What AUC (Area Under Curve) of a plasma concentration-time curve actually means

Statisticians have it legibly inscribed in their books that in any experiment conducted on a popuplation or on a sample of the population, the test of normality must almost always validate your work.

That is to say, majority of the observations (about 95% of them) should span three (3) standard deviation units on either side of the graph; half of the remaining 5%, each, should occupy the ends of the graph.

(The standard normal graph is bell-shaped! If you still can’t visualize, picture a cone sitting on its circular base.)

The 95% observations for majority means that in any study of a continuous variable of a population or sample, ninety-five percent(95%) of the population will be within a certain range of values for that continuous variable. Only few or very few of the population will be at the extremes, representing ‘exceptional’ values.

To simplify it, if you are to conduct a class exercise on students of a particuar class, majority of students will score around 40-69, very few will score 70-100, and very few will score 0-39 (yeah! It is an exceptional range , isn’t it?)

What really does account for these variations in the marks obtained by these students who were taught by the same teacher in the same class at that same time (assuming they were all in class?) Does the difference stem from the fact that we all understand differently? Or, perhaps, we read different books?

Well, I think a fact is a fact! Maybe teaching methods will be different, but the final result should be the same: we are all to understand right!

As a student statistcian, my curiosity spurred me on…

After mid-semester examinations, I did a post hoc anaylsis on quite a number of students (n=10) on what they thought or knew about Area Under Curve (AUC) for plasma concentration-time curve.

Five of them said same things, three of them said they did not know, and the remaining two also said same things but differently from the other five.

“Area under curve gives the total concentration of drug in your body.” Response from the five students.

“Area under curve gives the average concentration of drug in the body during a period of time.” Response from the two students.

“No idea.” Response from the three students.

************

When a plasma concentration-time curve is drawn for a particular drug administered extravascularly, a bell-shaped graph is obtained. To be able to apply the test of normality to any trial, the continuous variables studied must be fairly constant. In other words, the variable must not change so rapidly in the course of the experiment.

In the concentration-time curve, two processes act concurrently: Absorption and Elimination. The latter is dependent on the former. In that, the fraction eliminated is high if the amount absorbed is also high.

The time-axis gives the period our experiment is supposed to span. If we are assuming a period of 24hrs, then the Area Under Curve gives a certain value measured over 24hrs.

The process of absorption marked (+) because we are increasing blood concentration and elimination marked (-) because we are losing can be akin to these values, if we are assuming these values arbitrarly for the 24 hour period: +10, -5, +15, -7, +9, -4.

Since those two aforementioned phases occur simultaneously and differently (in terms of rate), then we can as well assume that the value obtained at the end of the 24 hour period gives us the average or mean concentration of the drug present in the blood. Does it make sense?

So in short, AUC gives or measures the AVERAGE CONCENTRATION of a drug sample over a PERIOD OF TIME. Omitting the time factor would mean that the concentrations at time t= 0 and t= 10 hours will give same areas under the curve. And that is veritably not true.

What then is the significance of AUC?

The plasma therapeutic concentration of Theophylline is quoted as 10-20 ug/ml. Assuming at the end of our calculation for AUC we obtained say, 12ug/ml, then this value is within the therapeutic range and hence therapeutic effects will still be observed during the 24 hour period for that particular administered dose (the initial starting dose). That means that the dose will be given once daily.

KNUST hosts 2nd White Coat Ceremony (WCC)

The faculty of Pharmacy hosted its second White Coat Ceremony (WCC) on thursday, 12th October, 2017 at the CCB AUDITORIUM-KNUST.

The ceremony, and for that matter the White Coat Ceremony, was organised to usher the currently 5th years of the undergraduate profession into their clinical years after four years of pre-clinical studies.

The ceremony which was moderated by Dr. Cynthia Amaning Danquah, a pharmacology lecturer, staged the following dignitaries:

FDA representative, Secretary of Christian council, Former Deans of College of Health Sciences, Registrar of Pharmacy Council, Provost of College of Health Science (CoHS), Preceptors and Parents.

The current Dean of the Faculty of Pharmacy, Prof. Mrs. Rita Dickson, delivered an insightful speech after the ceremony was set into motion with an opening prayer from Dr. Joseph Adu, a pharmaceutical chemistry lecturer.

The Dean in her speech also expressed her gratitude to PSGH, Preceptors, and Alumni for their unwavering support in making the ceremony a successful one.

Going back in time, the President of the PSGH-Pharmaceutical Society of Ghana- unfurled how the pharmacy programme began and how far it has come.

