Dr Catherine Lucas

Dr Catherine Lucas

Lecturer

School of Medicine and Public Health

Career Summary

Biography

Dr Catherine Lucas is a lecturer in clinical pharmacology and is a dual accredited clinical pharmacologist and nuclear medicine physician. She studied pharmacy and subsequently medicine at the University of Queensland. Her research interests include medicinal cannabis, pharmacokinetic-guided individualisation of drug-dosing regimens, medical education and theranostics.

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
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
7/3/2016 -  Nuclear Medicine Physician Hunter New England Local Health District
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Journal article (20 outputs)

Year Citation Altmetrics Link
2021 Martin JH, Lucas C, 'Reporting adverse drug events to the therapeutic goods administration', Australian Prescriber, 44 2-3 (2021)
DOI 10.18773/austprescr.2020.077
Co-authors Jen Martin
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]

Aim: Vancomycin guidelines for therapeutic drug monitoring (TDM) aim to maximise efficacy while minimising toxicity and resistance. Vancomycin is effective against Staphylococcus ... [more]

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.

DOI 10.1111/jpc.14683
Citations Scopus - 2Web of Science - 1
Co-authors Jen Martin
2020 Graham M, Lucas CJ, Schneider J, Martin JH, Hall W, 'Translational hurdles with cannabis medicines', PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, 29 1325-1330 (2020)
DOI 10.1002/pds.4999
Citations Scopus - 1
Co-authors Jennifer Schneider, Myfanwy Graham, Jen Martin
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]

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 va... [more]

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.

DOI 10.1111/bcp.14057
Citations Scopus - 7Web of Science - 5
Co-authors Jen Martin
2019 Ryan J, Patel J, Lucas CJ, Martin JH, 'Tobacco smoking and its potential drug interactions', Clinical Pharmacist, 11 (2019)

Smoking induces a number of enzymes that affect drug metabolism. Smoking cessation leads to prompt reversal of enzyme induction, which leads to significantly altered drug concentr... [more]

Smoking induces a number of enzymes that affect drug metabolism. Smoking cessation leads to prompt reversal of enzyme induction, which leads to significantly altered drug concentrations. Smoking cessation should always be encouraged and supported; however, prescribers should also give careful consideration to the doses of medicines that are metabolised via CYP1A2 and CYP2B6 in smokers, particularly when a person ceases smoking. Therapeutic drug monitoring, where available, should also be considered. NRT and varenicline may be used to increase chances of successful cessation and do not have any known significant drug¿drug interactions. Bupropion is another option for smoking cessation, but this drug has multiple potential interactions that should be taken into consideration at initiation and cessation of therapies.

Co-authors Jen Martin
2018 Lucas CJ, Galettis P, Song S, Solowij N, Reuter SE, Schneider J, Martin JH, 'Cannabinoid Disposition After Human Intraperitoneal Use: An Insight Into Intraperitoneal Pharmacokinetic Properties in Metastatic Cancer', Clinical Therapeutics, 40 (2018)
DOI 10.1016/j.clinthera.2017.12.008
Citations Scopus - 5Web of Science - 5
Co-authors Jen Martin, Peter Galettis, Jennifer Schneider
2018 Martin JH, Schneider J, Lucas CJ, Galettis P, 'Exogenous Cannabinoid Efficacy: Merely a Pharmacokinetic Interaction?', Clinical Pharmacokinetics, 57 539-545 (2018) [C1]

Endocannabinoid pharmacology is now relatively well understood with a number of endocannabinoids and endogenous cannabinoid neurotransmitters identified and the pharmacokinetics r... [more]

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.

DOI 10.1007/s40262-017-0599-0
Citations Scopus - 21Web of Science - 20
Co-authors Peter Galettis, Jennifer Schneider, Jen Martin
2018 Ryan J, Patel J, Lucas CJ, Martin JH, 'Optimal cancer drug dosing in adolescents: new issues and the old unaddressed ones', INTERNAL MEDICINE JOURNAL, 48 1023-1027 (2018)
DOI 10.1111/imj.14020
Citations Scopus - 1Web of Science - 1
Co-authors Jen Martin
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]

Objective: To examine the laxative prescriptions in hospital inpatients with cancer and non-cancer pain on oxycodone compared to oxycodone plus naloxone combination. Design: Retro... [more]

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.

DOI 10.1080/15360288.2018.1545725
Citations Scopus - 1Web of Science - 2
Co-authors Jen Martin
2018 Martin JH, Schneider J, Lucas CJ, Galettis P, 'Exogenous Cannabinoid Efficacy: Merely a Pharmacokinetic Interaction? (vol 57, pg 539, 2018)', CLINICAL PHARMACOKINETICS, 57 645-645 (2018)
DOI 10.1007/s40262-018-0633-x
Co-authors Jennifer Schneider, Peter Galettis, Jen Martin
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]
DOI 10.1111/bcp.13695
Citations Scopus - 33Web of Science - 31
Co-authors Chris Grof, Jen Martin, Peter Galettis, Nanthi Bolan, Jennifer Schneider
2018 Lucas CJ, Galettis P, Schneider J, 'The pharmacokinetics and the pharmacodynamics of cannabinoids.', British journal of clinical pharmacology, 84 2477-2482 (2018) [C1]
DOI 10.1111/bcp.13710
Citations Scopus - 95Web of Science - 83
Co-authors Peter Galettis, Jennifer Schneider
2017 Lucas CJ, Patel J, Martin JH, 'Predicting drug interactions in addiction treatment', Internal Medicine Journal, 47 872-878 (2017) [C1]

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. Th... [more]

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.

