Preparing Students for Future Therapies: The Development of Novel Agents to Control the Renin-Angiotensin System

INTRODUCTION Every year the FDA approves approximately 25 new chemical entities (NCE) which are subsequently marketed and introduced into medical and pharmaceutical practice. Many of these new compounds, such as ceftibuten (a new cephalosporin), glimepride (a new sulfonylurea), and moexepril (a new angiotensin converting enzyme inhibitor), are structurally and pharmacologically similar to current agents, while others, such as saquinavir (an HIV protease inhibitor), zafirlukast (a leukotriene receptor antagonist), and anastrozole (an aromatase inhibitor) represent new drug classes as well as novel approaches to the management of specific diseases. An elective course, entitled Advances in Drug Therapy, was developed to allow an increased emphasis on this latter group of compounds. Initially offered in the fall 1990 semester to fifth year students enrolled in a 0-5 BS curriculum, this course has been subsequently taught in either the spring semester to fourth year students or in the fall semester to fifth year students. With the development of a new 2-4 PharmD curriculum at Duquesne, this course will be taught in the future as an elective in the spring semester of the third professional year. The objectives of this course are to: (i) introduce students to drugs and drug classes which are currently in development (clinical or pre-clinical) and which represent novel and promising approaches to drug therapy; (ii) discuss the biochemical and/or pathological basis for certain diseases and disorders and the potential approaches to drug intervention in these diseases and disorders; (iii) describe the rationale behind selecting a particular target for drug therapy from a variety of choices; (iv) compare the relative merits of current drug therapy with those of novel drugs or drug classes; (v) prepare students for their future practice by emphasizing drug therapies which will become available within the next five to ten years; and (vi) introduce students to current research areas in drug development and to identify unsolved problems in these areas. The course has a slight bent toward medicinal chemistry; however, the pharmacological and clinical aspects of the drugs are also presented. Particular attention is given to the underlying biochemical rationale for new therapies, and when appropriate, the advantages and disadvantages of investigational alternatives are compared to currently available therapies. The following text is a summary of a two-hour lecture sequence presented within the Advances In Drug Therapy course. Discussions of recombinant DNA, the advantages and disadvantages of using peptides and proteins as pharmaceuticals, and the identification of drug targets immediately precede these lectures.