Kingsley Coulthard - Academia.edu (original) (raw)

Papers by Kingsley Coulthard

Annual review of chronopharmacology, 1986

Journal of Paediatrics and Child Health, Jun 1, 1982

Clinical and Experimental Pharmacology and Physiology, Dec 1, 1980

The Australian Journal of Hospital Pharmacy, Feb 1, 2000

The author discusses the current situation of clinical pharmacy and presents his outlook for the ... more The author discusses the current situation of clinical pharmacy and presents his outlook for the practice of clinical pharmacy in the future. (non-author abstract)

Journal of Antimicrobial Chemotherapy, Nov 12, 2003

Objectives: To define the steady-state pharmacokinetics of colistin methanesulphonate and colisti... more Objectives: To define the steady-state pharmacokinetics of colistin methanesulphonate and colistin in patients with cystic fibrosis (CF) following intravenous administration of the former. Materials and methods: The study was conducted in 12 patients with CF following intravenous administration of colistin methanesulphonate (1.63-3.11 mg/kg) every 8 h for at least 2 days. On the day of study, four blood samples were collected from each patient at 60, 120, 240 and 360 min after the end of the infusion. Concentrations of colistin methanesulphonate and colistin in plasma were measured separately by HPLC. Results: At steady-state, colistin methanesulphonate had a mean (± S.D.) total body clearance, volume of distribution and half-life of 2.01 ± 0.46 mL/min per kg, 340 ± 95 mL/kg and 124 ± 52 min, respectively. Colistin had a significantly longer mean half-life of 251 ± 79 min (P < 0.001). With the regimen used, colistin methanesulphonate was well tolerated. This is the first report on the pharmacokinetics of colistin methanesulphonate in CF patients determined using concentrations of colistin methanesulphonate and colistin in plasma. Conclusions: Based on the in vitro pharmacodynamics against Pseudomonas aeruginosa previously published by our group and these pharmacokinetic findings, dose escalating trials may be warranted to maximize efficacy.

British Journal of Clinical Pharmacology, Sep 1, 1988

The effect of erythromycin on the pharmacokinetics of phenytoin was studied in eight healthy volu... more The effect of erythromycin on the pharmacokinetics of phenytoin was studied in eight healthy volunteers using a balanced randomised cross-over design. Volunteers received a single oral dose of 400 mg of phenytoin sodium during each phase. During the treatment phase, the phenytoin sodium dose was administered 4.5 days after the commencement of a 7 day course of erythromycin base (250 mg every 6 h). There was no significant difference between the control and treatment phases (P > 0.05) with respect to the area under the plasma phenytoin concentration-time curve, the fraction of phenytoin unbound in plasma, the area under the unbound phenytoin concentration-time curve, the elimination half-life of phenytoin or the fraction of the dose excreted in urine as free and conjugated hydroxyphenylphenylhydantoin. This single dose study indicated that the intrinsic clearance of unbound phenytoin was unaffected by the concurrent administration of erythromycin.

European Journal of Clinical Pharmacology, 1983

The absolute oral bioavailability of a sustained release theophylline tablet (Nuelin-SR250), give... more The absolute oral bioavailability of a sustained release theophylline tablet (Nuelin-SR250), given 12 hourly was determined in 14 asthmatic children aged 5 to 13 years. In 4 of the patients, mean bioavailability of the fourth dose was 38.9+8.4% and that of the sixth dose was 67.9 + 25.9% (p < 0.05) in the other ten patients. This suggests steady-state had not been achieved after four doses. In the initial study with 9 patients, a significant diurnal variation in predose plasma theophylline concentrations was observed, as the mean morning predose concentrations were 2.9 fold greater than the mean evening predose concentrations (p < 0.005). Dual peak plasma concentrations occurred in 5 out of the 9 patients. The mechanism of this diurnal variation was investigated in a further 5 asthmatic children (10.8 years + 1.6). Morning and night steady-state plasma theophylline concentrations during a continuous intravenous infusion of aminophylline were not different (14.9 + 5.3 mg/1 vs. 15.6 + 5.9 mg/l), demonstrating that there was no diurnal variation in the plasma clearance of theophylline. The diurnal variation in predose concentrations with Neulin-SR250 was confirmed with the morning concentrations again being 2.6 fold greater than those in the evening. However, bioavailability was not significantly different for day (09.00-21.00) and night (21.00-09.00) dosing intervals after doses 6 and 7 respectively of Nuelin-SR250. The plasma concentration versus time profiles suggested that the diurnal variation in predose concentrations was due to slower absorption of the evening dose.

British Journal of Clinical Pharmacology, Feb 1, 1983

This report describes the use of a naloxone infusion at a rate of 300 ,ug/h to provide constant a... more This report describes the use of a naloxone infusion at a rate of 300 ,ug/h to provide constant antagonism of the respiratory depressant effects of a near fatal nor-methadone dose in a 2 year old boy. The terminal half-life for nor-methadone was calculated to be 13.5 h. The results indicate that a single dose of a narcotic antagonist with a short half-life (e.g. naloxone) will probably be inadequate to provide long lasting reversal of the effects of overdoses of long half-life narcotic agonists, and that continuous infusion may be the preferable to repeated bolus doses.

