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.

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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.

Cross-check your assumptions

If you feel you have had a less-than-perfect talk with your partner, sometimes, asking your partner about their situation may lessen your emotional burden and save you from emotional derangements.

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

Ebony warns Fans

Famous Ghanaian female dancehall artiste, Ebony Reigns, has thrown strong vituperative words at her male fans who send her pictures of their manhood to abstain from masturbating with her nude pictures.

The artiste who recently enterred into the music industry with hit songs like “kupe,” showing romantic graphics and lyrics has gained prominence and the attention of most of the public, if not all.

She said in an interview on 3FM’s showbiz927 on saturday that some male fans send her pictures of their manhood masturbating with her nude seductive pictures.

“I have received a couple of pictures of their manhoods with my pictures masturbating. I want them to be aware that I am not the one spurring them on to do this peccant act. Before they do, they must know what masturbation is about. I am not responsible for their actions,” she said.

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.

When all odds are against you

If you tossed a coin myriad times in a gamble waiting for the tail to win  in support of me, then you would be waiting probably for eternity. I was just a quintessence of truancy. I virtually missed all except when lectures was to be handled by my academic tutor. Despite the unfriendly nature of the semester, I enjoyed a brisk semester by ricochetting from one party to another. I hardly missed any birthday party. 

Not that my alarm was faulty; my alarm had tintinnabulated with a shrill tone, but I had slept in profundity that I could not even feel the weight of a placard that had fallen on my face, and the amazing part was that the sound had lasted for almost an hour. I took a stimulant- caffeine- to help him stay awake throughout the night but all I did became dead in the water. I woke up after two hours when my exam for the day was about commencing. So I wore the shirt I wore the ereyesterday, slipped my foot into one of my old sneakers and hurried to the exam centre. It is amazing how all these menaces never inclined me to fret. 

With my equableness I strutted to join the queue waiting for my turn to enter. My first two touches, one on each side of my pocket, was a big wake-up call to me. I had left my student ID card in my cubicle! “Really?” I asked myself. I pleaded for consideration from the security man, but the security man did not grant me favour. I was only made to enter after I explained things to my academic tutor. 

I strolled through the lanes searching for my seat. I found my seat eventually at the back when one guy signalled me. I sat, shaded my index number and all other protocols. It was at the course code session I realised I had learnt a different course. My heart began to thump. I began to process my prayers, and fortunately or unfortunately for me, I happened to sit in tandem to the best student of my class, Samuel. I made the cross sign and sighed greatly. “B))dee33 ooo.”(lol) 

Coincidentally, samuel’s paper was skewed to the right so I could see unto it with no obstruction. Under twenty minutes, I finished the paper and did not even bother skimming through to look out for and correct mistakes. Not even a cursory look! Before, I had seen an inscription as “W23” on the top right corner of samuel’s scantrom, but it never pricked or tickled me. I stood and submitted my paper. It was then I knew the meaning of that inscription on samuel’s paper. 

Each one was supposed to check the footpage of page 8 for a secret code and then rewrite on the top of the scantrom. I had not done that. Quickly, my hands began to shake. My lips were jiggling in tetany. “Gentleman, what is it? Submit your paper and leave!” A satiric voice told me. I looked to see my mates and, then, up. Tears started to trickle down. I had copied wrongly. My secret code was Y12. What was I going to do?

My pen cries; Guest post

When dryness parted ways with Circle

And all extinguishers were upset

Innocent souls bade untimely bye 

To us who survived.

When the pillars of Melcom

Could no longer hold it to position

And licensed it ruins

The story of life was once again

Continue reading
Told by an idiot;

Souls left this phase of the world

To its second.

I know of just two seasons 

In my homeland Ghana.

Yet a time came

That we registered a third.

The season which birthed too much pain;

The suicide season.

 Let me pause a minute 

To console the affected;

Family, friends and the entire human race. 

I wish I could whisper

To them in their graves

That IT still lives

The very reason they died for,

Still lives. 

Sorry if the world was too small

To contain your quandaries.

The pain of the oppressed 

Is counted joy for the oppressor

The sanity of the innocent 

Never ceases to be naivity for the infidel. 

My pen cries tears of loneliness 

I am lonely like Amma Darko is.

If my modified breathe can’t call for a reform, 

Then my pen, my sword, 

Should stab this albatross of mishap

That hangs around our necks to death.

I sit on my couch 

To recollect those memories in tranquility 

Those days 

When we sit outside

From dusk to dawn

To enjoy granny’s tales

But what do we see today? 

The vices of this world

Have placed curfews on us. 

My pen cries weary tears for reform

The world can be a little better, 

If not the best.

My pen critiques negligence and indifference 

Let’s not be architects of our own problems.

The Tabernacle

After genuflecting before the altar and sending my prayers in procession to the Father, who is seated in the heavenly places, it dawned on me to read Exodus 25 through to chapter 30, and in this I realised something great. Something precious. Something eternal. 

“Make a sanctuary for me, and I will dwell among them.” Exodus 25:8

“Make this tabernacle and all its furnishings exactly like the pattern I will show you.” Exodus 25:9

After skimming through this whole chapters, I understood all things except for one thing- The Tabernacle. So I decided to seek after God, and this was the realisation: 

The Tabernacle is like a football field, with short pillars (60 of them) arranged round the field with a flat board linking adjacent pillars. Each pillar had two hooks through which ropes were passed to fasten them to the field.
​”And then I will dwell among the Israelites and be their God. They will know that I am the Lord their God, who brought them out of Egypt so that I might dwell among them.” Saith the Lord

A zoom of one short pillar revealed a cap-like structure and a foot-like structure. The cap-like structure was made of silver, while the foot-like structure was made of brass. And the shaft of the pillar was made of gold. 

I became more confused, and I was like ‘what does these all stand for, spiritually?’ 

But the spirit of the Lord did not dare to leave me in limbo, but rather explained to me:

The silver represents grace; the brass, judgement; and the gold (which represents Power) shaft, The saint. And the link between adjacent pillars represents the bond unifying all saints. 

The gold shaft (the saint) standing on the brass (judgement) and making it its footstool means that all saints have overcome judgement, and that no judgement awaits saints: For we have overcome. 

However, the gold shaft (the saint) beneath the silver cap (grace) means that all saints are under the grace of God, and that no one is greater than the grace of God Almighty.

The thumping of my heart begun to wane, and a smile flickered across my face. 

This gives me hope that, truly and indeed, I have overcome judgement!!! I hope you believe too.

#HappyEaster#GlorybetoGod#WeAreSaints