Natalie Medlicott

Natalie Medlicott
University of Otago · School of Pharmacy

PhD BPharm(Stats)

About

133
Publications
15,581
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1,746
Citations
Citations since 2017
41 Research Items
863 Citations
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2017201820192020202120222023050100150
2017201820192020202120222023050100150
2017201820192020202120222023050100150

Publications

Publications (133)
Article
Full-text available
Objective To determine if very low dose (VLD, 0.5% phenylephrine, 0.1% cyclopentolate) mydriatic microdrop (approximately 7 μL) administration (up to three doses) is non-inferior to low dose (LD, 1% phenylephrine, 0.2% cyclopentolate) mydriatic microdrop administration for ophthalmologist-determined successful retinopathy of prematurity eye examina...
Article
Full-text available
Women face complicated decisions regarding psychotropic medication use during pregnancy. Patient decision aids (PDAs) could be a valuable tool to assist with decision-making. The objective of this review was to evaluate the effectiveness of PDAs in this population. A systematic search of the literature was conducted using PRISMA guidelines. Three m...
Article
Full-text available
Purpose Ketamine has rapid-onset antidepressant effects in patients with treatment-resistant depression. Common side effects include dissociation (a sense of detachment from reality) and increases in systolic and diastolic blood pressure. The objective of this structured review was to examine the effect of ketamine formulation and route of administ...
Article
Full-text available
Background: COVID-19 has caused calamitous health, economic and societal consequences globally. Currently, there is no effective treatment for the infection. Areas covered: We have recently described the NZACE2-Pātari project, which seeks to administer modified Angiotensin Converting Enzyme 2 (ACE2) molecules early in the infection to intercept and...
Article
Objective This study was aimed to determine mydriatic regimen(s) used in neonatal units in Aotearoa New Zealand (NZ) and Australia and to estimate the frequency of adverse drug events following mydriatic administration in preterm neonates. Study Design A cross-sectional survey was sent to neonatal nursing staff listed in the Australian and New Zeal...
Article
Manuka oil, an essential oil derived from the Leptospermum scoparium, has been traditionally used for wound care and as a topical antibacterial, antifungal, and anti-inflammatory. However, the essential oil is not well retained at mucosal sites, such as the oral cavity, where the benefits of the aforementioned properties could be utilized toward th...
Article
Full-text available
INTRODUCTIONDabigatran etexilate has become widely used in New Zealand, but information relating to when renal function monitoring is being undertaken is lacking. AIMTo investigate if clinically appropriate renal function monitoring is being undertaken in New Zealand primary care for stroke prevention in non-valvular atrial fibrillation patients pr...
Article
Aims To determine if Very low dose mydriatic eye microdrop regimen sufficiently dilates the pupil (above 4.1 mm) compared with the currently used low dose mydriatic eye microdrop regimen. Cardiovascular, gastrointestinal and respiratory adverse effects occur following eye drop instillation. Methods Seventeen premature infants were recruited into t...
Article
The synthesis and specific surface functionalization of antimicrobial silver nanoparticles (AgNPs) and their incorporation into an alginate hydrogel is described. Divalent cation-mediated ionic crosslinking was used to disperse the AgNPs throughout the gel, made possible by –COO- cross-linking sites provided by the surface-enhanced nanoparticles, i...
Article
Full-text available
COVID-19 is a new zoonotic disease caused by the SARS-CoV-2 virus. Since its emergence in Wuhan City, China, the virus has rapidly spread across the globe causing calamitous health, economic and societal consequences. It causes disproportionately severe disease in the elderly and those with co-morbidities, such as hypertension and diabetes. There i...
Article
Full-text available
Background Ketamine’s defining side effects are dissociation and increased blood pressure/heart rate. An oral formulation with delayed absorption could minimize these effects. We recently reported safety and tolerability data for an extended release ketamine tablet in healthy volunteers. Methods To assess safety, tolerability, efficacy, and pharma...
Article
Parenteral ketamine has fast‐onset antidepressant and antianxiety effects; however, it causes dissociation, hypertension, and tachycardia shortly after dosing. Ketamine's antidepressant effects may be due to active metabolites rather than to ketamine itself. We hypothesized that oral controlled‐release ketamine tablets would improve safety and tole...
