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Hi,
David Bourne suggested I send this question to all on the listserv to
see what kind of software you use in hospital setting. We had been
using Kintidex (a product of Micromedex) which has helped dose most
of our vancomycin/aminoglycoside dosings since 1993. Unfortunatley
the software does not communicate on windows XP. Temporarily we have
used global RPh. I was wondering what software you have found useful
for dosing aminoglycosides/vancomycin which helps adjusts the dose
once levels are back? I appreciate any help.
Thank You,
Joe Connolly BS, Pharm D
joe.connolly.aaa.mchsi.com
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The following message was posted to: PharmPK Hi, Joe
We have developed a tool for clinical PK services. This
tool has two versions: one for mobile devices (PalmOS PDA,
cellular phones, and Pocket PC Win CE 2003) and its desktop
version (for WinXP, MacOS X or Linux-PC) running with Java RE.
You can download it from folloiwng links and try it. The
Desktop version allows you to define your own model with
Bayesian estimation algorithms and it's freeware. The mobile
device version is shareware. Both have aminoglycosides and
vanco estimation as you need.
JavaPK for Mobile Devices - http://javapk.pkpd.org.tw/
JavaPK for Desktop - http://jpkd.pkpd.org.tw/
Best regards,
~~
Yung-jin Lee, Ph.D.
Associate Professor
College of Pharmacy,
Kaohsiung Medical University,
Kaohsiung, TAIWAN 807
Phone: (07)312-1101 ext. 2262
Fax: (07)313-6316
Skype: yjlee_2006
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The following message was posted to: PharmPK
Dear Joe,
In response to your question on software for vancomycin/aminoglycoside
dosing guided on plasma level measurements:
MwPharm is a general clinical pharmacokinetic program including dosage
regimen calculation, Bayesian parameter estimation based on measured
plasma
levels after any medication history, population pharmacokinetic
analysis,
and many more. The program has a database with pharmacokinetic
parameters of
about 180 drugs, and data of new drugs can be entered and stored
unlimited.
Linear and Michaelis-Menten elimination kinetics and 2- and 3-
compartmental
models, in any combination, are included. The program calculates dosing
regimens based on the therapeutic window, pharmacokinetic parameters,
and
individual patient characteristics. The medication history can take into
account any dosing and sampling schedule, changing creatinine level,
changing body weight, and extracorporeal clearance. The program
includes a
module for population analysis based on an Iterative Two-Stage Bayesian
procedure, which allows an easy, fast and reliable generation of
population
parameters from the patient data stored in the database. A module for
selection of optimal sampling points is also included.
MwPharm is widely used by hospital pharmacists in the Netherlands and in
many other countries. An earlier version of the program has been
distributed
by Lilly for computer aided therapeutic drug monitoring of Vancocin
(vancomycin) and Obracin (tobramycin).
The current version 3.60 is still a DOS-version but runs nicely with
WindowsXP. We are working on a Windows version to be released this
year. A
demo version (not yet including Bayesian forecasting) is available from
www.mediware.nl.
The program is distributed by MediWare; for general info, trial
version,
prices and orders you can contact Eddy van Essen at info.aaa.mediware.nl.
For
technical/scientific questions you can contact me, the major
developer of
the program.
Best regards,
Hans Proost
Johannes H. Proost
Dept. of Pharmacokinetics and Drug Delivery
University Centre for Pharmacy
Antonius Deusinglaan 1
9713 AV Groningen, The Netherlands
tel. 31-50 363 3292
fax 31-50 363 3247
Email: j.h.proost.at.rug.nl
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The following message was posted to: PharmPK
Hi Joe,
We are also in a search for PK software.
Several pharmacists have recommended RxKinetics
http://www.rxkinetics.com/. The product description on the website
looks interesting. So I asked our IT department to evaluate for
networking. They did not recommend this product because the company is
apparently a one-man show. They felt the business risks are too high.
Thanks,
Mike
Michael A. Jones, Pharm.D.