DOI 10.1111/imj.13500
Citations Scopus - 2Web of Science - 1
Co-authors Jen Martin
2017 Patel J, Martin JH, Lucas CJ, 'Comment on a paper by Dupoiron etal. "A phase III randomized controlled study on the efficacy and improved bowel function of prolonged-release (PR) oxycodone- naloxone (up to 160/80mg daily) versus oxycodone PR"', EUROPEAN JOURNAL OF PAIN, 21 1772-1773 (2017)
DOI 10.1002/ejp.1098
Co-authors Jen Martin
2017 Lucas CJ, Martin JH, 'Pharmacokinetic-Guided Dosing of New Oral Cancer Agents', Journal of Clinical Pharmacology, 57 S78-S98 (2017) [C1]

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-age... [more]

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.

DOI 10.1002/jcph.937
Citations Scopus - 13Web of Science - 12
Co-authors Jen Martin
2016 Schneider J, Galettis P, Williams M, Lucas C, Martin JH, 'Pill testing at music festivals: can we do more harm?', INTERNAL MEDICINE JOURNAL, 46 1249-1251 (2016)
DOI 10.1111/imj.13250
Citations Scopus - 13Web of Science - 13
Co-authors Peter Galettis, Jennifer Schneider, Jen Martin
2016 Lucas C, Byles J, Martin JH, 'Medicines optimisation in older people: Taking age and sex into account', Maturitas, 93 114-120 (2016) [C1]

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 polyph... [more]

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.

DOI 10.1016/j.maturitas.2016.06.021
Citations Scopus - 8Web of Science - 8
Co-authors Jen Martin, Julie Byles
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 &apos;no smoking&apos; 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.

DOI 10.18773/austprescr.2013.037
Citations Scopus - 19
Co-authors Jen Martin
2013 Lucas C, Donovan P, ''Just a repeat' When drug monitoring is indicated', AUSTRALIAN FAMILY PHYSICIAN, 42 18-22 (2013)
Citations Scopus - 10Web of Science - 8
2013 Lucas C, Ezard N, Day R, 'Synthetic Cannabinoid Use: The Importance of Surveillance', Drug and Alcohol Review, 32 48-48 (2013)
DOI 10.1111/dar.12077
Show 17 more journal articles

Conference (11 outputs)

Year Citation Altmetrics Link
2019 Graham M, Lucas C, Schneider J, Fizzell J, Brett J, Martin JH, 'Cannabis medicines - Absolutely Safe?', Medical Cannabis and Cannabinoids, Barcelona, Spain (2019)
DOI 10.1159/000500623
Co-authors Jennifer Schneider, Jen Martin, Myfanwy Graham
2019 Graham M, Lucas C, Galettis R, Martin J, 'Cannabis and Palliative Care Trials and Tribulations - on behalf of CARE NSW Investigators', London (2019)
Co-authors Jen Martin, Myfanwy Graham
2019 Graham M, Williams A, Lucas C, Martin J, 'NSW Cannabis Medicine Advisory Service (CMAS) methodology and evolution', Queenstown, New Zealand (2019)
Co-authors Jen Martin, Myfanwy Graham
2019 Fradgley E, Lynam J, Britton B, Martin J, Lucas C, Watts G, et al., 'Rapid-Fire Abstracts', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY (2019)
DOI 10.1111/ajco.13255
Co-authors Benjamin Britton, Jen Martin, Elizabeth Fradgley
2018 Lucas C, Schneider J, Renaud E, Fizzell J, Graham M, Cootes A, et al., 'Setting up the world's first drug information/medical advisory service for cannabinoid use for symptom control.', Brisbane (2018)
Co-authors Myfanwy Graham, Jennifer Schneider, Jen Martin
2017 Martin J, Lucas CJ, Reuter SE, Galettis P, 'Cannabinoid Toxicity Post Therapeutic Intraperitoneal Injection', Prague, Czech Republic (2017)
Co-authors Jen Martin, Peter Galettis
2016 Lucas CJ, Goodman S, Smith J, Burge M, Wyld D, Ravi Kumar A, 'Dosimetry to Estimate the Effect of Gelofusine® on the Renal Absorbed Dose of Lutetium 177-DOTA-octreotate.', Barcelona, Spain (2016)
2014 Lucas CJ, Smith J, Goodman S, Ravi Kumar A, 'A Case Report of Yttrium 90 Microsphere Dosimetry to Estimate Hepatic Tolerance of Subsequent Lutetium 177-DOTA-octreotate Therapy for Metastatic Neuroendocrine Tumor.', Melbourne, Australia (2014)
2013 Lucas CJ, Day R, 'Outcomes of Sedation for Acute Behavioural Disturbance in St Vincent s Hospital Emergency Department', Melbourne, Australia (2013)
2012 Lucas CJ, Kubler P, Martin J, 'Is the process for approval of high cost drugs for off-formulary use leading to clinically appropriate outcomes?', Sydney, Australia (2012)
Co-authors Jen Martin
2002 Stowasser D, Coombes I, Lucas CJ, Proper J, Allen BJ, Brammer J, et al., 'A Quality Use of Medicines Self-Assessment Audit', Christchurch, New Zealand (2002)
Show 8 more conferences
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Grants and Funding

Summary

Number of grants 4
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
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
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
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

Use of prochlorperazine to enable efficacy of targeted therapies in head and neck cancer.

Funding body: Calvary Mater Newcastle

Funding body Calvary Mater Newcastle
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
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Dr Catherine Lucas

Position

Lecturer
Clinical Pharmacology
School of Medicine and Public Health
College of Health, Medicine and Wellbeing

Contact Details

Email catherine.lucas@newcastle.edu.au
Phone 02 4042 0908
Fax (02) 4960 2088

Office

Location John Hunter Hospital

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