A Review of the Renoprotective Effects of Novel Antidiabetic Agents.

The objective of this review article was to identify and examine current evidence surrounding the potential renoprotective effects of newer antidiabetic agents such as sodium-glucose cotransporter 2 (SGLT-2) inhibitors, glucose-like peptide 1 (GLP-1) agonists, and dipeptidyl peptidase 4 (DPP-4) inhibitors. A literature search of MEDLINE and PubMed (January 2000 to April 2019) was performed using the following search terms: "diabetes treatment," "renoprotection," "kidneys," "SGLT-2 inhibitors," "GLP-1 receptor agonists," "DPP-4 inhibitors," and the drug names in each of those classes as well as any combination of these terms. Literature was excluded if published in a language other than English, performed in nonhuman subjects, did not include patients from the United States, was nonrandomized, or the data were available from poster presentations. There were 11 studies that met the search criteria. The majority of the studies focused on renal outcomes as secondary end points and looked at albuminuria, estimated glomerular filtration rate changes from baseline, urinary albumin-to-creatinine ratio, serum creatinine, and need for renal replacement therapy. There are fewer studies that focused on renal protection as a primary end point. After reviewing the available literature, the use of SGLT-2 inhibitors and GLP-1 agonists in addition to standard of care may be considered in patients with or at risk of developing chronic kidney disease. SGLT-2 inhibitors and GLP-1 agonists should be considered when patients' diabetes is no longer well controlled with metformin. Other factors such as cost, cardiovascular disease, and other comorbidities may also be taken into consideration when recommending therapy for patients.

Teaching History of Pharmacy in U.S. Pharmacy Schools.

Objective. To determine how the standards for teaching pharmacy history were met by U.S. pharmacy schools, whether schools wanted to expand their commitment to pharmacy history, what pedagogical assistance, if any, was desired, and whether elective courses were offered. Methods. There were 133 school deans who were asked to identify the responsible faculty for teaching pharmacy history. A 10-question online survey instrument was designed and emailed to these faculty or the dean if no faculty were identified. Follow-up emails were sent at 2-week intervals. If they were non-responsive after three attempts, then telephone solicitation was attempted. Results. There were 100 schools (75%) that responded. Fifty-three percent were public and 47% were private; with 50% having class sizes of 100 or less, 41% with 101-250, and 9% having over 250. Eighty-six percent of respondents meet the ACPE requirement within a required course. Seventy-two percent devote only one to five hours of instruction to meet the requirement. Sixty-eight percent use no supporting literature, and among those who do, there was no common textbook. Interestingly, 21% wanted more teaching time, and 91% desired pedagogical assistance, varying from a packaged course (26%) to a syllabus with assignments and assessment banks (23%). Conclusion. Since no time or material guidelines were established to fulfill the ACPE pharmacy history educational requirements, these results provide a starting point to judge what is adequate and/or preferred. With the development of teaching guidelines and adoptable teaching materials, the pedagogical solution to this ACPE standard may become more complete and consistent.