Pharmacy Informatics
Pharmacy Care Team A027
University of Colorado Hospital
Phone: 303-372-8214
Pager: 303-266-6893
michael.jones.-a-.uch.edu
www.uch.edu
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Dear Joe:
We use the USC*PACK MM-USCPACK software for multiple model
Bayesian adaptive control of individualized dosage regimens. We use
it for aminoglycosides, vancomycin, digoxin, and several
antiepileptics. It runs in XP, and is based on nonparametric
population models, for which we also have good software
(see Bustad A, Terziivanov D, Leary R, Port R, Schumitzky A, and
Jelliffe R: Parametric and Nonparametric Population Methods: Their
Comparative Performance in Analysing a Clinical Data Set and Two
Monte Carlo Simulation Studies. Clin. Pharmacokinet., 45:365-383, 2006 )
and multiple model dosage design (see Jelliffe R, Schumitzky A,
Bayard D, Milman M, Van Guilder M, Wang X, Jiang F, Barbaut X, and
Maire P: Model-Based, Goal-Oriented, Individualized Drug Therapy:
Linkage of Population Modeling, New "Multiple Model" Dosage Design,
Bayesian Feedback, and Individualized Target Goals. Clin.
Pharmacokinet. 34: 57-77, 1998. This design specifically develops
dosage regimens which achieve desired target goals with maximum
precision (minimum weighted squared error). Effect models of
bacterial growth and kill are also employed, so that one can get a
good estimate of the circumstances under which a given serum
concentration profile will kill organisms.
Other related references include:
1. Lent-Evers NA, Mathot RA, Geus WP, van Hout BA, Vinks AA.
Impact of goal-oriented and model-based clinical pharmacokinetic
dosing of aminoglycosides on clinical outcome: a cost-effectiveness
analysis. Ther Drug Monit. 1999; 21(1):63-73,
2. Corvasier S, Maire P, Bouvier d'Yvoire M, Barbaut X, Bleyzac
N, and Jelliffe R: Comparisons between Antimicrobial Pharmacodynamic
Indices and Bacterial Killing as Described by Using the Zhi Model.
Antimicrobial Agents and Chemotherapy 42: 1731-1737, 1998.
3. Bleyzac N, Souillet G, Magron P, Janoly A, Martin P, Bertrand
Y, Galambrun C, Dai Q, Maire P, Jelliffe R, and Aulagner G: Improved
clinical outcome of paediatric marrow recipients using a test dose
and Bayesian pharmacokinetic individualization of busulfan dosage
regimens. Bone Marrow Transplantation, 28: 743-751, 2001.
45.
4. Jelliffe R: Estimation of Creatinine Clearance in Patients
with Unstable Renal Function, without a Urine Specimen. Am. J.
Nephrology, 22: 3200-324, 2002.
5. Martin P, Bleyzac N, Souillet G, Galambrun C, Bertrand Y,
Maire P, Jelliffe R, and Aulagner G: Relationship between CsA trough
blood concentration and severity of acute graft-versus-host disease
after paediatric stem cell transplantation from matched sibling
or unrelated donors. Bone Marrow Transplantation 32: 777-784, 2003.
6. Martin P, Bleyzac N, Souillet G, Galambrun C, Bertrand
Y, Maire P, Jelliffe R, and Aulagner G: Graft Versus Host Disease:
Clinical and Pharmacolgical Risk Factors for Acute Graft-versus Host
Disease after Paediatric Bone Marrow Transplantation from matched
sibling or Unrelated Donors. Bone Marrow Transplantation 32: 881-887,
2003.
7. Bayard D, and Jelliffe R: A Bayesian Approach to Tracking
Patients having Changing Pharmacokinetic Parameters. J. Pharmacokin.
Pharmacodyn. 31 (1): 75-107, 2004.
Note that we estimate creatinine clearance well even when
serum creatinine is unstable, and that we can, if needed, track
unsuspected changes in PK parameter values during the period of data
analysis in unstable patients who have such changes, usually due to
changes in clinical status without any other information from
descriptors.
Other information is on our web site www.lapk.org, under
teaching topics, and demonstration software is available at
www.lapkp.org/beta.
Very best regards,
Roger Jelliffe
Roger W. Jelliffe, M.D. Professor of Medicine,
Division of Geriatric Medicine,
Laboratory of Applied Pharmacokinetics,
USC Keck School of Medicine
2250 Alcazar St, Los Angeles CA 90033, USA
Phone (323)442-1300, fax (323)442-1302, email= jelliffe.at.usc.edu
Our web site= http://www.lapk.org
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Copyright 1995-2010 David W. A. Bourne (david@boomer.org)