Klinická farmakologie a farmacie – 4/2020

www.klinickafarmakologie.cz / KlinFarmakol Farm2020; 34(4): 152–157 / KLINICKÁ FARMAKOLOGIE A FARMACIE 157 ORIGINÁLNÍ PRÁCE Comparison of DOS and Windows version of the MwPharm – a pharmacokinetic software for PK/PD monitoring of digoxin patients > 65 years, including thosewith pre‑ served systolic function and at higher serum digoxin concentration, digoxin reduces HF hospitalization but has no effect onmortality or all‑cause hospitalizations [16]. Due to the fact that during routine TDM we focus prioritally on a safety (avoiding overdose, revealing non‑compliance), the one‑compartment (pharmacokinetic) mo‑ del, used by MwPharm, is thus sufficient for these purposes, even though pharmacoki‑ netics of digoxin is better described by the two‑compartment (PK/PD) model [5, 17]. In the context of our finding, a major li‑ mitation of this study should be acknowled‑ ged. A small sample size in a subgroup of infants and pregnant women (one infant or pregnant woman) which is a common problem of studies in diseases with low incidence. Although there is a PK/PD target for digoxin, a comparison of two different versions of the same software package is still lacking [18]. This makes it difficult to analyze the results with respect to efficacy. Diversion of data (especially, difference in the PK of digoxin and its high concentrati‑ ons in children and pregnant women) taken into account by a model is necessary. Conclusions Thedigoxinmodel in theWindows version of theMwPharmsoftware suitewas validated. Based on available evidence and our study results, we conclude that there is no significant difference between quality of prediction of plasma levels of digoxinbybothTDMsoftware packages, their %PE were comparable. DOS andWIN versions of the s/w suite can be used for TDMof digoxin interchangeably. In general, variations in results occurred with the same immunoassay processed on different analysers, as well as using different TDM software packages. In case when blo‑ od samples from the same patient are every time analyzed in different laboratories, it may increase an amount of the possible laboratory‑based errors. These apparent and marked differences in SDC may have significant implications for patient care. Clearly, there is considerable potential for confusion or dosing error. Accurate TDM remains essential to ensure appropriate concentrations are maintained. Consequently, it should be considered if routinely using updated versions of the same TDM software always brings benefits to patients – not only in case of MwPharm, but also other packages. As a result, future research is needed to gain a better under‑ standing of this thema. Author contributions TP: manuscript writing and literature search; BK: manuscript writing and literature search; MG: study design; IK: study design Conflict od interest statement The authors declared no potential con‑ flicts of interest with respect to the research, authorship, and/or publication of this article. Funding The authors received no financial sup‑ port for the research, authorship, and/or publication of this article. REFERENCES 1. Kang JS, Lee MH. Overview of therapeutic drug monito‑ ring. Korean J Intern Med.2009; 24:1–10. 2. Rogers NM, Jones TE, Morris RG. Frequently discordant re‑ sults from therapeutic drug monitoring for digoxin: clinical confusion for the prescriber. Intern Med J. 2010; 40: 52–56. 3. Proost JH, Meijer DK. MW/Pharm, an integrated software package for drug dosage regimen calculation and therape‑ utic drug monitoring. Comput Biol Med. 1992; 22(3): 155–163. 4. Fuchs A, Csajka C, Thoma Y, et al. 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