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Dr. Aduragbenro D. A. Adedapo

Head of Department

 

A BRIEF HISTORY THE DEPARTMENT OF CLINICAL PHARMACOLOGY

The Department of Clinical Pharmacology commenced operations in the late 1970s as a semi-autonomous unit of the University of Ibadan Department of Pharmacology & Therapeutics and Specialty of Internal Medicine under the leadership of Emeritus Professor L. A. Salako.  The then ‘amorphous’ unit was a hob of research activities, initially focused on cardio-renal pharmacology until emphasis shifted to malaria chemotherapy in the 1980s.   In the 1970s and 1980s training had partly involved the use of facilities at a few well-resourced institutions in Europe partly due to the lack of a clinical pharmacology laboratory.  Indeed, Professor O. Walker and Professor A. Sowunmi, both former Heads of the Department, had the benefit of some training in Karolinska Institute in Sweden and the University of Oxford, in the UK, respectively.

The department continues to maintain symbiotic relationship with the department of Pharmacology and Therapeutics of the College of Medicine, University of Ibadan.  Indeed, headship of the department of Clinical Pharmacology had always largely been determined by the happenings in the College of Medicine, department of Pharmacology and Therapeutics.  So far, the Department had contributed or solely trained several fellows some of whom currently occupy positions as consultants in the department.  At the present the department has six consultants namely Prof. A. Sowunmi, Prof. Catherine O. Falade, Prof. F. A. Fehintola, Dr. Aduragbenro Deborah A. Adedapo, Dr. Obaro S. Michael and Dr. Waheed A. Adedeji.  Also, five residents at various stages are undergoing residency programme in Clinical Pharmacology.

 

S/NList of Head of DepartmentPeriod
1Prof.  L.A. Salako1982 – 1991
2Prof O. WalkerApril, 1991–Feb, 1994
3Prof.  A. SowunmiFeb,1994–Feb, 1998; Mar, 1998 –Feb, 2001; Aug, 2006 –Aug, 2010
5Dr. Catherine. O. FaladeFeb, 2004 – Aug, 2006; Aug, 2010 – Feb, 2016
8Prof. F. A. FehintolaFeb, 2016 – Feb 2019
9Dr. Aduragbenro Deborah A. AdedapoApril 2019 till date

 

The department has recorded numerous achievements, a few of which are listed below.

  1. Chloroquine pruritus was a common adverse drug effect in the days of extensive use of the drug in the treatment of malaria. The first insight into the pathogenesis of chloroquine pruritus was worked out at the department by Prof Olatunde in the late 70’s. This seminal work led to a rise in research into this once mysterious drug effect nationally and internationally. The publication remains a landmark in the annals of World Health Organization (WHO). This in fact contributed largely to the recognition and collaborations by the WHO which eventually resulted in funded studies on malaria, the most prevalent disease in Nigeria.
  2. At the onset of decline in the efficacy of chloroquine in the late 80’s and the 90’s, there was an international effort to search for agents that could reverse resistance to the drug in humans. A similar feat had been achieved in vitro for the first time in 1994 at the laboratories of the malaria research group Ibadan. In a paper published in 1997, Sowunmi reported the reversal of chloroquine resistance in humans by chlorpheniramine. This work gained international recognition as the first and led to similar successes in other parts of the World. It was as a result of other studies by Sowunmi et al on reversal of CQ resistance by chlorpheniramine that chlorpheniramine was listed in the Word drug reference, Martindale, as an agent that could be used to reverse malaria parasite resistance to chloroquine in vivo.
  3. Dr Falade’s landmark paper (Falade et al 1997) provided the first clear evidence of established resistance in Plasmodium falciparum to (Chloroquine and Sulfadoxine) commonly used antimalarial drugs in Nigeria. This prompted a rethink in the management of this common but serious parasitic infection.
  • Between 2001 and 2002, Dr Falade led a rural antimalarial research that showed for the first time in the World that Chlorpheniramine could reverse falciparum resistance to amodiaquine. Prof Falade (Falade et al 2005) led the team of researchers that demonstrated the remarkable efficacy of 6-dose artemether-lumefantrine which is currently the global gold standard for the treatment of acute uncomplicated malaria. The outcome of this research effort was also used by Federal Ministry of Health in articulating a change in policy of the treatment of malaria in Nigeria.
  • Prof Falade and her team reported conclusively that the use of sulfadoxine-pyrimethamine for intermittent preventive treatment (SP-IPT) is effective in preventing maternal and placental malaria as well as improving pregnancy outcomes among parturient women in Ibadan, Nigeria; providing evidence for the implementation of the IPT-SP strategy in reducing the national burden of malaria in pregnancy (Falade et al. 2007).
  • Dr Catherine Falade as a key member of the WHO sponsored Home management of Malaria Studies in a series of publication in a special supplement of (Clinical Infectious Diseases 2016;63(S5) of the demonstrated that community health workers can be trained to perform malaria rapid diagnostic test to diagnose malaria, treat acute uncomplicated malaria withCoartem,  provide pre-referal treatment of severe malaria with artesunate suppository, prepare blood smears and blood sports on filter paper.
  • Prof Falade and her PhD student (2018) reported extensive diversity in the allelic frequency of Plasmodium falciparum merozoite surface proteins and glutamate-rich protein in rural and urban settings of southwestern Nigeria. Malar J. 2018 Jan 2;17(1):1. doi: 10.1186/s12936-017-2149-5. This confirms that the transmission of malaria was still intense in southwest Nigeria despite all efforts aimed at malaria control/eradication.
  • Also reported pfhrp2 and pfhrp3 deletions in Plasmodium falciparum isolates and the implications for malaria rapid diagnostic tests in Nigeria. Acta Tropica.196:121-125. When this occurs,it leads to false negative malaria RDT results.
  1. Dr F.A Fehintola in 2001 showed that antibacterial agent like Cotrimoxazole, has antimalarial and might have constituted a form combination therapy for malaria in the management of children with malaria on a background of prevalent upper respiratory tract infections. In conjunction with local and International Scholars, he is providing direction in area of artemisinin-based combination therapy (ACT) and anti-retro viral (ART) drug interaction.
  2. Aduragbenro D. A. Adedapo pioneered the Pharmacoepidemiology Unit and convened the first-in-the-NationPharmacoepidemiology and Drug Utilization research in Clinical Practice in January 13 – 15, 2020. In attendance wereHealth Care Practitioners Doctors, Pharmacists and Nurses from the Northern, Central, Western, Southern, Eastern parts of Nigeria and the Federal Capital territory. We published the first intensive adverse drug reaction monitoring at the University College Hospital, Ibadan in the British Journal of Clinical Pharmacology 2020 titled Cohort study on Adverse Drug Reactions in adults admitted to the medical wards of a tertiary hospital in Nigeria: Prevalence, incidence, risk factors and fatality.
  3. Michael passion for poison control and toxicology will feature concertedefforts at information and education series to be hosted on the website.
  4. W.A. Adedeji, will anchor drug adherence clinic, which will run concurrently with the existing adverse drug reactions clinic on Wednesdays.
  1. Clinical trials
  2. Therapeutic Drug Monitoring
  3. Chemotherapy/Antimicrobial
  4. Pharmacoepidemiology/precision medicine
  5. Medical toxicology and Poison control etc
  1. F. A. Fehintola
  2. A. Sowunmi
  3. Catherine O. Falade
  4. Aduragbenro D.A. Adedapo
  5. O. S. Michael
  6. W. A. Adedeji
  1. State Ministry of Health
  2. Southwest branch of NAFDAC
  3. World Health Organization
  4. State University of New York at Buffalo (SUNY– B)USA
Location

