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Gwendolyn A. McMillin, Ph.D.
Assistant Professor (Clinical), University of Utah Pathology
Titles:
- Medical Director, Associated Regional and University Pathologists (ARUP) Laboratories, Clinical Toxicology, Salt Lake City, Utah.
- Medical Director, Associated Regional and University Pathologists (ARUP) Laboratories, Clinical Drug Abuse Testing, Salt Lake City, Utah.
- Medical Director, Associated Regional and University Pathologists (ARUP) Laboratories, Trace Elements, Salt Lake City, Utah.
- Co-Medical Director, Associated Regional and University Pathologists (ARUP) Laboroatories, Pharmacogenomics, Salt Lake City, Utah.
About Gwendolyn A. McMillin, Ph.D.
Dr. McMillin is interested in laboratory testing that supports and improves drug therapy. As such, she serves as the Medical Director at ARUP Laboratories over testing for therapeutic drugs, drugs of abuse, metals, and is Co-Medical Director over pharmacogenetics. She actively pursues research in these areas to better understand clinical utility of existing testing and to develop and validate new testing. Areas of recent focus include:
1. Pre-therapeutic pharmacogenetic testing to select warfarin dosing. Several analytical methods for warfarin genotyping have been evaluated in our pharmacogenetics laboratory, and a clinical study is underway in collaboration with the University of Utah Anticoagulation Services Group and the Orthopaedic Center. This study compares outcomes when warfarin dose is selected using genetic information as compared to outcomes when warfarin dose is selected using conventional means. Pharmacogenetic testing related to tamoxifen, irinotecan, and various neuroleptics have also been studied in our laboratory.
2. Application of liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) for quantitative testing of drugs in urine, blood, serum/plasma, and meconium has generated rapid multi-analyte tests with unheralded sensitivity and specificity. This technology is being applied in our drug testing laboratory to both drugs of abuse (e.g. opiates, benzodiazepines, nicotine) and therapeutic drugs (e.g. antipsychotics, anticonvulsants, antidepressants). The new assays, when compared to existing assays, exhibit dramatic improvements in efficiency, accuracy, sensitivity, specificity, and precision.
3. Metals are much like drugs, exhibiting variable absorption, metabolism, protein binding, and elimination. As such, laboratory tests designed to detect and quantify metals should consider the related pharmacokinetics or toxicokinetics. Recent projects conducted in our metals laboratory have focused on separating clinically or toxicologically significant fractions of metals for quantification. For example, we developed an arsenic fractionation method which separates and quantifies the various species of arsenic. This fractionation is important due to the differential toxic potential of inorganic arsenic, methylated metabolites of arsenic, and the relatively non-toxic but commonly observed organic forms of arsenic. We also developed a novel method for measuring the free fraction of copper, important to the diagnosis and monitoring of Wilson Disease.
Selected Publications
- REVIEW ARTICLES
- Clarke W, McMillin G, (2006) Emerging strategies for therapeutic drug management. Clinical Laboratory News, Apr;32(4):10-2.
- Clarke W, McMillin G,(2006) Application of TDM, pharmacogenomics and biomarkers for neurological disease pharmacotherapy: focus on antiepileptic drugs. Personal Medicine, May; 3(2)139-49.
- McMillin G, Lyon E, (2006) Contributions of genetic testing in personalized pharmacotherapy. Invited review for Advanced News Magazine for Administrators of the Laboratory, July;15(4)20.
- Bornhorst J, McMillin G, (2006) Trace and toxic elemental testing in clinical laboratory. Lab Medicine, 37(11):690-5.
- McMillin GA, Melis R, Lyon E. (2006) Cytochrome P450 genotyping by Tag-It. Expert Review of Molecular Diagnostics, 6(6):811-20.
- ORIGINAL PUBLICATIONS
- Juenke, J, Brown P, Urry F, McMillin, GA.(2006) A procedure for the monitoring of levetiracetam and zonisamide by HPLC-UV. Journal of Analytical Toxicology, Jan/Feb;30(1):27-30.
- Juenke J, Brown P, Urry F, McMillin, GA.(2006) A procedure for the monitoring of oxcarbazepine metabolite (MHD) by HPLC-UV. Journal of Chromatography. 44:45-8.
- Coles R, Kushnir M, Nelson G, McMillin GA, Urry FM.(2007) Simultaneous determination of codeine, morphine, hydrocodone, hydromorphone, oxycodone and 6-acetylmorphine in urine, serum, plasma, whole blood and mecronium by LC-MS/MS. Journal of Analytical Toxicology. Jan/Feb:31(1):1-10.
- Yang X, Janatova J, Juenk JM, McMillin GA, and Andrade JD.(2007) An ImmunoChip for simultaneous detection of antiepileptic drugs using an enhanced one-step homogeneous immunoassay. Anal Biochem. 365:222-9.
- Marin SJ, Coles R, Urry FM, McMillin GA. Confirmation Test for cannabinoids in meconium using two dimensional gas chromatography with mass spectrometry detection. Accepted for publication in J Chrom B. 2007.
- BOOK CHAPTERS
- McMillin GA and Hammett-Stabler CA.(2006) Therapeutic Drug Monitoring. In: Contemporary Practice in Clinical Chemistry. 2nd Ed. edited by W. Clarke and Dufour DR. American Association for Clinical Chemistry. pp. 453-64.
- Hammett-Stabler CA and McMillin GA.(2006) Toxicology and the Clinical Laboratory. In: Contemporary Practice in Clinical Chemistry. 2nd Ed. edited by W. Clarke and Dufour DR. American Association for Clinical Chemistry pp. 465-76.
- McMillin GA.(2007) Pharmacogenetics. In: Tietz Fundamentals of Molecular Diagnostics. 6th Ed., edited by C. Burtis, E. Ashwood and D. Bruns. Elsevier Saunders (St. Louis, MO.). pp. 197-215.
- Burtis C, Bruns D, Roberts W., McMillin GA. Reference Information for the Clinical Laboratory and Therapeutic Drugs. In: Tietz Fundamentals of Clinical Chemistry. 6th Ed. edited by C. Burtis, E. Ashwood, and D. Bruns. Accepted for publication in 2007 by Elsevier Saunders.
- Moyer T., McMillin GA and Shaw L. Therapeutic Drugs. In: Tietz Fundamentals of Clinical Chemistry. 6th Ed., edited by C. Burtis, E. Ashwood, and D. Bruns. Accepted for publication in 2007 by Elsevier Saunders.
- McMillin GA and Bornhorst JA. Toxic Element Testing with Clinical Specimens. In: Handbook of Drug Monitoring Methods, edited by A. Dasgupta. Accepted for publication in 2007 by Humana Press.
- All Publications: Click Here
Courses Taught:
Honors and Awards
- 1993 Association for Women in Science Award
- 1993 Pre-doctoral Fellowship Award ($6,000), American Foundation for Pharmaceutical Education
- 2003 Paul E. Strandjord Young Investigator Award, Academy of Clinical Laboratory Physicians and Scientists
- 2004 Paul E. Strandjord Young Investigator Award, Academy of Clinical Laboratory Physicians and Scientists
- 2004 Young Investigator Award, TDM and Toxicology Division of the American Association for Clinical Chemistry
Professional Education
- 1985-1989 B.A. Grinnell College (Psychology) Grinnell, IA
- 1990-1994 Ph.D. University of Utah (Pharmacology) Salt Lake City, Utah
- 2001-2004 Post-doctoral Fellowship University of Utah (Clinical) Chemistry Salt Lake City, Utah