Conference Paper
Full-text available
Ketamine acts swiftly in a range of neurotic disorders even in patients resistant to conventional antidepressant and anxiolytic drugs. We recently reported effects of ketamine on frontal EEG in patients with treatment-resistant (TR) generalised anxiety (GAD) and social anxiety (SAD) disorders. Ketamine increase high frequency EEG power, and decreas...
Article
Full-text available
Background We previously reported that ketamine has anxiolytic effects in patients with treatment-resistant generalized anxiety and social anxiety disorders. Aims The purpose of this study was to replicate our earlier report about ketamine‘s anxiolytic activity, using a more robust study design. Methods This was a double-blind, psychoactive-contr...
Article
Full-text available
Background Dabigatran etexilate has become widely used for the prevention of stroke in patients with nonvalvular atrial fibrillation (NVAF). Currently, there is limited information in real-world patients relating to dabigatran etexilate exposure and response. Methods This retrospective cohort study used administrative health data for NVAF patients...
Article
Background Gentamicin is commonly used in the NICU setting and is often administered via long lines, which increases variability in the rate of administration. We aimed to model drug delivery pharmacokinetic parameters for intravenous gentamicin administered via umbilical venous catheters (UVCs). Methods Data was modelled from infusion simulations...
Article
Full-text available
Objective Urine collection and analysis is important for diagnosis, monitoring of clinical progress, and research in neonates. This study aims to validate a novel methodology for neonatal urine collection, which combines the convenience of cotton ball collection with accurate timing via a urine continence monitor. Design Laboratory model using a c...
Article
Full-text available
Introduction Routine retinopathy of prematurity eye examinations are an important part of neonatal care, and mydriatic medicines are essential in dilating the pupil for the eye examination. There are concerns about the level of evidence for efficacy and safety of these mydriatic medicines. Objective This review evaluates both efficacy and safety e...
Article
Full-text available
Purpose Worldwide, the use of insulin pumps for the management of type 1 diabetes is increasing. There are no national or international published guidelines and few guidance recommendations detailing the education and training required to commence insulin pump therapy. The aim of this study is to describe current clinical practice regarding initiat...
Article
Full-text available
INTRODUCTION: Dabigatran etexilate is now prescribed for 51% of the patients receiving oral anticoagulation treatment in New Zealand. Its prescribing trends in relation to patient outcomes are, however, largely unknown for these patients. AIM: To describe patient characteristics, effectiveness and safety of treatment with dabigatran etexilate in th...
Article
In this paper, we present an ordinary differential equation model depicting the interactions of basic fibroblast growth factor (bFGF) and its binding agents in a chronic wound. The delivery of bFGF was treated as a control variable and is coupled to an objective functional. By optimising the objective functional with respect to the control, predict...
Article
Full-text available
Background Clinical significance of dosing dabigatran with different estimates of renal function for treatment of atrial fibrillation (AF) is unknown. Renal function is routinely estimated by the chronic kidney disease epidemiology initiative equation (CKD-EPI) and used to guide dosing. The aim of this study was to investigate the risk of adverse o...
Article
Purpose Insulin dose requirements at new diagnosis of type 1 diabetes mellitus (T1DM) vary widely. Current guidelines recommend an initial total daily dose (TDD) ranging from 0.5 to 1.0 IU/kg/day. It often takes several days of frequent dose adjustments before an optimal insulin dose is achieved. The aim of this study was to identify the influence...
Article
Background: Ketamine has been shown to produce a rapid and potent antidepressant response in patients with treatment-resistant depression. Currently ketamine is most commonly administered as a 40-minute intravenous infusion, though it is unknown whether this is the optimal route of administration. Aims: To determine the plasma concentration time...
Article
Full-text available
Background: Recently, New Zealand has taken a system wide approach providing the biggest reform to New Zealand community pharmacy for 70 years with the aim of providing more clinically orientated patient centred services through a new funding model. The aim of this study was to understand the types of services offered in New Zealand community phar...
Article
Objective: In this maintenance treatment study, we sought to evaluate the effect on anxiety ratings, safety and tolerability of 3 months of weekly ketamine in 20 patients with treatment-refractory DSM IV generalised anxiety disorder (GAD) and/or social anxiety disorder (SAD), and subsequent assessment of remission post-treatment. Methods: This w...
