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Dr. Brookie M. Best
Brookie M. Best, Pharm.D., MAS Clinical Research
Professor of Clinical Pharmacy and Pediatrics
Associate Dean for Admissions and Outreach
Skaggs School of Pharmacy and Pharmaceutical Sciences
Department of Pediatrics, School of Medicine-Rady Children's Hospital San Diego
Research Summary: Clinical Pharmacology
Dr. Best specializes in pharmacokinetics – the processes by which a drug is absorbed, distributed, metabolized and eliminated by the body – and pediatric clinical pharmacology research. Her research efforts have focused on studying anti-HIV drugs in infants, children, adolescents, non-pregnant adults, and pregnant women. She also studies drugs used to treat Kawasaki disease, the leading cause of acquired heart disease in children. She has specific interests and expertise in maternal-fetal clinical pharmacology, therapeutic drug monitoring of antiretrovirals, antiretroviral pharmacogenomics, and penetration of antiretrovirals into the central nervous system.
Dr. Best's research program encompasses projects with key state-wide, national and international HIV/AIDS and pediatric pharmacology collaborative research networks, including the:
- International Maternal Pediatric Adolescent AIDS Clinical Trials network (IMPAACT)
- NICHD Research in Pediatric Developmental Pharmacology Network
- California Collaborative Treatment Group (CCTG)
Education: B.S. in Chemistry/Chemical Education (1994) UCSD; Pharm.D. (1999) UCSF; Pharmacy Practice Residency (2000) UC San Diego Medical Center; NIH/NRSA Fellowship in Pediatric Clinical Pharmacology Research (2004) UCSD; Masters of Advanced Studies in Clinical Research (2007) UCSD.
Awards and Honors: Awards and Honors: Valedictorian, National Center for Leadership in Academic Medicine; 7th Annual "40 Under 40" Honoree, San Diego Metropolitan Uptown Examiner & Daily Business Report; Professor of the Year Award, Associated Students (2010, 2013); Distinguished T eaching Award, University of California Academic Senate, San Diego Division.
Leadership Experience: Editorial Board Member, Journal of Acquired Immune Deficiency Syndromes; Director, NIH Training Program in Pediatric and Maternal/Fetal Pharmacology. Panel Member, Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission Guidelines, U.S. Department of Health and Human Services.
- Biopharmaceutics, Clinical Pharmacokinetics (SPPS 224, 226)
Key Contributions to Pharmaceutical Sciences
- Described pharmacokinetics and correct doses of antiretrovirals to use in pregnant women (results have been incorporated into US DHHS Treatment Guidelines)
- Discovered the lack of penetration of commonly- used antiretrovirals into cerebrospinal fluid, highlighting the importance of effectively treating this sanctuary site.
- Determined the pharmacokinetics, appropriate dose and safety of infliximab in pediatric Kawasaki disease patients (the first new treatment in this disease in 30 years, currently completing efficacy studies).
Selected Recent Publications (from >85 peer-reviewed articles)
Ellis et al. (2014). Randomized trial of CNS-targeted antiretrovirals for HIV-associated neurocognitive disorder. Clin Infect Dis. 58:1015-22
Watts et al. (2014). Raltegravir pharmacokinetics during pregnancy. J Acquir Immune Defic Syndr. 2014 Aug 26. [Epub ahead of print]
Cressey et al. (2014). Impact of body weight and missed doses on lopinavir concentrations with standard and increased lopinavir/ritonavir doses during late pregnancy. J Antimicrob Chemother. 2014 Sep 25. pii: dku367 [Epub ahead of print]
McCormack et al. (2014). Protecting the fetus against HIV infection: a systematic review of placental transfer of antiretroviral agents. Clin Pharmacokinet. 2014 Sep 16. [Epub ahead of print]
Potential Collaborative Programs with the Pharmaceutical Industry
- 14 years experience in designing, conducting and analyzing Phase I-II pediatric and obstetric pharmacokinetic clinical trials.
- Expertise in intensive and sparse population pharmacokinetic modeling and simulation techniques.