“KNUST are the pioneers of the pharmacy profession. Pharmacy in earlier times awarded a diploma certificate, and then transitioned to the Bpharm (four years duration) which awarded a degree, and finally to the six years undergraduate degree, now called Doctor of Pharmacy. In other words, pharmacy has seen a paradigm from far-off patient to near-patient care.”

The president, despite aware of the main focus of the pharm D, entreated the students to venture into the area of research. “Some of you must go into research, identify new molecules and impact the lives of others.”

In his wrap-up message, he assured all and sundry, and for that matter posterity, that the pharm D programme has come to stay with us for good.

Professor Ansah, the past Dean of the pharmacy faculty and now a pro-Vice Chancellor, also did not go unheard. He acknowleged stakeholders, and flagged up two indispensable signatures of a pharmacist: Truthfulness and Transparency.

“As upcoming decorous pharmacists, key elements as truthfulness and transparency should be your hallmark.”

The insightful, invigorating but long discourses was capped off with the “moment of gowning and recitation of the pledge”. Dignitaries were called upon including parent pharmacists to gown the students of the ceremony.

Miss Dora, a student of the ceremony, gave the vote of thanks, and Professor Merlin, lecturer in the department of pharmacognosy, called the ceremony to an ecclesiastic end with a prayer.

The benediction was recited by Prof. Opuni Frimpong

KNUST ready to organise its 2nd White Coat Ceremony for its Second Batch of PHARMD students-#PharmDIsComing

When the certainty of science began to grow in the nineteenth century, scientists of this contemporary world decided to set themselves apart from the quackery and mysticism of the old in the practice of medicine. As part of this offshoot, they introduced the ‘White Coat’.

The White Coat Ceremony (WCC) is a ‘ritual’ performed by many health sciences to usher their final years into their clinical years from their pre-clinical years.

This practice lately has crawled into the field of the Doctor of Pharmacy programme, and this year the second batch of this highly-esteemed undergraduate profession in Kwame Nkrumah University of Science and Technology-KNUST- who are yet to graduate, is yet to enjoy another heart-warming White Coat Ceremony (WCC) which comes off this Thursday 12th of October, 2017 at the CCB AUDITORIUM-KNUST commencing exactly at 10:00AM, with the keynote speaker being Mr. Benjamin Botwe, the President of the Pharmateutical Society of Ghana, Ag Rectòr Ghana College of Pharmacists.

Pharmacy has, until recently, been industry- and academia-biased, with inadequate attention to clinical care. This has led to a number of lapses in the provision of quality pharmaceutical care in clinical settings.

It has been evidenced by the FDA that medication errors cause at least 1 death everyday and injure approximately 1.3 million individuals annually. This has become the problem of this modern era due to increasing complexity of pharmacotherapy.

Therefore, a new sect of individuals with different skills and improved knowledge are needed to assist with the delivery or provision of pharmaceutical care…

The long-awaited solution is now born- The Doctor of Pharmacy programme! This undergraduate professional degree, a six-year course, was born in Ghana in the year 2012.

It came not to dislodge the Bpharm of the old, but to fill it full. The PharmD seeks to provide extensive didactic professional clinical preparation as well as clinical training in various hospitals.

Yet-to-be graduates are poised and enthused to wax lyrical about the improvement in quality of healthcare that this novel paradigm shift in pharmacy will rain on its patients.

FIRST BATCH OF PHARMD AT WHITE COAT CEREMONY

If you are looking for justification for the pharmD, turn to the current shortage of primary care physicians- a problem that is predicted to grow in the coming years.

A team of PharmD is confident to fill this void and serve as valued physician extenders.

#PharmDIsComing

The New-Generation Pharmacist–World Pharmacist Day

While I was doing my attachment at one hospital, a pregnant woman in her early trimester presented with symptoms of nausea, and symptoms of a urinary -tract infection: pain in the abdomen, yellowish urine, etc.

After a culture and sensitivity testing was carried out, it was reported that the organism responsible for the symptoms was highly resistant to ampicillin but sensitive to nitrofurantoin, gentamicin, tetracycline, trimethoprim, and cefalexin…

Critical care was needed to relieve the pregnant patient of her symptoms, and there was about five different antibiotics to choose from that could resolve the symptoms and treat the causative organism. We (the attachment students) stood aloof and ‘unconcerned’. Not that we were unconcerned, but as naive as we were, we did not know so much about the antibiotics, and besides we were only in second year at that time.

The patient kept on complaining of pain in her abdomen. I felt very uneasy while I watched her shrill shriekingly.

“Does nobody here know what to offer to lull the pain of this patient?” I thought.

