Objectives: The aim was to investigate patients' perceptions and understanding on the appropriate use of non-prescription ibuprofen. Methods: In this pilot study, a self-administered anonymous survey was completed by 183 patients presenting at one of the eight selected community pharmacy premises in South Australia and the Northern Territory during the study. The questionnaire comprised items on: demographics (age, gender), current medications, frequency of ibuprofen use, medical consultations, reading manufacturer's printed dosage/warning instructions, sources from which drug information was gathered and understanding of common indications for ibuprofen. Key findings: Sixty per cent of patients (n= 110/183), predominantly females, were currently on other medications and 64.5% of patients (n= 118/183) did not seek medical advice before using non-prescription ibuprofen. Seventy-one per cent (n= 130) of these patients had used ibuprofen for more than a year. The majority of patients did not provide precise answers for the common indications of ibuprofen. Sixty-six per cent of patients (n= 110) reported rarely or never reading manufacturer's printed warning instructions on the potential drug interactions or adverse effects associated with the use of the product. Conclusions: Many patients are unaware that non-prescription analgesics such as ibuprofen can cause potentially serious adverse effects when used in combination with other common medications

Pulmonary cytochrome P450 enzymes belonging to the CYP4B subfamily from an Australian marsupial, the tammar wallaby (Macropus eugenii)

Cytochromes P450 (CYPs) are critically important in the oxidative metabolism of a diverse array of xenobiotics and endogenous substrates. We have previously reported the cloning and characterisation of the koala CYP4A15, the first reported member of the CYP4 family from marsupials, and have demonstrated important species differences in CYP4A activity and tissue expression. In the present study, the cloning of CYP4B1 in the wallaby (Macropus eugenii) and their expression across marsupials is described. Rabbit anti-mouse CYP4B1 antibody detected immunoreactive proteins in lung and liver microsomes from all test marsupials, with relative weak signal detected from the koala, suggesting a species-specific expression. Microsomal 2-aminofluorene bio-activation (a CYP4B1 marker) in wallaby lung was comparable to that of rabbit, with significant higher activities detected in wallaby liver and kidneys compared to rabbit. A 1548 bp wallaby lung CYP4B complete cDNA, designated CYP4B1, which encodes a protein of 510 amino acids and shares 72% nucleotide and 69% amino acid sequence identity to human CYP4B1, was cloned by polymerase chain reaction approaches. The results demonstrate the presence of wallaby CYP4B1 that shares several common features with other published CYP4Bs; however the wallaby CYP4B1 cDNA contains four extra amino acid residues at the NH2-terminal, a fundamentally conserved transmembrane anchor of all eukaryote CYPs.

Appropriate use of non-prescription ibuprofen: A survey of patients' perceptions and understanding

OBJECTIVES: The aim was to investigate patients' perceptions and understanding on the appropriate use of non-prescription ibuprofen. METHODS: In this pilot study, a self-administered anonymous survey was completed by 183 patients presenting at one of the eight selected community pharmacy premises in South Australia and the Northern Territory during the study. The questionnaire comprised items on: demographics (age, gender), current medications, frequency of ibuprofen use, medical consultations, reading manufacturer's printed dosage/warning instructions, sources from which drug information was gathered and understanding of common indications for ibuprofen. KEY FINDINGS: Sixty per cent of patients (n = 110/183), predominantly females, were currently on other medications and 64.5% of patients (n = 118/183) did not seek medical advice before using non-prescription ibuprofen. Seventy-one per cent (n = 130) of these patients had used ibuprofen for more than a year. The majority of patients did not provide precise answers for the common indications of ibuprofen. Sixty-six per cent of patients (n = 110) reported rarely or never reading manufacturer's printed warning instructions on the potential drug interactions or adverse effects associated with the use of the product. CONCLUSIONS: Many patients are unaware that non-presciption analgesics such as ibuprofen can cause potentially serious adverse effects when used in combination with other common medications.Ngo, SN; Stupans, I; Leong, WS; and Osman, M.http://www.ncbi.nlm.nih.gov/pubmed/2040559

Identifying the core concepts of pharmacology education

Pharmacology education currently lacks an agreed knowledge curriculum. Evidence from physics and biology education indicates that core concepts are useful and effective structures around which such a curriculum can be designed to facilitate student learning. Building on previous work, we developed a novel, criterion‐based method to identify the core concepts of pharmacology education. Five novel criteria were developed, based on a literature search, to separate core concepts in pharmacology from topics and facts. Core concepts were agreed to be big ideas, enduring, difficult, applicable across contexts, and useful to solve problems. An exploratory survey of 33 pharmacology educators from Australia and New Zealand produced 109 terms, which were reduced to a working list of 26 concepts during an online workshop. Next, an expert group of 12 educators refined the working list to 19 concepts, by applying the five criteria and consolidating synonyms, and added three additional concepts that emerged during discussions. A confirmatory survey of a larger group resulted in 17 core concepts of pharmacology education. This list may be useful for educators to evaluate existing curricula, design new curricula, and to inform the development of a concept inventory to test attainment of the core concepts in pharmacology

Defining and unpacking the core concepts of pharmacology: a global initiative

Background and PurposeDevelopment of core concepts in disciplines such as biochemistry, microbiology, and physiology transformed teaching. They provided the foundation for the development of teaching resources for global educators, as well as valid and reliable approaches to assessment. An international research consensus recently identified 25 core concepts of pharmacology. The current study aimed to define and unpack these concepts.Experimental approachA two-phase, iterative approach, involving 60 international pharmacology education experts was used. The first phase involved drafting definitions for the core concepts and identifying key sub-concepts via a series of online meetings and asynchronous work. These were refined in the second phase, through a two-day hybrid workshop followed by a further series of online meetings and asynchronous work.Key ResultsThe project produced consensus definitions for a final list of 24 core concepts and 103 sub-concepts of pharmacology. The iterative, discursive methodology resulted in the modification of concepts from the original study, including the change of 'drug-receptor interaction' to 'drug-target interaction' and the change of the core concept 'agonists and antagonists' to sub-concepts of drug-target interaction.Conclusion and ImplicationsThe definitions and sub-concepts of the 24 core concepts provide an evidence-based foundation for pharmacology curricula development and evaluation. The next steps for this project include the development of a concept inventory to assess acquisition of the concepts, as well as the development of cases studies and educational resources to support teaching by the global pharmacology community, and student learning of the most critical and fundamental concepts of the discipline

Rosemary and cancer prevention: Preclinical perspectives

Published online: 26 May 2011Colorectal cancer is the second leading cause of cancer death in Australia. Nutrition, particularly intake of vegetables and certain plant components, has been reported to have a major role in cancer risk reduction. Recently, there has been a growing research interest in rosemary, a common household plant grown in many parts of the world. This study aims to review scientific evidence from all studies, published from 1996 to March 2010 that examined the protective effects of rosemary on colorectal cancer and other types of cancer. Literature evidence from animal and cell culture studies demonstrates the anticancer potential of rosemary extract, carnosol, carnosic acid, ursolic acid, and rosmarinic acid. No evidence for other rosemary constituents was found. The reported anticancer properties were found to arise through the molecular changes in the multiple-stage process of cancer development, which are dose related and not tissue or species specific. This is evidenced by the ability of rosemary to suppress the development of tumors in several organs including the colon, breast, liver, stomach,as well as melanoma and leukemia cells. The results suggested that the different molecular targets modulated by rosemary and its active constituents are useful indicators of success in clinical cancer chemo-prevention trials.Suong N. T. Ngo, Desmond B. Williams and Richard J. Hea