Sherif Mahmoud, BSc(Pharm), MSc, PhD, FNCS

Area of Study / Keywords

Translational Pharmacotherapy Pharmacokinetics Neurocritical Care Epilepsy Subarachnoid Hemorrhage Augmented Renal Clearance Antiseizure Medications Patient Assessment Pharmacogenomics

About

Dr. Sherif Mahmoud is a Clinical Professor and the Associate Dean, Academic, at the Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta. He is also a neurocritical care clinical pharmacist at the University of Alberta Hospital. He received his BSc (Pharm) degree and Master’s in Clinical Pharmacy from Ain-Shams University and his PhD in pharmacokinetics from the University of Alberta. This is in addition to his clinical research training at Harvard Medical School. He has been involved in pharmacy practice for more than 25 years where he had many roles as a clinician, researcher, educator and leader. Dr. Mahmoud’s research areas include epilepsy, antiseizure medications, neurocritical care pharmacotherapy and altered action and disposition of drugs in critical illness. Dr. Mahmoud studies how neurological injury and other patient factors alter the pharmacokinetics and pharmacodynamics of drugs, an important avenue for personalized pharmacotherapy. This is in addition to teaching patient assessment skills in various practice settings. His approach to patient assessment is unique and exceptional as acknowledged by his students and peers. In addition, he is the sole editor of “Patient Assessment in Clinical Pharmacy: A Comprehensive Guide”, an indispensable resource for pharmacists looking to learn or improve crucial patient assessment skills relevant to all pharmacy practice settings. Dr. Mahmoud is actively involved with the Neurocritical Care Society committees including the research and pharmacy leadership committees. Dr. Mahmoud received multiple accolades for his role in neurocritical care and he is inducted as Fellow of the Neurocritical Care Society (FNCS) for his exceptional service, academic excellence, and leadership in the field of Neurocritical care. His work has significantly advanced personalized pharmacotherapy and patient care in neurocritical settings. In recognition of his career journey, Dr. Mahmoud got named as the Canadian Pharmacists Association 2024 Canadian Pharmacist of the Year.

Dr. Mahmoud's Lab Website - Neurotherapeutics and Clinical Pharmacokinetics Laboratory (Neuro-CPK)

Education

GCSRT – Clinical Research Training, Harvard Medical School

Advanced training in methods and conduct of clinical research (clinical trials and epidemiology) 

PhD, Pharmacokinetics, University of Alberta

Master of Science, Clinical Pharmacy, Ain Shams University

Bachelor of Science, Pharmacy, Ain Shams University

Clinical Practice

Neurosciences Intensive Care Unit, University of Alberta Hospital, Edmonton, Alberta

Select Awards

Canadian Pharmacist of the Year, Canadian Pharmacists Association (2024)

2024 Presidential Citation, Neurocritical Care Society Annual Meeting (2024)

Teaching Excellence Award (Year 3), Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta (2024)

2023 Presidential Citation, Neurocritical Care Society Annual Meeting (2023)

2021 Presidential Citation, Neurocritical Care Society Annual Meeting (2021)

Fellow of the Neurocritical Care Society - FNCS (2020)

2020 Presidential Citation, Neurocritical Care Society Virtual Annual Meeting (2020)

2018 Presidential Citation, Neurocritical Care Society, Annual Meeting (2018)

Teaching Excellence Award, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta (2016)

Preceptor Recognition Award, Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta (2016) 

Staff Pharmacist of The Year, University of Alberta Hospital Pharmacy, Alberta Health Services (2010)

Publications – A complete list of publications can be found here.

Books and Book Chapters 

1. Patient Assessment in Clinical Pharmacy: A Comprehensive Guide (Springer Nature; 2019) - Editor. Link to Book is here

2. Drugs and Drugs: A Practical Guide to the Safe Use of Common Drugs in Adults - Section Co-editor (Neurologic Agents)

Research

Dr. Mahmoud's research (Neuro-CPK lab) centers on understanding how neurological injuries influence drug action and disposition. The lab bridges basic research with clinical applications to improve patient outcomes. The overall goal of the Neuro-CPK lab is to translate benchside and bedside observations into clinical practice protocols that will potentially improve outcomes in patients with neurological illnesses including neurocritical care population. This goal is pursued through diverse methodologies, including critical appraisal of clinical trials, systematic reviews and meta-analyses, design and conduct of retrospective and prospective observational studies, pharmacokinetic studies and clinical trials. Additionally, the lab incorporates wet lab techniques to investigate the underlying pathophysiological changes driving observed alterations in drug pharmacokinetics and pharmacodynamics. This multifaceted approach enables a comprehensive understanding of the challenges faced by patients with neurological conditions, guiding personalized therapeutic strategies to improve efficacy and safety. 

Funding: Canadian Institutes for Health Research (CIHR), University Hospital Foundation (UHF), Canadian Society of Hospital Pharmacy Foundation (CSHP Foundation)

1. Subarachnoid Hemorrhage

Subarachnoid hemorrhage (SAH) is a neurological emergency characterized by the extravasation of blood into the subarachnoid space. Although SAH accounts for 5% of all strokes, given the relatively younger age at onset, it has a significant burden on productive-life years. The average mortality rate for SAH has been reported to range from 30-50%, with a significant proportion of survivors left with disability. Neurological and medical complications are common after SAH and contribute significantly to the overall prognosis. The aim of this research is pharmacotherapy optimization of existing therapies and translation of new therapeutics in SAH for the sake of preventing those complications and improving patient outcomes. 

