The laboratory

Clinical Pharmacology Service "Franco Ghezzo"

Officially recognized by the Piedmont Region in March 2009, the Clinical Pharmacology Service has a mixed nature, both hospital and university-based. It is, to date, a drug dosing service aimed at therapeutic drug monitoring (TDM). Franco Ghezzo was a pharmacology professor, the creator of the project, who passed away at the age of 53 in 2006. The service is provided within the AOU San Luigi Gonzaga, in Orbassano. Professor Francesco Di Carlo coordinated the laboratory for two years before passing the responsibility to Professor Giuseppe Poli, Professor of General Pathology, and later to Professor Silvia Racca, Associate Professor of Pharmacology.

Timeline of the Laboratory

2002: Analytical methods are developed for drugs with a narrow therapeutic window at the University Pharmacology Laboratory of the Department of Clinical and Biological Sciences at the University of Turin. The requests primarily involved the analysis of hydroquinidine, an antiarrhythmic drug used for short QT syndrome, and mitotane, an antitumor drug used in the treatment of adrenal cortical carcinoma.
2006: Following the untimely death of Professor Ghezzo, the service is taken over by Professor Francesco Di Carlo. The work continues and is expanded into the oncological-hematological field, with the development of new methods for quantifying tyrosine kinase inhibitors (imatinib, dasatinib, and nilotinib) in leukemia patients.
March 1, 2009: The laboratory becomes the Clinical Pharmacology Service, officially recognized as a hospital structure affiliated with Internal Medicine I, which was directed by Professor Alberto Angeli at the time.
January 4, 2010: The Clinical Pharmacology Service is integrated into the laboratory of San Luigi, providing Therapeutic Drug Monitoring (TDM) analyses as a hospital service. The service also expands its drug dosing activity by developing specific methods for quantifying new drugs, responding to requests from specialized departments. The list of drugs now includes voriconazole and posaconazole (antifungals), deferasirox (iron chelator), haloperidol (antipsychotic), flecainide, amiodarone, and propafenone (antiarrhythmic drugs), and dexamethasone (steroidal anti-inflammatory).
September 17, 2012: The Clinical Pharmacology Service is asked to measure additional new drugs. Following requests from the Regional Laboratory Commission, the service develops new analyses for patients from both A.O.U. San Luigi and ASL TO3 (OO.R.R. of Rivoli: Rivoli, Giaveno, Susa, Venaria, Avigliana; O. of Pinerolo: Pinerolo, Torre Pellice). New drugs requested include some antiepileptics: levetiracetam, oxcarbazepine and its metabolite, lamotrigine, and phenytoin; and antibiotics such as vancomycin and teicoplanin.
From 2012 to the present, despite intermittent setbacks due to reorganizations by the Regional Laboratory Commission, the service has remained active, sometimes facing significant workloads. Recently, the service developed three specialized and original assays at the request of the hematology department at San Luigi: the analysis of venetoclax in plasma, red blood cells, and PBMCs for patients with chronic lymphocytic leukemia. These assays were integrated into the service’s analyses at the beginning of 2022. Even more recently, the plasma determination of lacosamide (antiepileptic drug), hydroxyurea (anticancer drug), and desethylamiodarone (active metabolite of amiodarone) has been included, further enhancing the scope of antiarrhythmic activity.

To date, the laboratory is capable of reporting on several dozen drugs of various types: antitumor drugs, oncological-hematological drugs, antiepileptics, antifungals, antibiotics, iron chelators, anti-inflammatory drugs, cardiological drugs, and antipsychotics (Here is the full list). The requests that reach the service are currently of three types:

Analyses for patients within the Piedmont Region: Direct access to the San Luigi sample collection center with a referral from the attending physician or a specialist request.
Analyses for patients admitted to hospital facilities within the Piedmont Region: The sample arrives according to inter-hospital agreements.
Analyses for samples from patients outside the region: According to inter-regional agreements.

It is also possible to send a sample to request a TDM analysis: here are all the instructions. The equipment currently available at the service for TDM analyses consists of HPLC-UV instruments. The analyses are performed following guidelines and validated protocols (Eurachem Guides, The Fitness for Purpose of Analytical Methods: A Laboratory Guide to Method Validation and Related Topics).

Our Laboratory and the Tools We Use:

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