
Dr Catherine Lucas
Lecturer
School of Medicine and Public Health
- Email:catherine.lucas@newcastle.edu.au
- Phone:02 4042 0908
Career Summary
Biography
Qualifications
- Bachelor of Medicine, Bachelor of Surgery, University of Queensland
- Bachelor of Pharmacy, University of Queensland
Keywords
- pharmacology
Professional Experience
UON Appointment
Title | Organisation / Department |
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Lecturer | University of Newcastle School of Medicine and Public Health Australia |
Lecturer | Priority Research Centre (PRC) for Healthy Lungs | The University of Newcastle School of Medicine and Public Health Australia |
Lecturer | University of Newcastle School of Medicine and Public Health Australia |
Lecturer | University of Newcastle School of Medicine and Public Health Australia |
Professional appointment
Dates | Title | Organisation / Department |
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7/3/2016 - | Nuclear Medicine Physician | Hunter New England Local Health District |
Publications
For publications that are currently unpublished or in-press, details are shown in italics.
Journal article (19 outputs)
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2020 |
Patel J, Lucas CJ, Ryan J, Jenkins M, Martin JH, 'Vancomycin therapeutic drug monitoring in paediatrics', Journal of Paediatrics and Child Health, 56 563-570 (2020) [C1] © 2019 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: Vancomycin guidelines for therapeutic drug monitoring (TDM) aim to maximise effica... [more] © 2019 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: Vancomycin guidelines for therapeutic drug monitoring (TDM) aim to maximise efficacy while minimising toxicity and resistance. Vancomycin is effective against Staphylococcus aureus when it achieves area under the concentration¿time curve (AUC)/minimum inhibitory concentration (MIC) > 400. Studies in children have shown that target trough concentrations poorly correlate to AUC/MIC > 400; however, they are used in practice for clinical convenience. This review in paediatric inpatients aims to audit performance against TDM guidelines and consider what changes are needed to optimise vancomycin monitoring. Methods: Vancomycin prescriptions in patients younger than 18 years old were collected over a 15-month period. Primary outcome measures were vancomycin initial dose (mg/kg/day) and the timing and result of first trough concentration (mg/L). Secondary outcome measures were the numbers achieving recommended targets and whether appropriate dose adjustments were made in response to TDM. Results: A total of 133 courses reached the time when TDM should occur. Average patient age was 6.5 years, and the average initial dose was 52.55 mg/kg/day (range 19.05¿86.54 mg/kg). Only 25% of courses (n = 34) had a trough concentration measured at the recommended time. The mean trough concentration was 11.6 mg/L (range < 2.0¿39.7). Of 40 patients with a low trough concentration, 50% continued without dose adjustment. Conclusion: As shown in the literature, there is a poor correlation between the vancomycin dose given and the trough concentration achieved. Given that recommendations for trough concentration monitoring are designed to simplify the process yet are poorly adhered to, a strategic plan to address these issues is needed.
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2020 |
Graham M, Lucas CJ, Schneider J, Martin JH, Hall W, 'Translational hurdles with cannabis medicines', PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, 29 1325-1330 (2020)
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2019 |
Lucas CJ, Dimmitt SB, Martin JH, 'Optimising low-dose methotrexate for rheumatoid arthritis A review', British Journal of Clinical Pharmacology, 85 2228-2234 (2019) [C1] © 2019 The British Pharmacological Society Methotrexate at low doses (5¿25¿mg/week) is first-line therapy for rheumatoid arthritis. However, there is inter- and intrapatient varia... [more] © 2019 The British Pharmacological Society Methotrexate at low doses (5¿25¿mg/week) is first-line therapy for rheumatoid arthritis. However, there is inter- and intrapatient variability in response, with contribution of variability in concentrations of active polyglutamate metabolites, associated with clinical efficacy and toxicity. Prescribing remains heterogeneous across population groups, disease states and regimens. This review examines current knowledge of dose¿response of oral methotrexate in the setting of rheumatoid arthritis, and how this could help inform dosage regimens.