Article
Aim: To describe the current clinical practices and attitudes of neonatologists towards paracetamol treatment of PDA in Australia (AU) and New Zealand (NZ). Method: A web-based survey of all neonatologists registered under the 2017 Australia New Zealand Neonatal Network (ANZNN) was conducted. Results: The response rate for the survey was 67%,...
Article
Peripheral BDNF changes after ketamine administration have been proposed as a biomarker for brain BDNF changes. However, published data are conflicting and come from studies in paired animal groups. This study determined the time course of plasma BDNF concentrations following the administration of a single 10 mg/kg dose of ketamine by different rou...
Article
Protein drugs may encounter conformational perturbations during the formulation processing of lipid-based solid dosage forms. In aqueous protein solutions, attenuated total reflection Fourier transform infrared (ATR FT-IR) spectroscopy can investigate these conformational changes following the subtraction of spectral interference of solvent with pr...
Article
Protein biologics are prone to conformational changes during formulation development. Limited methods are available for conformational analysis of proteins in solid state and in the presences of formulation excipients. The aim of this study was to investigate the secondary structures of proteins encased in solid lipid matrices as a novel indicator...
Article
Background There are concerns regarding codeine in the <2 years age group, particularly in the context of post-tonsillectomy analgesia. Tramadol, although ap-proved for children in New Zealand (NZ), is not approved. <2 years age. From 2014, practice guidelines in NZ dis-couraged the use of codeine and tramadol in children. The WHO analgesic ladder...
Poster
Full-text available
Approximately 3,500 infants in New Zealand and Australia are screened annually for retinopathy of prematurity (ROP). To view the retina and diagnose ROP, adequate pupil dilation with mydriatic medicines is required. Although mydriatic drops are in common use in NICUs, there is no established or preferred mydriatic regimen in New Zealand and Austral...
Article
Full-text available
Objectives To explore and compare the relationships between postmenstrual age (PMA), insulin, C-peptide and blood glucose concentrations (BGC) in hyperglycaemic and euglycaemic preterm neonates (PMA <30 weeks). Design Observational. Setting Dunedin Hospital Neonatal Intensive Care Unit, New Zealand. Patients Preterm neonates were recruited and i...
Article
Aim: Researchers have recently developed a novel oily formulation for potential use as a saliva substitute for the treatment of dry mouth. The aim of this randomised, cross-over study was to compare this new formulation to a currently available saliva substitute and a control of water on measures of mastication, subjective feeling of oral dryness...
Poster
Full-text available
Aims: Very preterm infants require mydriatic eye drops in preparation for retinopathy of prematurity examination. Mydriatic dosing needs to provide adequate pupil dilation for the examination and yet, avoid adverse effects. Although the relative frequency of mydriatic administration is high, there is no established or preferred mydriatic regimen in...
Article
The N-methyl-D-aspartate receptor antagonist ketamine has rapid onset activity in treatment-resistant depression, post-traumatic stress disorder and obsessive compulsive disorder. Due to similarities in brain network activity in depression and anxiety disorders, we hypothesized that ketamine might also be active in other refractory anxiety disorder...
Article
Full-text available
Aim Antibiotic resistance mediated by extended-spectrum β-lactamases (ESBL) and AmpC β-lactamases is widespread and increasingly common, often rendering empiric antibiotic therapy ineffective. In septicemia, delays in initiating effective antibiotic therapy are associated with worse clinical outcomes. With current phenotypic antimicrobial susceptib...
Article
Objectives: To explore the relationships between postmenstrual age (PMA), insulin, C-peptide, glucagon and blood glucose concentrations (BGCs) in preterm and term neonates. To compare glucagon-like peptide-1 (GLP-1) concentrations in fed versus never-fed neonates. Design: Observational. Setting: Dunedin Hospital Neonatal Intensive Care Unit, N...
Article
Objectives: This pilot study aimed to compare the in-mouth retention of an oil-based saliva substitute (emulsion, consisting of rice bran oil, soy lecithin and water) with water and a 1% w/v methylcellulose suspension (polymer) in healthy volunteers. Methods: Each formulation was tagged with 1mmol/L lithium and participants (n=30) rinsed their m...
