Clinical Pharmacology & Toxicology

The ultimate goal of the Department of Clinical Pharmacology and Toxicology is achieving safe and effective therapy for every patient. 

Our 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.

We 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)].