Clinical Pharmacokinetics - Optimisation of drug dosage - e.g. Allopurinol & Febuxostat (gout), Metformin (antidiabetic), Anti-infectives e.g. Gentamicin & Vancomycin (antibiotics) and Ribavirin
- There is often a better correlation between patient responses to a drug and measured drug plasma concentrations than the administered drug dose.
- Many drugs have highly variable pharmacokinetics (plasma concentrations) .
- Optimising drug dosage according to pharmacokinetics is the key to optimising drug effectiveness.
- Clinical: Patient recruitment, blood collections .
- Analytical: Chromatography (HPLC), DNA extraction and genetic analysis (SNPs)
- Data analysis: Computerised PK modelling, simulations and optimising dosing, correlations with patient response
Decision support – Can we help doctors make better prescribing decisions?
- Medication management in Australian hospitals is shifting from paper to electronic formats, with many hospitals now using electronic prescribing systems
- These systems often include computerised alerts, which trigger at the point of prescribing to warn doctors about potential errors in orders
- Computerised alerts can help doctors make better prescribing decisions but getting this ‘decision support’ right is tricky
Qualitative methods (e.g. interviewing doctors) combined with quantitative methods (e.g. review of medication charts and alerts) to:
- Evaluate the current decision support at St Vincent’s Hospital – is it working?
- Understand what doctors want and need to be better prescribers – how can we help?
- Test new ways of helping doctors prescribe – what works and what doesn’t?
Can outcomes for gout sufferers be improved with eHealth?
- Gout is the most common form of inflammatory arthritis. It is characterised by extreme pain and swelling and is caused by a build up of uric acid in the bloodstream.
- Gout can be successfully managed by drug therapy. However, the prevalence of gout is increasing.
- A novel IT intervention (a mobile phone app) to support gout management in the community could enhance outcomes for gout sufferers.
- Qualitative methods (e.g. interviewing doctors and gout patients) to:
- Understand usability of IT interventions – are patients happy to use an app to manage their condition? Would “gamification” improve user uptake?
- Designing effective educational materials for GPs on gout.
- Interviewing gout patients about their treatment satisfaction.
- Understanding how gout patients with comorbidities view gout in relation to their other conditions.
Effect of Paracetamol on myeloperoxidase
- Paracetamol - major analgesic drug .
- Myeloperoxidase - enzyme of neutrophils.
- Myeloperoxidase produces HOCl - tissue oxidant .
- Myeloperoxidase present in atherosclerotic lesions .
- Paracetamol is substrate and inhibitor of myeloperoxidase .
- Paracetamol may decrease atherosclerosis .
- Interactions of paracetamol analogues with myeloperoxidase?
- Analytical: Enzyme assay, Chromatography (HPLC), UV spectroscopy, Nuclear magnetic resonance spectroscopy
- Statistical analysis
A critical look at drug development
- Increasing prices for cancer medicines challenge our ability to pay for them.
- Payers are being challenged to develop news ways for assessing the value of innovative cancer medicines.
- There is little agreement about how much these drugs are really worth, and how governments should respond.
• Outline of Project:
- Summarising critical information about cancer medicines subsidised, or denied subsidisation, by the Pharmaceutical Benefits Scheme.
- Access to medicines.
- Influences on the R&D and drug development agenda.
- Pharmaceutical policy.