Article
Introduction Preterm birth disrupts normal timing of physiological adaptation of insulin secretion putting premature neonates at risk of abnormal glucose homeostasis. The insulin/C-peptide (I/CP) ratio gives an indication of insulin clearance but has not been reported in neonates. Premature neonates have significantly higher fasting levels of GLP-1...
Article
Introduction Delayed gentamicin delivery through intravenous lines has been reported.Delay is expected to be greater in smaller neonates when the flow rate of carrier intravenous fluid and dose volumes are low. Aim To investigate the effects of neonate GA and weight on gentamicin peak concentrations after 30 minute infusion or bolus administrations...
Conference Paper
Background The New Zealand Formulary for Children (NZFc) was developed to build on the New Zealand Universal List of Medicines through the addition of clinical information about medicines use in paediatrics. The structure and content of the NZFc is based on the British National Formulary for Children (BNFc) but is adapted for New Zealand practice....
Article
INTRODUCTION: A major barrier to conducting pharmacokinetic studies in neonates is the relatively large blood volume required by most assays. The use of dried blood spots (DBS) has potential to enable use of smaller volumes and simplify sample processing and handling. AIM: To determine the effect of haematocrit on insulin concentrations from DBS. M...
Article
The administration of drugs to neonates poses significant challenges. The aim of this review was to provide insight into some of these challenges and resolutions that may be encountered with several of the most commonly used routes of administration and dosage forms in neonatal care, including oral, parenteral, transdermal, intrapulmonary, and rect...
Article
The aim of this study was to measure urinary C-peptide concentrations, and then calculate C-peptide clearance (Cl), and excretion rate (UER) in neonates. In addition, the effect of gestational age (GA) and blood glucose levels (BGL) on C-peptide UER were investigated. Insulin concentrations in plasma and C-peptide concentrations were measured in pl...
Article
The objectives of this study were to investigate the adsorption behavior of lysozyme (LSZ) onto magnesium aluminum silicate (MAS) at various pHs and to characterize the LSZ-MAS microparticles obtained from the molecular interaction between LSZ and MAS. The results showed that LSZ could be bound onto the MAS layers at different pHs, leading to the f...
Article
Full-text available
Forensic science has been portrayed in television, journalism, and fiction for over a century. Since the launch of the flagship television show “CSI: Crime Scene Investigation” in 2000, much has been made of the so-called “CSI Effect”. However, forensic science had been incorporated into many traditional media long before CSI. We used Ngaio Marsh’s...
Article
This study describes how protein release from polymer matrices correlate with simple measurements on the intrinsic viscosity of the polymer solutions used for casting the matrices and calculations of the solubility parameters of polymers and solvents used. Matrices of poly(DL-lactide-co-glycolide) (PLGA) were cast with bovine serum albumin (BSA) as...
Article
Objectives Enoxaparin is a low-molecular weight heparin (LMWH) widely used for the treatment of thrombosis and measured through a chromogenic assay (anti-Xa). The aim of this project was to investigate the impact of patient and sampling sources of variation on an anti-Xa assay for enoxaparin.MethodsCOATEST was used in accordance with manufacturer's...
Article
Paracetamol is one of the most common pharmaceutical agents taken in self-poisonings and may increase the prothrombin time (PT) through liver injury, and in overdose without hepatic injury by reducing functional factor VII [1-4]. PT is a measure of hepatic injury used to predict and monitor hepatotoxicity, reported as the International Normalised R...
Article
Intravenous acetaminophen is a commonly used analgesic following surgery. The aims of this study were to determine the population pharmacokinetic profile of intravenous acetaminophen and its metabolites in adult surgical patients and to identify patient characteristics associated with acetaminophen metabolism in the postoperative period. 53 patient...
Article
Intravenous drug administration presents a series of challenges that relate to the pathophysiology of the neonate and intravenous infusion systems in neonates. These challenges arise from slow intravenous flow rates, small drug volume, dead space volume and limitations on the flush volume in neonates. While there is a reasonable understanding of ne...