Medical Outpatient(MOP)

Number of Consultants

Six, with different areas of interest

Clinics

General and specialty clinics

1.Hypertension clinic on Tuesday

2.Adverse drug reaction clinic on Wednesday

3.General Medical Out-Patient Clinic onThursday

4.Malaria clinic on Mondays – Fridays

Other services

1.                  Attending /Routine Screening

2.                  Attending to consults or referrals from within and outside the hospital

In patient careThe department has an eight-bed ward for conducting research
Main area of focus

Phase III clinical trials, especially of antimalarial therapies and pharmacoepidemiology/drug utilization studies

Residency training

The department is accredited for residency training in Clinical pharmacology and Therapeutics by the National Postgraduate Medical College of Nigeria and The West African College of Physicians. Residency training commences after candidates pass primary examination(s) in Internal Medicine;

Pre-Part I

Residents’ rotation during the pre-part I postings is mainly undertaken (and organized) in the Department of Medicine.

Rotation through core specialties of: Neurology, Cardiology, Gastroenterology and liver diseases, endocrinology, dermatology, Respiratory Medicine.

Other rotations: Psychiatry, Haematology, Radiology, Medical Microbiology, Chemical Pathology, Emergency/ICU.

Post-part I

Residents continue to attend clinical meetings like Charts review, grand round, and postgraduate seminars while paying special attention to the requirements of the subspecialty of CPT as listed below.  In addition, residents are encouraged to register for MSc Pharmacology programme, hence unfettered access to facilities within (mainly) our University of Ibadan.

·         Resident is attached to, and actively participates in on-going clinical drug trials in the department (continuously for 1 year and subsequently on an ad-hoc basis)

·         Residents attend the Drug and Therapeutics Committee (DTC) meetings (throughout the post-part 1 stage)

·         Residents attend the Pharmacovigilance Committee meetings (throughout the post-part 1 stage)

·         Residents spend 4 weeks at Drug manufacturing plant

·         A six-month posting (rotation) in general medicine during the 2nd year post-part 1.  Subsequently, residents are encouraged to participate in activities of any sub-specialty of choice in addition to the mandatory 6 months’ rotation in selected subspecialties.

·         Residents undergo tutelage at our University of Ibadan animal facility

·         Residents provide tutorials for MBBS/BDS students of our University of Ibadan (throughout post-part 1 stage)

Other Unit/Departmental activities

Drug review/Case Presentation – provides an avenue for in-depth discussion on selected drug and/or drug management of an identified patient.  Discussions usually include: pharmacokinetics, pharmacodynamics, drug toxicity, adverse drug reactions, clinically important drug interactions relating to the selected drug(s) etc.  Invitations are usually extended to Hospital Pharmacist with a view to generating robust discussion and improve patient care and residents’ training.

·         Wednesday, 7:30am

·         Friday, 7:30am

·         Clinical Pharmacology Seminar – this weekly (Monday, 3pm) seminar was established to discuss topical issues relating to emergency medicine, toxicology, clinical drug trials, and journal reviews etc.  It also offers an opportunity for manuscript drafting/writing/critiquing and other sundry research-related activities.

Other unit/Departmental facilities (Primary and Secondary)

·         Clinical Research Room – CI3rd Clinical Pharmacology ward

o   Nine (9) beds

o   A side laboratory – equipped with microscopes, centrifuges, deep freezers, pH meter, water-bath

o   Internet-enabled desktop for storage and sourcing drug-related data

·         Drug Information Centre–located in the Pharmacy Department of the Hospital

·         HPLC and animal experimental facility – Professor Grace O. Gbotosho’s laboratory located in the Institute for Advanced Medical Research & Training, College of Medicine, University of Ibadan.  Residents are also exposed to animal experimentation in the Department of Pharmacology & Therapeutics, College of Medicine, University of Ibadan, Ibadan, Nigeria.

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