In this episode, we discuss the very early stages of drug targets and drug development with Dr. Mohd Shahid, PhD. Dr. Shahid’s research involves the IER3 gene, which is an important modulator of the body’s inflammatory response via its action in major immune cells, including macrophages and T-cells, and plays a role in metabolic disorders such as obesity, diabetes, and atherosclerosis, revealing a previously unknown function of this protein.

Key Concepts

1. Drug development is a multi-decade journey – human clinical trials occur very late in the process. Drug development often starts before a drug molecule is even conceived by identifying potential drug targets.
2. Chronic inflammation is important for a variety of diseases, including obesity and atherosclerosis. Dr. Shahid’s work focuses on a specific gene, Immediate Early Response 3 Gene (IER3 or IEX-1), and its role in modulating the inflammatory response in these disease states.
3. The research process frequently leads to unexpected discoveries and new lines of inquiry. With Dr. Shahid, his work in obesity and inflammation actually led to a new understanding of the IER3’s role in the interplay between macrophages, inflammation, and energy expenditure.

References

• Shahid M, Javed AA, Chandra D, et al. IER3 deficiency induces browning of white adipose tissue and resists diet-induced obesity. Sci Rep. 2016;6:24135. Published 2016 Apr 11. doi:10.1038/srep24135
• Shahid M, Hermes EL, Chandra D, et al. J Am Heart Assoc. 2018;7:e009261. DOI: 10.1161/JAHA.118.009261.
• Ridker PM, Danielson E, Fonseca FA, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359(21):2195-2207. doi:10.1056/NEJMoa0807646
• Tardif JC, Kouz S, Waters DD, et al. Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction. N Engl J Med. 2019;381(26):2497-2505. doi:10.1056/NEJMoa1912388

In this episode, we review the new 2025 ACC/AHA Acute Coronary Syndrome (ACS) guidelines, with a particular focus on guideline recommendations for analgesics, P2Y12 inhibitors, parenteral anticoagulation, and lipid management.

Key Concepts

1. Nitrates and opioids are recommended for symptomatic relief of chest pain. Some patients may not be appropriate for nitrates (e.g. recent PDE-5 inhibitor use, hypotension, or right ventricular infarction). Opioids are used for nitrate-refractory angina but have a theoretical risk of delaying the effect of oral antiplatelet medications.
2. Prasugrel and ticagrelor are preferred P2Y12 inhibitors over clopidogrel in most patients. Patient-specific factors, including the use of PCI, play a role in P2Y12 inhibitor selection.
3. Anticoagulation with heparin is recommended in nearly all acute coronary syndrome (ACS) scenarios. Alternative anticoagulants may be used depending on whether PCI/CABG is planned and whether the anticoagulant is used prior to PCI/CABG (“upstream”) or during the PCI procedure itself.
4. LDL goals after ACS have changed again. All ACS patients should have an LDL goal < 70 with a consideration of an LDL goal of 55-69. A variety of non-statin therapies may be added to a high intensity statin regimen if LDL is not at goal.

References

• Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online February 27, 2025. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001309

In this episode, we interview Morgan Anderson, PharmD, BCIDP, a graduate of the RFUMS College of Pharmacy, about her career path from a pharmacy resident, emergency medicine specialist, infectious diseases specialist, and now a medical sciences liaison.

The views, thoughts, and opinions expressed in this podcast are solely Dr. Anderson’s own and do not necessarily reflect the views, positions, or policies of her employer. This podcast is conducted in a personal capacity, and any reference to her professional background is for context only.

Key Concepts

1. Having a wide breadth of skills and making yourself marketable is important when transitioning between jobs or career paths. Skills like communication and teamwork can be improved and are applicable to a wide variety of careers within pharmacy.
2. Medical Science Liaisons (MSLs) are a common role for pharmacists in the pharmaceutical industry. MSLs are field-based roles within the medical affairs department of the company. MSLs are medical and scientific experts who build collaborative relationships with key thought leaders, facilitate exchange of scientific information and insights, and serve as a conduit between these thought leaders and other areas of the company.
3. Two common career paths to pharmacists becoming an MSL are via a fellowship program or after years in clinical practice. A fellowship program provides a more structured approach, including mentoring and networking, with access to a variety of areas of the company outside of medical affairs. A pathway after clinical practice is more self-directed with less structure, but provides pharmacists with a strong clinical background that can be helpful in an MSL role.
4. Being a scientific communicator, possessing strong emotional intelligence, and being adaptable are critical soft skills that are essential for success in an MSL role. These soft skills can be improved with practice!

References

• https://www.industrypharmacist.org/