Dr. Brookie M. Best

Clinical Pharmacology

Brookie M. Best, Pharm.D., M.A.S. Clinical Research

Associate Professor of Clinical Pharmacy and Pediatrics
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 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)
  • HIV Neurobehavioral Research Program (HNRP)

Academic Achievements

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: 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).

Leadership Experience: Director, UCSD SSPPS Student Required Research Project Programs; Editorial Board Member, Journal of Acquired Immune Deficiency Syndromes; Director, NIH Training Program in Pediatric and Maternal/Fetal Pharmacology.

Teaching

* 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 >55 peer-reviewed articles)

Best et al. (2010). Lopinavir tablet pharmacokinetics with an increased dose during pregnancy. J Acquir Immune Defic Syndr. 2010 Aug 1;54(4):381-8

Best et al. (2011). Efavirenz concentrations in cerebrospinal fluid exceed wild-type HIV IC50. J Antimicrob Chemother. 2011 Feb;66(2):354-357

Best et al. (2011). Pharmacokinetics of lopinavir/ritonavir crushed versus whole tablets in children. J Acquir Immune Defic Syndr. 2011 Dec 1;58(4):385-91

Best et al. (2012). Low CSF concentrations of the nucleotide HIV reverse transcriptase inhibitor, tenofovir. J Acquir Immune Defic Syndr. 2012 April 1;59(4):376-81

Potential Collaborative Programs with the Pharmaceutical Industry

  • 10 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