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2018 |
Martin JH, Schneider J, Lucas CJ, Galettis P, 'Exogenous Cannabinoid Efficacy: Merely a Pharmacokinetic Interaction?', Clinical Pharmacokinetics, 57 539-545 (2018) [C1] © 2017, Springer International Publishing AG. Endocannabinoid pharmacology is now relatively well understood with a number of endocannabinoids and endogenous cannabinoid neurotran... [more] © 2017, Springer International Publishing AG. Endocannabinoid pharmacology is now relatively well understood with a number of endocannabinoids and endogenous cannabinoid neurotransmitters identified and the pharmacokinetics relatively well ascertained. Further, the cannabinoid receptors are now molecularly and pharmacologically characterised and the cell processes involved in endocannabinoid transcription, synthesis, post-translational modification and protein expression are reported. Endogenous cannabinoids have been shown to have key roles in immune and pain pathways and neuro-behavioural signalling including appetite regulation. Significant recent interest has thus been shown in understanding these pathways to guide the development of agents that inhibit the natural catabolism of endogenous cannabinoids to modify pain and appetite, and to synthesise antagonists for the treatment of disease such as obesity. This research is concurrent with the renewed clinical interest in exogenous cannabinoids and their use in disease. However, the complex pharmacology and physiological effects of exogenous cannabinoids, either as individual components or in combination, as extracts or via administration of the whole plant in humans, are less well known. Yet as with all other therapeutics, including those derived from plants, knowledge of the pharmacokinetics and dynamics of the complete plant, the individual chemical molecules and their synthetic versions, including formulations and excipients is a standard part of drug development. This article covers the key pharmacological knowledge required to guide further exploration of the toxicity and efficacy of different cannabinoids and their formulations in blinded placebo-controlled studies.
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2018 |
Patel J, Lucas CJ, Margalit M, Martin JH, 'Laxative Use in Inpatients on Oxycodone/Naloxone Prolonged Release and Oxycodone Prolonged Release for Cancer and Non-cancer Pain', Journal of Pain and Palliative Care Pharmacotherapy, 32 116-123 (2018) [C1] © 2019, © 2019 Taylor & Francis Group, LLC. Objective: To examine the laxative prescriptions in hospital inpatients with cancer and non-cancer pain on oxycodone compared to ... [more] © 2019, © 2019 Taylor & Francis Group, LLC. Objective: To examine the laxative prescriptions in hospital inpatients with cancer and non-cancer pain on oxycodone compared to oxycodone plus naloxone combination. Design: Retrospective case note review. Setting: A palliative care inpatient unit and a general medical ward in a large tertiary referral hospital. Participants: Eighty-four patients receiving oxycodone or combination oxycodone/naloxone on general medical (45 patients) and palliative care wards (39 patients). Main outcome measures: The primary recorded outcomes were regular opioid dose (milligrams per day) and number of prescribed laxatives (type, doses, and frequency per day). Results: Sixty-three (75%) patients in the study were on at least one laxative. In the general medicine inpatients, those on combined oxycodone/naloxone received on average 3.7 laxative doses per day compared to the oxycodone patients receiving 1.6 doses a day. In the palliative medicine population, both groups received a similar number of laxatives, despite the oxycodone/naloxone patients being on lower opioid doses. Conclusion: This retrospective study of hospital inpatients with cancer and non-cancer pain found that laxative use was not reduced in those on combined oxycodone/naloxone compared to oxycodone alone, suggesting that despite the interpretations of the clinical trials in the phase IV setting, the addition of naloxone had no effect on reducing laxative use.
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2018 |
Dryburgh LM, Bolan NS, Grof CPL, Galettis P, Schneider J, Lucas CJ, Martin JH, 'Cannabis contaminants: sources, distribution, human toxicity and pharmacologic effects.', British journal of clinical pharmacology, 84 2468-2476 (2018) [C1]
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2018 |
Lucas CJ, Galettis P, Schneider J, 'The pharmacokinetics and the pharmacodynamics of cannabinoids.', British journal of clinical pharmacology, 84 2477-2482 (2018) [C1]
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2017 |
Lucas CJ, Patel J, Martin JH, 'Predicting drug interactions in addiction treatment', Internal Medicine Journal, 47 872-878 (2017) [C1] © 2017 Royal Australasian College of Physicians It is not uncommon to be treating people with addiction who also have significant other health problems, including heart, renal or ... [more] © 2017 Royal Australasian College of Physicians It is not uncommon to be treating people with addiction who also have significant other health problems, including heart, renal or liver failure, diabetes and vascular disease. These conditions require regular medications to be taken. This can be a problem for people living with addiction and difficult social circumstances affecting compliance, among other issues. Our perspective provides a summary of general pharmacological factors affecting medicine taking in people with addiction problems, to provide a guide for hospital doctors in this setting.
