ABSTRACT
During the past 15 years, the curriculum content for nonprescription medication and self-care therapeutics has expanded significantly. Self-care courses ranging from stand-alone, required courses to therapeutic content and skills laboratories, have evolved in colleges and schools of pharmacy to accommodate rapid changes related to nonprescription medications and to meet the needs of students. The design of and content delivery methods used in self-care courses vary among institutions. Teaching innovations such as team-based learning, role playing/vignettes, videos, and social media, as well as interdisciplinary learning have enhanced delivery of this content. Given that faculty members train future pharmacists, they should be familiar with the new paradigms of Nonprescription Safe Use Regulatory Expansion (NSURE) Initiative, nonprescription medications for chronic diseases, and the growing trends of health and wellness in advancing patient-care initiatives. This paper reviews the significant changes that may be impacting self-care curriculums in the United States.
Subject(s)
Curriculum , Education, Pharmacy , Self Care , Humans , Learning , Pharmacists , Teaching , United StatesABSTRACT
BACKGROUND: Lubiprostone, a prostaglandin E1 derivative, was approved in January 2006 for the treatment of chronic idiopathic constipation (CIC) in adults and in April 2008 for the treatment of irritable bowel syndrome with constipation (IBS-C) in adult women. OBJECTIVE: To review the pharmacology, efficacy and safety of lubiprostone and recommend its place in therapy for CIC and IBS-C. METHODS: We conducted a literature search using PubMed/Medline (1966-April 2008) using the keywords lubiprostone, chronic constipation, and irritable bowel syndrome. Data provided by the manufacturer and the FDA were also reviewed. CONCLUSION: Available literature for lubiprostone is mostly available in abstract data making it difficult to evaluate the clinical evidence. Although this medication shows promise, more information is needed to determine its place in therapy.
Subject(s)
Alprostadil/analogs & derivatives , Constipation/drug therapy , Irritable Bowel Syndrome/drug therapy , Adult , Alprostadil/adverse effects , Alprostadil/pharmacology , Alprostadil/therapeutic use , Chloride Channels/drug effects , Chronic Disease , Clinical Trials as Topic , Female , Humans , LubiprostoneABSTRACT
OBJECTIVE: To review lubiprostone's pharmacology, pharmacokinetics, efficacy, and safety in the treatment of chronic constipation. DATA SOURCES: A literature search was conducted using PubMed/MEDLINE (1966-January 2007), IngentaConnect, and International Pharmaceutical Abstracts (1977-January 2007). Key words used included lubiprostone, Amitiza, and chronic constipation. STUDY SELECTION AND DATA EXTRACTION: All articles identified from the data sources that were published in English were evaluated. DATA SYNTHESIS: Lubiprostone is a chloride channel activator approved by the Food and Drug Administration for the treatment of chronic constipation. A randomized, double-blind, parallel-group, placebo-controlled study evaluating the effect of lubiprostone on gastric function showed slowed gastric emptying and increased small bowel and colonic transit time. Peak plasma concentration was shown to be around 1.14 hours, with a majority of the drug excreted in the urine within 48 hours. Phase III trials have noted that most patients with chronic constipation have a spontaneous bowel movement within 24 hours after taking lubiprostone. The most common adverse events in these trials were nausea, diarrhea, abdominal pain, and headache. Lubiprostone use has not been studied in the pediatric population. CONCLUSIONS: Lubiprostone may be a reasonable alternative for use in patients who either fail or are intolerant of standard therapy for chronic constipation. Head-to-head comparison studies with conventional therapy are needed to contrast clinical efficacy and safety of this medication.
