Clinical Pharmacology & Toxicology
The ultimate goal of the Department of Clinical Pharmacology and
Toxicology is achieving safe and effective therapy for every patient.
cutting edge research employs a multi-faceted approach, to understand
the factors which contribute to the quality use of medicines. Our
research focuses on personalised medicine for a range of therapeutic
areas including endocrinology (diabetes), musculoskeletal disorders
(gout), pain, cardiology, nephrology and infectious diseases. We are
also researching methods of enhancing the safe use of medicines using
electronic medication management (eMMS) and decision support tools,
making use of critical patient-specific information such as organ
function, drug concentrations and genetic markers that are relevant.
are undertaking innovative research in predicting optimal drug dosing
for individual patients using Bayesian forecasting and population
pharmacokinetic modelling approaches. We are implementing these powerful
approaches to support a state-of-the-art therapeutic drug monitoring
service which has the potential to revolutionise precision medicine at
St Vincent’s Hospital and beyond.
Specifically, we are undertaking
internationally novel research in therapeutics in endocrinology
(extending the use of metformin), nephrology (metformin in chronic
kidney disease), gastroenterology (metformin in hepatic failure) and
cardiology (metformin in heart failure), infectious diseases
(therapeutic drug monitoring and personalising drug dosing for
antibiotics, antifungal, and antiviral medicines in critical illness)
and rheumatic disorders (gout) in the hospital setting as well as
extending into primary care. We are commencing collaborations with
medical oncology (efficacy of scalp cooling to reduce hair loss from
cytotoxics) and psychiatry (clozapine concentration monitoring for
safety and effectiveness).
Our external research collaborations
are many: George Institute of Global Studies for interventions for
treatment of low back pain and osteoarthritis, the Australian Institute
of Health Innovation at Macquarie University researching electronic
health solutions, decision support approaches, and prediction of health
outcomes, ANZ musculoskeletal clinical trials (ANZ MUSC), Australian
Kidney Trials Network (AKTN) examining allopurinol as a treatment to
slow progression of renal failure, and Prince of Wales Virology and
Nephrology for antiviral prevention of Cytomegalovirus (CMV) infection.
Recent funding sources include: NH&MRC [APP1054146
Creating safe, effective systems of care: the translational challenge.
2014 (Braithwaite J, Westbrook J, Coiera E, Runciman W, Day R, Hillman
K); APP1094708 Patient-centred eHealth approach to
improving outcomes for gout sufferers. 2015 (Day R, Zwar N, Reath J,
Westbrook J, Lau A, Baysari M, Laba T, McLachlan A, Runciman W); APP1094878
Delivering safe and effective care for children in hospital with
eHealth systems. 2015 (Westbrook J, Georgiou A, Day R, O’Brien T, Karnon
J, Dalla-Pozza L, Cowell C, Li L, Baysari M, Ambler G)], ARC Linkage Grant [LP0990670
Development of computer-based decision support tools using
population-based PK-PD modeling (Day RO, Kirkpatrick CM, Williams KM,
Greenfield J, Giacomini K)], UNSW Research Infrastructure Scheme 2017
[Supporting Collaborative Research. Installation of a Shimadzu Nexera
X2 UHPLC into the Department of Clinical Pharmacology and Toxicology.
(Day R, Carland JE, Stocker SL, Norris RLG, Greenfield JR)], St Vincent’s Clinic Foundation Research Grant 2017 [The
safety and pharmacokinetics of metformin in heart failure. (Day R,
Macdonald P, Greenfield J, Graham G, Stocker S, Carland J)], St Vincent’s Clinic Foundation Research Grant 2016 [Implementation
of drug-drug interaction alerts: An investigation of burden of
prescribers (Baysari M, Sandhu A, Richardson K, Li L, Day R)], Diabetes Australia Research Trust (DART) Research Grant 2014 [Safety of metformin in dialysis. (Day RO, Williams KM, Furlong TJ, Greenfield JR, Graham GG, Kumar SK)].