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2017 |
Lucas CJ, Martin JH, 'Pharmacokinetic-Guided Dosing of New Oral Cancer Agents', Journal of Clinical Pharmacology, 57 S78-S98 (2017) [C1] © 2017, The American College of Clinical Pharmacology Generally, licensed drug-dosing recommendations for chemotherapy are based on results from clinical trials in which subjects ... [more] © 2017, The American College of Clinical Pharmacology Generally, licensed drug-dosing recommendations for chemotherapy are based on results from clinical trials in which subjects are usually of relatively normal body size, middle-aged, and are relatively racially homogeneous, with minimal comorbidity and specific tumor characteristics. Very few nontrial patients meet these characteristics, resulting in clinical practice having to extrapolate dosing recommendations to the specific patient. There is insufficient research on the impact of obesity-associated physiological changes prevalent in patients with common cancers on standard pharmacokinetic and pharmacodynamic parameters. Yet quantifying the influence of obesity on the pharmacology of chemotherapy is vital, as dosing inappropriate for body composition (ie, flat dosing or mg/kg based on total body weight) may increase the risk of adverse events and reduce clinical effectiveness. Unfortunately, there are few cancer guidelines to aid clinicians in selecting the optimal dose in the obese¿even recent guidelines are based predominantly on clinical opinion/current practice in treating obese patients, rather than evidence. Data in many other vulnerable groups, for example, those with significant comorbidity and older patients, are also scarce. Because of the known limitations of body surface area¿guided dosing, therapeutic drug monitoring or pharmacokinetic-guided dosing, which predicts an individual's exposure, has increasingly been shown to be a powerful tool in cancer therapy. Used appropriately, it can adjust for differences in pharmacokinetic parameters not considered when body size¿based dosing or ¿one dose fits all¿ is used. This review will focus predominantly on the rationale for pharmacokinetic-guided dosing of the newer oral molecularly targeted antineoplastics in people whose drug exposure is not predicted by their physiology or body composition.
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2016 |
Lucas C, Byles J, Martin JH, 'Medicines optimisation in older people: Taking age and sex into account', Maturitas, 93 114-120 (2016) [C1] © 2016 Elsevier Ireland Ltd There are a number of complex and seemingly ignored issues around prescribing safely and effectively for older people, particularly for very old women.... [more] © 2016 Elsevier Ireland Ltd There are a number of complex and seemingly ignored issues around prescribing safely and effectively for older people, particularly for very old women. These issues include polypharmacy, possible compliance issues and communication barriers between patient, specialists and general practitioners (GPs). There are specific pharmacokinetic (PK) and pharmacodynamic (PD) parameters that change in older age generally, and in women more specifically, which if ignored are likely to cause symptoms and to impair quality of life when drug dosage is unchanged. These changed PK and PD parameters are not all-or-nothing processes, but a continuum across age, sex and comorbidity. Very old people also have less ¿reserve¿ when drugs are used in ¿standard' doses, are more likely to have multiple concurrent therapies, and the risk of adverse effects of drugs in this group is very high. Doctors need to consider these issues when providing therapy for this group, or when trying to unravel the complex prescribing cascade here. This review outlines general principles to consider when prescribing for older people, focusing on age- and sex-related changes in both PK and PD processes.
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2013 |
Lucas C, Martin J, 'Smoking and drug interactions', Australian Prescriber, 36 102-104 (2013) When patients enter hospital they may have to stop smoking abruptly if the hospital has a 'no smoking' policy. Abrupt smoking cessation can affect the metabolism of drug... [more] When patients enter hospital they may have to stop smoking abruptly if the hospital has a 'no smoking' policy. Abrupt smoking cessation can affect the metabolism of drugs. Cigarette smoking induces the activity of human cytochromes P450 (CYP) 1A2 and 2B6. These enzymes metabolise several clinically important drugs, including clozapine, olanzapine and methadone. Decreased CYP1A2 activity after smoking cessation increases the risk of adverse drug reactions, with reports of increased toxicity from clozapine and olanzapine. Predicting the required dose reduction of drugs metabolised by CYP1A2 after smoking cessation is challenging. Therapeutic drug monitoring should be used when possible. Nicotine replacement therapy does not influence CYP1A2 activity.