Just then, a man in a white lab coat, dressed in tie, hopped in. You could see he was in a hurry. He asked what the matter was, and it was expounded to him- He was the Pharmacist. Quickly, he asked for a cephalosporin (cefalexin 500mg q8 for 7 days) for the pregnant woman. She wasn’t vomiting so she could take the tablet. In about 6 hours later, the pain had subsided, and the patient was now calm. But she continued with the drugs till there was absolute remission.

We met him in his office and asked why he chose the cephalosporin group of antibiotics but not from the other groups aforementioned. In his own words, he said,

“The principles involved in the selection of an antibacterial must allow for a number of variables including changing the renal and hepatic function, increasing bacterial resistance, and information on side-effects. Duration of therapy, dosage, and route of administration depend on site, type and severity of infection must also not be overlooked.” He continued,

“the nitrofurantoin group of anitbiotics are very good class of antibiotics and help with urinary-tract infections. However, it has the potential of causing nausea (which was part of the patient’s complaints so the reason for its repudiation.

Gentamicin belongs to a group of antibiotics called aminoglycosides. They have the potential to resolve urinary-tract infections, but they are contraindicated in pregnancy (hence cannot be used) due to renal toxicity.

Tetracyclines are also a good class of antibiotics, but present with discoloration of teeth and bones- so-called teratogenic effects (hence contraindicated in pregnancy.)

Trimethoprim is an antifolate drug, however, pregnant women require even more folate for the formed elements of blood hence cannot be used in this patient.

The safest antibiotics to use in pregnancy are the penicillins and cephalosporins.”

Wow, isn’t it? Are pharmacists required to know all these, especially the side-effects? The functions of the new generation pharmacist goes beyond the ‘An)pa baako, ewia baako’ thing. Respect your pharmacist!

#WorldPharmacistDay #PharmacistsRock

It happens to all of us 100%

After a busy working day, you get to the house and as bored as you are, you feel being quickened. A look on your right is your partner. You jump unto him but his reaction is opposite that you experience on other times.

It quickly turns a knob in your brain. You begin wondering if your partner has no feelings for you again, or probably he is angry at something you might have done…

How hard and hurtful it feels…

Your partner is not angry at you! Your partner still feels the same way as he met you for the first time. Why then is he reacting differently?

The answer is, you are a victim of the famous psychology theory FAtE- Fundamental Attribution Error.

This theory unfurls how we humans give personality-based explanations for other people’s behaviour more than situational errors.

In otherwords, we tend to assume the way people treat us is a reflection of how they feel about us. But much of time, this assumption is comprehensively wrong.

In the above scenario, your partner may seem distracted. In fact, he is distracted. And all it means, in another way, is that you are not always the centre of his universe.

That doesnt mean your partner doesnt care so much about you, but that he thinks about other stuffs as well.

How then do we overcome this?

Accept what you can’t change

Accepting that it is a normal occurrence in life tends to safe us from such emotional worries. It is amazing to know that even the coiner of this theory more often suffers this theory too.

Never beat yourself up when you are faced with such situations. Accept that it is normal, and guys even impassively experience such things too.

Accept that it is normal and bound to happen in lifetime.

Faculty of Pharmacy Welcomes Freshers

The faculty of Pharmacy has enrolled a new sect of individuals into its premises. The admission begins this Friday, 1st September, 2017.

Out of the thousands of students admitted into Kwame Nkrumah University of Science and Technology, KNUST, about 300 was slated for the Doctor of Pharmacy program.

The Pharm D (Doctor of Pharmacy) program, which is an offshoot and a build-up of the formerly known Bpharm, is an undergraduate professional degree program spanning a duration of six (6) years. KNUST is the premier university to start this program, with its first batch occupying the sixth level now.

The main aim of this program is to clinically orient its graduates, with the first four years serving as a preparatory phase while the last two (2) years serve for clinical purposes.

The administration of the faculty officially welcomes the fresh pharmacy inmates into the confines of the faculty this Monday, 4th September, 2017. As part of this welcome, they will be asked to pen down their names and other details for their registration and, also, some souvenirs will be issued to them.

Are women naturally subordinated to men?

The convention of women in our traditional or modern societies being subordinated to men dates back to time immemorial.It has been so since creation although it might not be viewed in the same lens by everyone.However,this does not imply that women are totally robbed of their powers as humans in society.It is simply nature that has conducted a segregation excercise to put men in a higher position to dominate over women.

The concept of patriarchy is one that has become the proverbial albatross that hangs around the necks of many philosophers in their quest to unravel the mystery behind the assymmeteric men-women power relationships.Patriarchy is an institutionaliized system wherein women are in all spheres of life subordinated to men.This system is inherent to the Ghanaian traditional cultural set up.