Structurally Based Therapeutic Evaluation: A Therapeutic and Practical Approach to Teaching Medicinal Chemistry

In keeping with the mandate for more critical thinking, problem solving, and relevance in basic pharmaceutical science courses, the Structurally Based Therapeutic Evaluation (SBTE) of drugs is a new concept that has been introduced in the medicinal chemistry courses at Creighton University. Like the medicinal chemistry case study, this concept emphasizes the relevance of chemistry to the practice of pharmacy, and demands its inclusion in the therapeutic decision making crucial to the provision of pharmaceutical care. The unique feature of the SBTE approach is the inclusion of seven therapeutic criteria that must be addressed when translating chemical and structural understanding into predicted pharmacological action and therapeutic potential. These criteria, which are the same ones used to evaluate drug therapy decisions in clinical case studies, include: drug history/drug response, patient compliance, current medical history (CMH), past medical history (PMH), side effects, biopharmaceutics, and pharmacodynamics. Students are required to apply the SBTE approach to solve patient-related therapeutic problems on homework assignments, in voluntary recitation periods, and on examinations. SBTEs are summarized for each class of drugs and the students are encouraged to find additional criteria and to supplement existing SBTE criteria based on their understanding of concepts from other courses in the curriculum. The practical impact of medicinal chemistry on the practice of pharmacy becomes increasingly apparent with every new SBTE.