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2013 |
Lucas C, Donovan P, ''Just a repeat' When drug monitoring is indicated', AUSTRALIAN FAMILY PHYSICIAN, 42 18-22 (2013)
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Show 16 more journal articles |
Conference (11 outputs)
Year | Citation | Altmetrics | Link | |||||
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2019 |
Graham M, Lucas C, Schneider J, Fizzell J, Brett J, Martin JH, 'Cannabis medicines - Absolutely Safe?', Medical Cannabis and Cannabinoids, Barcelona, Spain (2019)
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2019 |
Graham M, Lucas C, Galettis R, Martin J, 'Cannabis and Palliative Care Trials and Tribulations - on behalf of CARE NSW Investigators', London (2019)
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2019 |
Graham M, Williams A, Lucas C, Martin J, 'NSW Cannabis Medicine Advisory Service (CMAS) methodology and evolution', Queenstown, New Zealand (2019)
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Show 8 more conferences |
Grants and Funding
Summary
Number of grants | 4 |
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Total funding | $4,661,460 |
Click on a grant title below to expand the full details for that specific grant.
20191 grants / $190,000
Early phase high throughput studies of cannabinoids using new understandings of glioblastoma biology, radiobiology and pharmacology$190,000
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
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Project Team | Professor Jennifer Martin, Doctor Michael Fay, Doctor James Lynam, Doctor Catherine Lucas, Doctor Peter Galettis, Associate Professor Nikola Bowden, Associate Professor Jenny Schneider, Associate Professor Paul Tooney, Doctor Ross Norris, Doctor Moira Graves |
Scheme | Project Grant |
Role | Investigator |
Funding Start | 2019 |
Funding Finish | 2021 |
GNo | G1900511 |
Type Of Funding | C3120 - Aust Philanthropy |
Category | 3120 |
UON | Y |
20182 grants / $4,463,754
The NSW Clinical Cannabis Medicines Program$4,443,754
Funding body: NSW Ministry of Health
Funding body | NSW Ministry of Health |
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Project Team | Professor Jennifer Martin, Associate Professor Jenny Schneider, Doctor Peter Galettis, Doctor Catherine Lucas |
Scheme | Research Funds |
Role | Investigator |
Funding Start | 2018 |
Funding Finish | 2020 |
GNo | G1701636 |
Type Of Funding | C2210 - Aust StateTerritoryLocal - Own Purpose |
Category | 2210 |
UON | Y |
A simple fingerprick and blood test to optimize chemotherapy dosing in oesophageal cancer$20,000
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
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Project Team | Associate Professor Jenny Schneider, Doctor Peter Galettis, Professor Jennifer Martin, Conjoint Professor Stephen Ackland, Doctor Catherine Lucas |
Scheme | Project Grant |
Role | Investigator |
Funding Start | 2018 |
Funding Finish | 2018 |
GNo | G1800190 |
Type Of Funding | C3120 - Aust Philanthropy |
Category | 3120 |
UON | Y |
20171 grants / $7,706
Calvary Mater Newcastle James Lawrie Head and Neck Cancer Research Grant$7,706
Funding body: Calvary Mater Newcastle
Funding body | Calvary Mater Newcastle |
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Project Team | Professor Jennifer Martin, Professor Stephen Ackland, Dr Catherine Lucas, Associate Professor Jennifer Schneider, Dr Peter Galettis |
Scheme | 2017 CMN Cancer Research Grant Funding |
Role | Investigator |
Funding Start | 2017 |
Funding Finish | 2018 |
GNo | |
Type Of Funding | Grant - Aust Non Government |
Category | 3AFG |
UON | N |
Dr Catherine Lucas
Position
Lecturer
Clinical Pharmacology
School of Medicine and Public Health
College of Health, Medicine and Wellbeing
Contact Details
catherine.lucas@newcastle.edu.au | |
Phone | 02 4042 0908 |
Fax | (02) 4960 2088 |
Office
Location | John Hunter Hospital , |
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