2. Augmented Renal Clearance

Augmented Renal Clearance (ARC) is a phenomenon of enhanced kidney function seen in critically ill patients.  ARC has a significant influence on how medications are removed from the body potentially resulting in insufficient doses and treatment failure subsequently leading to poor patient outcomes and increased health care cost. Therefore, patients with ARC require higher medication doses; however, ARC is largely undetected using kidney assessment methods currently used in practice. In addition, it is not clear how medications should be dosed in those with ARC. The majority of ARC research has not focused on neurocritical care patients where ARC predominantly exists. Therefore, our research aims to characterize the phenomenon of ARC in patients with life-threatening neurological illnesses through identifying the prevalence, risk factors and clinical impact of ARC and to guide improved dosing strategies of commonly used drugs in the ICU.

3. Epilepsy and Status Epilepticus

Epilepsy affects more than 50 million people worldwide and is characterized by recurrent unprovoked seizures. One of the main goals of treatment is to improve patient quality of life by optimizing the balance between seizure control and side effects of the antiseizure medications (ASMs). Although the majority of patients can be adequately controlled with ASMs, a significant number, estimated to be as high as 30 % stay uncontrolled with conventional medical treatment. This can be further complicated if a patient has other comorbidities contributing to poor control.  The aim of this research is pharmacotherapy optimization of AEDs in epilepsy patients with superimposing comorbidities.

Status epilepticus (SE) is the second most common life-threatening neurological illness in the world. It is defined by the International League Against Epilepsy (ILAE) as “a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms which lead to abnormally prolonged seizures (after time point t1). It is a condition that can have long-term consequences (after time point t2), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures.” Due to the significant amount of morbidity and mortality associated with SE, determination of the most effective therapies, particularly in refractory forms of SE, is essential. The aim of this research is pharmacotherapy optimization of existing therapies and translation of new therapeutics in SE for the sake improving patient outcomes.

4. Herpes Encephalitis 

Herpes encephalitis is a life-threatening viral infection of the brain caused primarily by herpes simplex viruses (types 1 and 2) and, less commonly, the varicella-zoster virus. Early administration of acyclovir significantly reduces morbidity and mortality. Without optimal treatment, the mortality rate is approximately 70%, but this can be reduced to around 20% with prompt initiation of acyclovir. The primary aim of this research is to optimize pharmacotherapy and facilitate the translation of new treatments for herpes encephalitis.

Teaching

Teaching Areas:

Patient Assessment Skills for Clinical Pharmacists

Patient assessment is the first step within the pharmacy patient care process, a framework for pharmacists practice. Patient assessment is an integral component of pharmacists’ day-to-day practice regardless of their practice setting (community, hospitals, and specialized clinics). Therefore, acquiring patient assessment skills is indispensable for proper patient care. Dr. Mahmoud is the editor of “Patient Assessment in Clinical Pharmacy: A Comprehensive Guide”, an indispensable resource for pharmacists looking to learn or improve crucial patient assessment skills relevant to all pharmacy practice settings.

Management of Neurological Disorders for Pharmacists 

This includes, but not limited to, headache disorders, seizures and epilepsy, antiseizure medications, neuropathies, stroke, traumatic brain injury  

Clinical Pharmacokinetics

Basic and advanced principles in pharmacokinetics and their application in clinical practice. 

Clinical Decision Making Skills for Pharmacists

Advanced skills to facilitate critical thinking, evidence search and appraisal and decision making in clinical practice 

Courses Taught at the University of Alberta: 

PHARM 444: Neurology and Oncology

PHARM 448: Advanced Pharmacotherapy

EXPH 2553: CCPP Pharmacotherapy I

PHARM 312: BASE III (Behavioral, Administrative, Social and Evidence based Pharmacy)

PHARM 203: Introduction to Pharmacology

PHARM 417: Neurology

PHARM 447: Psychiatry

PHARM 489: Seminars in Therapeutics and Professional Practice

PHARM 503: Advanced Pharmacotherapy

PHARM 523: Advanced Pharmacotherapy - Part I

PHARM 532: Patient Assessment

PHARM 533: Advanced Pharmacotherapy - Part II

Nursing 215: Pharmacotherapeutics in Nursing (Faculty of Nursing)

PMCOL 306: Drug Disposition and Metabolism (Dept. of Pharmacology, Faculty of Medicine and Dentistry)

BIOCH 415: Metabolic Modifications in Health and Disease (Dept. of Biochemistry, Faculty of Medicine and Dentistry)

PHARM 448 - Pharmacotherapy 10

Students will expand their knowledge and skills in order to provide care to various patient populations. Students will engage in active learning and focus on using evidence, applying the biopsychosocial model, making decisions, monitoring outcomes, and adjusting drug therapy for complex patients across the age spectrum. Students will further develop their critical thinking and advocacy skills in the provision of care. (Restricted to Pharmacy students.)

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2024 November;