Clinical Pharmacology has both a diagnostic and a medical research role. The aim is to blend the two to generate research findings into new laboratory and clinical skills that contribute to the state-of-the-art clinical care of hospital patients and those remote from TQEH. The department focusses on personalised medicine, and therapeutic drug monitoring.
One study involved drugs used in organ transplantation to avert rejection, while others look at cancer or local anaesthetic drugs in post-operative pain management.
The department continues to investigate the treatment of angina, particularly in patients receiving an older but very effective drug, perhexiline. However, it can cause serious liver and nerve toxicity if dosages are not individualised based on the testing provided in our laboratory. Current research aims to better understand the mechanisms perhexiline in the body and eventually provide safer clinical use. This work has led to the development of a provisional patent application, which has been lodged both in Australia and in the USA.
The clinical department is investigating genetic factors which may influence the efficacy of immunosuppressant drugs and therefore transplant rejection or organ toxicity. The department has recruited 200 kidney transplant recipients and their donors to assist in this project. They are are one of the first laboratories to have measured the amount of immunosuppressant drugs within transplanted kidneys through biopsy samplings.
They have also collected clinical, biochemical and genetic data, which will be used to establish whether it may be possible to further reduce the incidence of rejection. Initial results indicate that transporter proteins within the transplanted kidney determine its exposure to some immunosuppressant drugs. They’re now analysing whether the genetics of both the transplanted organ and the recipient, along with the knowledge of the kidney’s exposure to these drugs, may lead to individualising the distribution of medication. The project is collaborating with researchers in the Netherlands.
A relatively new area of research for the department is the dose individualisation of chemotherapeutic agents, in particular the drug Docetaxel, which is used in the treatment of breast and prostate cancer. The studies are investigating how the current “one dose fits all” policy of chemotherapeutic agents compares to a targeted concentration approach with the ultimate aim to reduce the adverse side effects associated with this drug while optimising drug actions.
Another project aims to determine if inhibition can prevent bystander side effects whilst maintaining the efficacy of radiation therapy.
They have three projects involving anaesthetic drugs:
The first is for post-operative pain control that remains an under-treated clinical problem. It looks at ways of treating pain after laparoscopic or open surgery. The aim is to pump a continuous trickle of local anaesthetic drug next to to the incision site following colorectal surgery. Thereby treating the pain at the local site, instead of giving patients opioid drugs which can have adverse effects and inhibit recovery of the bowel after surgery. This project is now completed and has been submitted for publication.
The second project involved measuring plasma concentrations of local anaesthetic after a spinal TAP-block in Intensive Care Unit patients. Again the aim was to review the amount absorbed into the blood stream after the dose to enhance the therapeutic benefit. This project is completed and currently under consideration for publication.
A third project has begun investigating a drug interaction between an anaesthetic reversing agent and other drugs used during surgery to prevent post-operative nausea. The aim is to determine if the efficacy of the drugs is compromised or enhanced when combined with the reversing agent.
All projects have involved collaboration with personnel in the Department of Anaesthetics, nursing staff and the Department of Clinical Pharmacology.
Principal Medical Scientist/Professor
(Retired February 2012)
R Morris BSc PhD FFSc(RCPA)
Principal Medical Scientist/Assoc Professor
BC Sallustio BSc PhD
Senior Medical Scientist
IS Westley BMedSc PhD
BD Noll BSc(Hons)
D Mohanasundaram PhD
Senior Technical Officer
FA Wicks BSc
P Dubois BSc(Hons)
A Kalaitsidis BSc
D Dinow BSc
C de Nichilo BSc
1 Postgraduate Students
3 PhD Candidates
1 BSc Honours Candidate