Abstract and Introduction
Abstract
Objective. To show why medicinal chemistry must be a key component of the education of pharmacy students, as well as in the pharmacist's practice.
Findings. Five case reports were selected by their clinically relevant elements of medicinal chemistry and were explained using structure-activity relationship data of the drugs involved in the case easily obtained from primary literature and in medicinal chemistry textbooks.
Summary. This paper demonstrates how critical clinical decisions can be addressed using medicinal chemistry knowledge. While such knowledge may not explain all clinical decisions, medicinal chemistry concepts are essential for the education of pharmacy students to explain drug action in general and clinical decisions.
Introduction
The International Union for Pure and Applied Chemistry (IUPAC) defines medicinal chemistry as a "chemistry-based discipline, also involving aspects of biological, medical and pharmaceutical sciences. It is concerned with the invention, discovery, design, identification and preparation of biologically active compounds, the study of their metabolism, the interpretation of their mode of action at the molecular level and the construction of structure-activity relationships."[1]
In Brazil, medicinal chemistry is often called pharmaceutical chemistry. Pharmaceutical chemistry is a specific pharmacy area because its "emphasis is given on patient-focused pharmaceutical care and on the pharmacist as a therapeutic consultant, rather than a chemist."[2] Regardless of denomination, clinically relevant medicinal chemistry must be part of the formation of all pharmacy students, especially including those which are expected to work on clinical pharmacy.
Traditionally, pharmacy courses in Brazil present medicinal chemistry as a mandatory discipline, considered part of a pharmacist's formation together with other disciplines such as pharmacognosy, pharmaceutics/pharmacotechnique, pharmacology and pharmaceutical care. Knowledge of medicinal chemistry is not only important to a pharmacist's role as a member of the health care team, but also essential to the pharmacist's specific knowledge about medicines from other health care professionals.
The Brazilian National Curriculum Guidelines for the pharmacy courses define a pharmacist as one who must be capable to "act in all health care levels, based on scientific and intellectual rigor."[3] These guidelines also state that pharmacy graduate courses must have key program contents such as "theoretical and practical knowledge related to research and development, production and quality assurance of pharmaceutical raw materials, ingredients and products," where medicinal chemistry is included. Moreover, among the 31 specific skills and competencies necessary to the formation of a pharmacist are the requirements that a pharmacist must be able, "to act in research, development, selection, manipulation, production, storage and quality control of ingredients, natural, synthetic and recombinant drugs, medicines, cosmetics, sanitizings and correlates" and "perform individual and collective pharmaceutical assistance." In relation to this, medicinal chemistry contributes to a pharmacist's drug design and development skills, and knowledge of structure-activity relationships (SAR), thereby enabling a pharmacist to perform in adverse reactions management and pharmaceutical care.
In 2013, the Brazilian Federal Council of Pharmacy (FCP) published resolution #586.[4] The FCP regulates independent pharmacists' prescribing authority in Brazil, and assigns new responsibilities to pharmacists. Independent pharmacists' drug prescribing authority can be defined as the exercise of drug prescribing by a pharmacist autonomously within his/her clinical competence. This practice is implemented in several countries worldwide, such as Canada, UK, South Africa and Australia.[5–8]
Medicinal chemistry discipline in pharmacy curriculum plays an important role in the construction of a specific knowledge of a pharmacist from other prescribers regarding pharmacotherapy. Pharmacy students must use medicinal chemistry concepts as one of the determinants of pharmacotherapy decisions, especially the SAR background of the involved drugs, to achieve a high-level practice on clinical pharmacy. Several papers published in this Journal reported on this topic. Khan and colleagues,[9] Alsharif and colleagues,[10] and Beleh and colleagues,[11] emphasized the importance of medicinal chemistry knowledge for pharmacy students. Moreover, this can be noted by the shift in classical textbooks of medicinal chemistry such as those by Lemke and colleagues,[2] and Currie and colleagues[12] that emphasize the clinical relevance of the discipline and which have been adopted by many medicinal chemistry courses around the world.
Thus, the aim of this paper is to show examples of how medicinal chemistry can be helpful in pharmacotherapy decisions through a review of case reports in the literature and application of medicinal chemistry concepts to elaborate and explain the clinical decision made in each case.
Am J Pharm Educ. 2018;82(2) © 2018 American Association of Colleges of Pharmacy
