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Introduction Pharmacy students share a prevailing sense of stress. Many methods to increase student wellness are pharmacy program specific and faculty driven. This commentary is a call to action for student pharmacists to take shared ownership over improving the current crisis of student well-being. Schools of pharmacy should empower their students to guide the improvement of student wellness. Student-led wellness initiatives can take many forms; this commentary will focus on a student-led walking group as means to bolster wellness within a school of pharmacy. Perspective Exercise activities promote school-life balance, and when initiated by peers, will naturally conform to their schedule and develop collegial support through socialization. Student pharmacists should begin with encouraging peers to engage in exercise as a positive coping mechanism. Students should lead their peers in developing activities and electronic device sharing to encourage socialization and positive coping mechanisms. Implications While many efforts are in place for faculty and schools of pharmacy to improve student well-being, little has been studied on the impact of student-led wellness programs. This article calls student pharmacists to take shared ownership over the student wellness crisis and find ways to intervene. Schools of pharmacy should empower students by providing supportive structures while allowing students to problem-solve and practice wellness themselves.

To describe the Summer Academic Enrichment Program (SAEP) for underrepresented minority (URM) matriculants at Virginia Commonwealth University (VCU) School of Pharmacy.The SAEP is a six-week summer pipeline program at VCU for undergraduate and post-baccalaureate students interested in applying to medical, dental, physical therapy, or pharmacy school, divided into school tracks. Demographic and matriculation information about the pharmacy track program participants was obtained from the program and school administration from inception in 2012 through 2019. A retrospective analysis of the impact of SAEP on URM matriculation at VCU School of Pharmacy was conducted.Of the 80 pharmacy track participants, 56.3% (n = 45) have enrolled at VCU School of Pharmacy. Among those 45 that matriculated, 33.3% (n = 15) identified as one or more of the following URM populations: Black or African American 28.9% (n = 13), Hispanic or Latinx 4.4% (n = 2), and American Indian 2.2% (n = 1). In comparison, the same URM classifications for students enrolled at VCU School of Pharmacy over the last nine years ranged from 5% to 11% Black or African American, 0% to 5% Hispanic or Latinx, and 0% to 2% American Indian with a total URM representation range of 7% to 25% during this timeframe.SAEP is a program utilized to increase matriculation of students from diverse backgrounds, including URM populations. This type of pipeline program is described as one way to improve URM representation.

Medicinal chemistry is a polarizing subject for pharmacy students where, if not embraced, future pharmacists may be limited in their role as drug experts. An understanding of medicinal chemistry and its structure-activity relationships creates a strong foundation upon which our knowledge of pharmacotherapy is built.As the field of pharmacy has shifted to an increasingly clinical role, with an emphasis on patient care as a member of the interprofessional team, pharmacy has also seen an increase in postgraduate training, specifically residencies and fellowships. Pharmacy students noting this trend may depreciate medicinal chemistry early in the curriculum and place more focus on therapeutics and clinical rotations. However, forgoing the fundamental understanding of medicinal chemistry may hinder pharmacy students' current breadth and understanding, and the ability to rationalize future developments in their practice. Medicinal chemistry empowers pharmacists with the ability to reason through medications' impact versus simply memorizing their actions. Pharmacists play a unique role as drug experts, with advanced problem-solving and critical thinking skills that set them apart from drug references and search engines.As the field moves towards pharmacists as a member of the clinical team, the faculty should integrate medicinal chemistry throughout the doctor of pharmacy curricula. Faculty without this ability for a curriculum change should consider integration in their content. The field of pharmacy must take care to not allow clinical knowledge to significantly overshadow the importance of medicinal chemistry or run the risk of saturating the field with underprepared pharmacists.

Purpose Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have demonstrated glycemic efficacy and cardiovascular and renal benefits in people with type 2 diabetes mellitus (T2DM). However, they are also associated with serious adverse events (AEs), but little consensus exists for clinicians regarding AE management. This study aimed to develop a list of best practices for the safe use and monitoring of SGLT-2 inhibitors in people with T2DM. Methods A 15-member interprofessional panel was surveyed in a four-round Delphi process. Panelists were asked to comment on and rank statements regarding initial prescribing considerations and actions for minimizing and managing eight specific AEs and a broad category for other AEs. In the final round, panelists selected if the statements should be considered a best practice specific to SGLT-2 inhibitors, a best practice for general safe medication use in T2DM, or if the statement should not be considered as a best practice for safe medication use. Results Consensus was achieved for 36 best practice statements specific to SGLT-2 inhibitors and 24 statements as general best practices for safe medication use. Fifty-six percent of the best practice statements for SGLT-2 inhibitors related to managing and/or preventing hypotension, urinary tract infections, and genital infections. The general best practices for safe medication use primarily focused on medication histories, past medical history considerations, physical exam components, and patient education. Conclusion A list of best practice statements was developed using the Delphi method, which can be utilized by clinicians to guide the safe use and monitoring of SGLT-2 inhibitors in people with T2DM.

Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are highly effective at lowering hemoglobin A1c (HbA1c) and facilitating weight loss. Four agents in the GLP-1 RA class, albiglutide, liraglutide, dulaglutide, and semaglutide, also have cardioprotective effects. However, subcutaneous administration of these agents remains a major reason for their underutilization. A new coformulation of semaglutide with sodium N-[8-(2-hydroxybenzoyl) amino caprylate (SNAC) is the first oral GLP-1 RA reviewed by the U.S. Food and Drug Administration (FDA). The SNAC technology prevents destruction of semaglutide in the stomach and facilitates transcellular absorption through the gastric membrane enabling semaglutide to reach systemic circulation intact. The oral formulation of semaglutide was studied in the PIONEER trials, demonstrating similar efficacy to the presently available GLP-1 RAs with regard to HbA1c lowering and weight loss. Although the PIONEER 6 trial suggests positive effects on cardiovascular mortality with oral semaglutide, these benefits may not fully be appreciated until the completion of the SOUL trial.

Introduction Student pharmacists are in a notable wellness deficit. Pharmacy organizations are issuing statements and providing resources addressing efforts to increase student wellness. This commentary suggests that institutions refocus recruiting efforts on students with experience balancing the demands of school, wellness, and mental health. Perspective The purpose of this commentary is to start the conversation on increasing efforts to recruit candidates who already possess the resilience needed to perform in pharmacy school, with a focus on former college athletes. This piece in no way suggests decreased attention on wellness programs or efforts to reduce burnout. Former student athletes, through their training, have increased experience in resilience and may be less at risk for burnout. These candidates will likely have an increased team mentality and acceptance of constructive criticism. Additionally, this is an untapped resource for candidates as only 2% of collegiate athletes pursuing professional athletic careers. Of the 140 accredited pharmacy schools, 82.9% have an undergraduate program that offers at least one National Collegiate Athletic Association sport. Implications Schools of pharmacy should consider additional recruitment efforts and admissions criteria weight for former student athletes who meet the same standards as other candidates. As many pharmacy faculty direct significant effort toward the prevention of student burnout, perhaps an additional approach is to recruit students who are already capable of the expected demands. The athletic community may answer both the need for additional pharmacy recruits and provide a cohort with advanced abilities in stress management, wellness, and teamwork.

Atherosclerotic cardiovascular disease (ASCVD) is caused by elevated levels of low-density lipoprotein cholesterol (LDL-C). Although statins significantly reduce ASCVD risk, there remains a high degree of residual risk in statin-treated patients. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition has emerged as a significant therapeutic target for further lowering of LDL-C when used in combination with statins. The purpose of this review is to provide an update on recent evidence supporting the use of PCSK9 inhibitors in patients with ASCVD. Alirocumab and evolocumab were approved by the US Food and Drug Administration in 2015. Multiple phase II and III studies have demonstrated that these agents reduce LDL-C levels by up to 60% and are relatively safe, with the exception of injection site reactions. Additionally, two randomized controlled clinical trials have demonstrated that both alirocumab and evolocumab reduce ASCVD events when used in combination with statin therapy compared to statin alone. In light of this evidence, the 2018 Cholesterol Guideline incorporated PCSK9 inhibitors into the treatment algorithm for select secondary prevention patients unable to achieve an LDL-C below 70 mg/dL despite maximally tolerated statin plus ezetimibe. Although PCSK9 inhibitors provide substantial reductions in LDL-C levels and reduce ASCVD events in secondary prevention populations, the cost-effectiveness of alirocumab and evolocumab limit widespread use. Additional research is needed to explore the role of PCSK9 inhibitors in other populations, including primary prevention, patients unable to tolerate statins, and acute myocardial infarction.