Article
Full-text available
Efficacy and safety concerns have been raised in the literature with the use of tribromoethanol (TBE) (Avertin(®)) for anesthesia in rats and mice when administered by intraperitoneal (IP) injection. Despite the controversy, it remains in common usage as an anesthetic agent in laboratory rodents for short-term surgical procedures. Cyclodextrins hav...
Article
The aim of this study was to validate the use of lithium as a marker to indicate the retention of simple liquids in the oral cavity and use this to determine how much liquid is retained in the oral cavity following 30 s of rinsing. This is a validation study in which saliva was spiked with known concentrations of lithium. Twenty healthy participant...
Article
The purpose of the present study was to investigate lecithin-rice bran oil rheological properties with the view to consider these as potential saliva substitutes in patients with severe xerostomia and salivary hypofunction. Pseudo-ternary phase diagrams of rice bran oil, lecithin and water mixtures were constructed and characterised using polarisin...
Conference Paper
This study investigated the effect of sol-vents on the uncoiling of four different line-ar polymers. Solubility parameters were used to represent solubility power towards the polymers, while the intrinsic viscosity of the polymer solution was used as a represen-tation of polymer conformation/uncoiling. This approach may be used to control poly-mer...
Conference Paper
Objectives: To investigate the use of lithium, a ubiquitous, non-radioactive cation, as a marker for retention of aqueous dosage forms in the oral cavity. Methods: Lithium carbonate (0-1.1 mmol/L) was dissolved in distilled water, buffered to pH 7.4 and used to spike saliva samples collected from a single donor. Potassium was added to some sample...
Conference Paper
Objectives: To characterise the physicochemical properties of an emulsion for potential use as a saliva substitute in patients with xerostomia. Methods: A pseudo-ternary diagram containing biocompatible components rice bran oil(RBO), 1:1 lecithin/propylene glycol mix(SM) and water(W) was characterised. Flow rheological and viscoelastic properties...
Article
Full-text available
To investigate infusion variables that delay delivery of gentamicin through neonatal infusion lines. Infusions were set up to simulate administration of gentamicin to neonates. The primary infusion was 10% dextrose (Baxter Colleague pump). A syringe driver was used to deliver a coloured marker via the T-connection over 35 min followed by a 1 ml nor...
Article
Bovine serum albumin (BSA) adsorption to oil-water interfaces was studied in the presence and absence of two linear polymers poly(dimethylamino)ethyl methacrylate (PDMAEMA) and PDMAEMA-block-[poly Bu acetate]38700-PDMAEMA33000 (PBuA). As the hydrophobicity of the polymers is pH dependent, the pH was varied using pH 6.6, 7.0 and 7.4 during the measu...
Chapter
Biomaterials have found application in cutaneous wound healing either as the basis of wound dressings or as platforms for the delivery of therapeutic agents into wounds. Increased wound epithelialization was first reported in pigs following application of occlusive dressings made from polyethylene films by Winter in 1962 and has led to the current...
Article
Background: Intravenous (IV) paracetamol is commonly used in the postoperative period for the treatment of mild to moderate pain. The main pathways for paracetamol metabolism are glucuronidation, sulfation, and oxidation, accounting for approximately 55%, 30%, and 10% of urinary metabolites, respectively. The aim of this study was to describe the...
Chapter
Safety and efficacy for protein nanopharmaceuticals are as important as for any other medicinal product. Most often long-term safety is difficult to assess and therein lies the challenge, it is essential to maintain the protein in its active form and avoid introduction of structural changes or aggregation. In this chapter, we will discuss the reaso...
Article
The objective of this study was to describe the construction of a non-invasive device for the collection of submandibular saliva. Preliminary tests were carried out on saliva collected from a single donor in order to determine whether the rheological properties of submandibular saliva collected using the device were comparable to whole saliva colle...
Chapter
Understanding how the biological environment contributes to drug release following administration is increasingly becoming a focus for drug delivery research. Achieving therapeutic levels of a bioactive relies on appropriate drug release following parenteral administration that must be complimentary to subsequent drug absorption, distribution, meta...
Article
Full-text available
Introduction: In the area of peptide and protein drug products, interfaces are present as part of the basic liquid formulation, when freeze-dried formulations are reconstituted and when particulate delivery systems are prepared. Proteins are known to interact with these interfaces, and the effects seen are often irreversible adsorption and structu...