Determining drug clearance for clinically applicable dosing individualisation

Career objectives: To become a clinical pharmacologist with a major role in research. Research objectives and principal methodologies: Ultimately, to establish a clinically useful method of individualising maintenance drug dosing from a pharmacokinetic perspective, for both metabolically and renally cleared drugs. Sub-objectives include: quantifying the change in drug clearance with ageing, using regression models of published literature of pharmacokinetically relevant drug subgroups; assessing and optimising the use of clinical biomarkers of hepatic and renal function in predicting drug clearance, and thus drug dosing using method comparison procedures and pharmacokinetic modelling; assessing the change in protein binding with ageing and effect on total- and free-drug clearance using pharmacokinetic programmes. Potential health outcomes: Improve dosing and thus potentially optimise efficacy and minimise toxicity of drugs. The scope for benefit from this is large, because choice of maintenance dose-rate is a key part of drug use in chronic conditions.