Effect of faculty-mediated interventions on pharmacy students' pursuit of postgraduate training.

PURPOSE: The influence of faculty-mediated interventions on the pursuit of postgraduate training (PGT) by pharmacy students was studied. METHODS: Three weeks before graduation, members of the class of 2005 (control group) at a Florida pharmacy school completed a questionnaire assessing their understanding of PGT opportunities. Members of the class of 2006 (intervention group) were exposed to faculty-mediated interventions during their final academic year of pharmacy school. The interventions consisted of informational pamphlets, a PGT booth during the school's career day, and PGT-related dinner programs. These students were surveyed before and after the interventions. RESULTS: Seventy-three percent (120/165) of control-group students and 63% (132/211) of intervention-group students completed the survey. Of the control students, 14% (15/108) reported plans to enter PGT after graduation. Sixteen percent (21/132) of intervention-group students reported such plans; the difference was not significant. All faculty-mediated interventions were reported to be helpful to students in making their postgraduation plans. Analysis of the combined groups suggested that students' interaction with faculty and residents during advance practice experiences positively affected pursuit of PGT. CONCLUSION: Students who received faculty- mediated interventions designed to inform them about PGT were not significantly more likely to pursue such training than students who did not receive the interventions. However, students reported the information to be helpful.

An elective course in adult acute care medicine using a hybrid delivery system.

OBJECTIVE: To develop and assess the effectiveness of an elective course modeled after activities students encounter on internal medicine advanced pharmacy practice experiences (APPEs). DESIGN: This hybrid elective course used a Web-based course management system linking pre-class lectures and assignments, classroom discussions, and projects to promote active student learning. ASSESSMENT: Assessment of student performance was based on assignments, quizzes, and participation in classroom discussions. Students were surveyed to ascertain their opinion of the elective. CONCLUSION: This elective in adult acute care medicine increased student exposure to inpatient settings and provided students additional opportunities to communicate effectively, evaluate medical literature, and think critically.

Trospium chloride for the treatment of overactive bladder with urge incontinence.

BACKGROUND: Urinary incontinence is caused by an overactive bladder, leading to symptoms of urgency, frequency, and incontinence. Urge incontinence occurs predominantly in women as they age. OBJECTIVES: This article reviews the current primary literature concerning the efficacy and tolerability of the anticholinergic agent trospium chloride (TCl) in the treatment of overactive bladder with symptoms of urge incontinence, urgency, and frequency. The pharmacokinetics of TCl are also reviewed. METHODS: Pertinent articles in English were identified through a search of MEDLINE (1966-present), EMBASE Drugs & Pharmacology (1980-third quarter 2004), Current Contents/Clinical Medicine (week 42, 2003-week 41, 2004), Cochrane Database of Systematic Reviews, MICROMEDEX Healthcare Series, and International Pharmaceutical Abstracts (1970-present). The search terms were overactive bladder, urinary incontinence, trospium, randomized controlled clinical trial, oxybutynin, tolterodine, scopolamine, imipramine, desipramine, and propantheline. RESULTS: TCl, a quaternary amine, exhibits high solubility in water but low oral bioavailability (9.6%) and poor central nervous system penetration. Approximately 80% of the absorbed fraction is renally eliminated as unchanged drug via active tubular secretion, with approximately 15% hepatically metabolized into a spiroalcohol and hydrolysis/oxidation products. In 3 placebo-controlled studies, patients who received TCl had an increase in maximum bladder filling capacity and bladder compliance, with a reduction in maximum cystometric capacity (P < 0.005); however, only 1 of these studies showed an increase in bladder compliance, with reductions in maximum detrusor pressure (P < 0.001), number of voids/d (P < or = 0.001), and incontinence episodes/d (P < or = 0.001). In another placebo-controlled study, TCl reduced the number of voids/d and incontinence episodes/d (both, P < or = 0.001). In 2 double-blind studies, TCl and oxybutynin were similarly effective in significantly increasing maximum cystometric capacity and bladder compliance, and in significantly reducing maximum detrusor pressure compared with baseline (all, P < 0.001); there were no significant differences between the 2 treatments at end point. In a third double-blind study comparing TCl and tolterodine with placebo, only TCl significantly reduced the frequency of micturitions/d (P = 0.01). Commonly reported adverse effects in patients receiving TCl included dry mouth, constipation, and headache. CONCLUSIONS: In the 7 studies reviewed, TCl was effective and well tolerated in patients with urge incontinence caused by idiopathic detrusor muscle overactivity or neurogenic detrusor overactivity resulting from spinal cord injury. However, this agent was associated with anticholinergic adverse effects similar to those of other anticholinergic agents; careful monitoring of tolerability is required.