Journal of Paediatrics and Child Health, Sep 1, 1980

S OF PAPERS PRESENTED AT THE 13th ANNUAL MEETING, SYDNEY, MAY 1980 TRANSPLACENTAL TRANSFER OF C3 ... more S OF PAPERS PRESENTED AT THE 13th ANNUAL MEETING, SYDNEY, MAY 1980 TRANSPLACENTAL TRANSFER OF C3 NEPHRITIC FACTOR (C3Nef). L. P. Royand P. A. Worsdall. Department of Nephrology and Children's Medical Research Foundation, Royal Alexandra Hospital for Children, Camperdown. NSW. The transient presence of C3NeF in the circulation of a baby born to a mother with mesanglo-capillary giomerulonephritis (MCGN) is described. C3NeF is believed to be a siightly altered immunoglobulin of the IgG class. It is found In the sera of patients with MCGN, particularly the form with intramembranous electron dense deposits (Type 11). A 23 year old woman with Type II MCGN, but normal blood pressure and renal function, was delivered of a normal baby at term. Complement assays were carried out on,blood obtained from the mother at 8 months gestation and complement and immunoglobulin assays were carried out on blood frBm the baby at birth (cord blood) and at 5 days, 21 days and 10 weeks. C3, C4, properdin, Factor B, IgG and IgM were determined by radial immunodiffusion, CH50 by standard haemolytic assay and C3Nef by showing C3 breakdown products in normal serum, which had been incubated with test serum in MgEGTA buffer at 37'C for 1 hour, by 2 dimensional immunoelectrophoresis. The relevant results are shown in the Table. C3 C4 Factor6 C3NeF IgG

Australian family physician, 1988

Journal of Paediatrics and Child Health, 1998

Objective:To determine the relative bioavailability and plasma paracetamol concentration profiles... more Objective:To determine the relative bioavailability and plasma paracetamol concentration profiles following administration of a proprietary formulation of paracetamol suppositories to postoperative children.Methodology and Results:Study A—eight children undergoing minor surgery had blood samples collected following the rectal administration of either a 250 mg or 500 mg paracetamol suppository on one day and an equivalent oral dose on the following day. A mean dose of 13 mg/kg gave a mean Cmax (Tmax) of 7.7 mg/L (1.6 h) and 4.9 mg/L (2.0 h) following oral and rectal administration, respectively. The mean relative rectal bioavailability was 78% (95% confidence interval of 55–101%). Study B—20 children undergoing tonsillectomy and/or adenoidectomy were randomly assigned to receive a postoperative dose of 500 mg of paracetamol either as 2×250 mg liquid filled or 1×500 mg hard wax Panadol® suppository. A mean dose of 25 mg/kg produced mean maximum plasma paracetamol concentrations of 13....

Antimicrobial Agents and Chemotherapy, Mar 1, 2010

To identify the fosfomycin pharmacokinetic (PK)/pharmacodynamic (PD) index (fT .MIC , fAUC/MIC or... more To identify the fosfomycin pharmacokinetic (PK)/pharmacodynamic (PD) index (fT .MIC , fAUC/MIC or fC max /MIC) most closely correlated with activity against Pseudomonas aeruginosa and determine the PK/PD target associated with various extents of bacterial killing and the prevention of emergence of resistance. Methods: Dose fractionation was conducted over 24 h in a dynamic one-compartment in vitro PK/PD model utilizing P. aeruginosa ATCC 27853 and two MDR clinical isolates (CR 1005 and CW 7). In total, 35 different dosing regimens were examined across the three strains. Microbiological response was examined by log changes and population analysis profiles. A Hill-type E max model was fitted to the killing effect data (expressed as the log 10 ratio of the area under the cfu/mL curve for treated regimens versus controls). Results: Bacterial killing of no more than $3 log 10 cfu/mL was achieved irrespective of regimen. The fAUC/MIC was the PK/PD index most closely correlated with efficacy (R 2 " 0.80). The fAUC/MIC targets required to achieve 1 and 2 log 10 reductions in the area under the cfu/mL curve relative to growth control were 489 and 1024, respectively. No regimen was able to suppress the emergence of resistance, and near-complete replacement of susceptible with resistant subpopulations occurred with virtually all regimens. Conclusions: Bacterial killing for fosfomycin against P. aeruginosa was most closely associated with the fAUC/MIC. Suppression of fosfomycin-resistant subpopulations could not be achieved even with fosfomycin exposures well above those that can be safely achieved clinically.

European Journal of Hospital Pharmacy

British journal of clinical practice. Supplement, 1984

Journal of Paediatrics and Child Health, 1981

This article cites 12 articles, 3 of which can be accessed free at:

element. Drug education and antibiotic guidelines Two primary strategies that many hospitals have... more element. Drug education and antibiotic guidelines Two primary strategies that many hospitals have adopted to achieve rational use of anti-infectives are education and/or guidelines for use. Whilst education alone and thus perhaps “self-initiated” compliance with the principles of good prescribing are desirable, the perpetual demands of operating such a stand alone strategy and the resources needed have seen an increasing trend towards guidelines. Various nomenclature is used to describe what is essentially a strategy of control of the prescribing of these agents. Regardless of the real or imaginary implications of antibiotic “guidelines” or antibiotic “policies”, this approach sets out to either define the agents of choice for specific conditions and is usually accompanied by a process of authorisation whereby certain agents can, for example, only be prescribed following approval by an infectious diseases (ID) clinician. The roles of the pharmacist are many-fold in this strategy; th...

This article cites 13 articles, 6 of which can be accessed free at: