From The New England Journal of Medicine, May 18, 2000
"Medicines," wrote Leonardo da Vinci, "will be well used when the doctor understands their nature, what man is, what life is, and what constitution and health are. Know these well and you will know their opposites; you will then know well how to devise a remedy." As the coauthor of a textbook on clinical pharmacology and drug therapy for medical students, in which this principle is espoused, I applaud any attempt by others to do likewise. That is indeed the basis for this textbook on drug therapy for clinical pharmacists. An introductory section on some of the basic principles of clinical pharmacology is followed by 16 sections on the management of diseases, organized according to systems of the body. In each of the chapters dealing with individual diseases, the authors first discuss the pathophysiologic principles and then outline the methods of drug therapy appropriate to each, firmly grounding the therapy in the context of the pathophysiology. Some of the sections on systems of the body include accounts of the evaluation of the diseases to which the system is prey. In each case, the arguments for using one drug or another are based on the most recent evidence, cited in the bibliography at the end of each chapter, although one of the cornerstones of evidence-based medicine, the number of patients who would need to be treated to produce a given outcome (known as the number needed to treat), is conspicuously absent. The discussions are for the most part excellent, but the chapters that include contributions from physicians have a slight edge over those that do not. It is strange that such a high-quality text is not accompanied by better diagrams. Although there are several good anatomical diagrams, there are few that illustrate normal physiology or the pathophysiology of disease, and those that are provided do not show the use of drugs and where they act. In contrast, for virtually every condition, there is a flow chart indicating what to do when a test is positive or negative, when a patient has a particular clinical feature that might modify therapy, or when a patient does or does not have a response to treatment. But these diagrams are difficult to use. Moreover, their rigid format does not accommodate an understanding that the enormous variability among the patients one encounters in everyday practice greatly militates against such an approach in all but the simplest stepwise problem, such as the treatment of asthma, which is clearly illustrated by the simplicity of the flow chart for asthma. The introductory chapters are disappointing. To open with a chapter on the economics of drug therapy surely gives the wrong emphasis, even in an increasingly cost-conscious health care system. The chapter on pharmacokinetics and pharmacodynamics sets a high bar to vault, and other chapters are too short to allow their authors a long enough run up to succeed. An introduction of only 90 pages (less than 4 percent of the text) is not enough, although to be fair, some general aspects of drug therapy are discussed in other chapters (for instance, there is a description of how to alter drug dosages in the section on renal disorders). I found few mistakes in the book and none of importance, except for the curious dose ranges for angiotensin-converting-enzyme inhibitors listed in the chapter on heart failure, with daily doses as high as 400 mg given for drugs such as enalapril. This book is a good reference for clinical pharmacists who can create their own diagrams. But to get the most out of the text, they will need to know their basics pretty well and be prepared to flesh out certain points by consulting the review literature. Jeffrey K. Aronson, D.Phil., F.R.C.P.
Copyright © 2000 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.


Book News, Inc.
The present edition contains 132 chapters contributed by educators and practitioners affiliated with various college and university pharmacy departments. The overall organization of previous editions is retained, as is the emphasis on understanding disease mechanisms and principles of therapy. New chapters have been added on disorders of the pituitary gland and substance-related disorders, and treatment sections in each chapter are now boxed, making them easier to locate. The first seven chapters cover fundamentals, such as pharmacoeconomics, pharmacoepidemiology, pharmacokinetics, drug interactions, and clinical toxicology. Most of the remaining chapters focus on the epidemiology, pathophysicology, clinical presentation, desired outcomes, treatment, and treatment evaluation of specific disease states. -- Copyright © 1999 Book News, Inc., Portland, OR All rights reserved


Review
"This is likely one of the most well-established references in use by practicing pharmacist-clinicians and students. It is more comprehensive than other similar books and has expanded its content since first published in 1988. This new edition continues to provide valuable information for the pharmacotherapeutic management of disease states. " "4 stars"


Book Description

* Comprehensive: acclaimed in a prior edition as “the best pharmacotherapy textbook available,”* it offers you the most detailed pathophysiologic approach to selecting and using pharmaceutical agents in disease management and pharmaceutical care
* Current: the 5th Edition presents the latest information on new drugs and new approaches to treatment and disease management in all therapy sections
* New Chapters: now covers evidence-based medicine, pharmacogenetics, benign prostatic hyperplasia, endometriosis, erectile dysfunction, urinary incontinence, and much more
* Disease Management Focus: meets the needs of pharmacy curriculum and establishes a strong pathophysiologic basis for treatment
* Student-Friendly: provides clear explanations on how a particular organ system and related drug therapy is evaluated; includes dozens of treatment algorithms, figures and tables for quick readability; also offers the necessary background to understand topics including pharmacoeconomics and the used of evidence-based decision-making in practice
*Annals of Pharmacotherapy on the 4th Edition


Book Info
Medical College of Georgia, Augusta. Comprehensive reference to clinical pharmacy and pharmacotherapy. For practitioners and graduate pharmacy students. New chapters cover disorders of sodium, endometriosis, pharmacogenetics, erectile dysfunction, benign prostatic hyperplasia, and more. Previous edition: c1999.

ANNOTATION

The book contains color illustrations.

FROM THE PUBLISHER

* Comprehensive: acclaimed in a prior edition as ￯﾿ﾽthe best pharmacotherapy textbook available,￯﾿ﾽ* it offers you the most detailed pathophysiologic approach to selecting and using pharmaceutical agents in disease management and pharmaceutical care
* Current: the 5th Edition presents the latest information on new drugs and new approaches to treatment and disease management in all therapy sections
* New Chapters: now covers evidence-based medicine, pharmacogenetics, benign prostatic hyperplasia, endometriosis, erectile dysfunction, urinary incontinence, and much more
* Disease Management Focus: meets the needs of pharmacy curriculum and establishes a strong pathophysiologic basis for treatment
* Student-Friendly: provides clear explanations on how a particular organ system and related drug therapy is evaluated; includes dozens of treatment algorithms, figures and tables for quick readability; also offers the necessary background to understand topics including pharmacoeconomics and the used of evidence-based decision-making in practice
*Annals of Pharmacotherapy on the 4th Edition

FROM THE CRITICS

Doody Review Services

Reviewer: Joan M. Stachnik, PharmD, BCPS (University of Illinois at Chicago College of Pharmacy)Description: This is the fifth edition of a book on treatment of major disease states, with an emphasis on medication selection based on the pathophysiology of the disorder. It is an update of the 1999 edition. Purpose: The purpose of the book is to provide healthcare professionals, primarily pharmacists, and students with a pathophysiologic basis for medication selection. The authors recognize the important role of pharmacists in assuring that patients receive appropriate and optimal drug therapy. This role can only be fulfilled if the practicing clinician has a strong foundation in pathophysiology and pharmacotherapy. Given the complexity of disease state management and continual advances in pharmacotherapy, this is a necessary book. As with previous editions, the authors exceed the book's objectives. Audience: This book is written for practicing clinicians, primarily pharmacists, who are responsible for recommending or managing a patient's drug therapy. It is also written for students, to provide them with a strong foundation in these areas. The authors of each chapter are selected for their expertise in various areas. The editors are all recognized educators and clinicians. Features: The book covers the basic concepts of pharmacotherapy as well as major disease states. Each chapter includes a review of the epidemiology, etiology, pathophysiology, clinical presentation, and treatment of major disease states. Although new information has been added, the format of each chapter remains consistent with previous editions. This makes the book familiar to long-time users, and easy to use for students. Several new chapters have been added. Graphs, illustrations, and tables are used frequently to illustrate major concepts. Assessment: This is likely one of the most well-established references in use by practicing pharmacist-clinicians and students. It is more comprehensive than other similar books and has expanded its content since first published in 1988. This new edition continues to provide valuable information for the pharmacotherapeutic management of disease states.

Booknews

The present edition contains 132 chapters contributed by educators and practitioners affiliated with various college and university pharmacy departments. The overall organization of previous editions is retained, as is the emphasis on understanding disease mechanisms and principles of therapy. New chapters have been added on disorders of the pituitary gland and substance-related disorders, and treatment sections in each chapter are now boxed, making them easier to locate. The first seven chapters cover fundamentals, such as pharmacoeconomics, pharmacoepidemiology, pharmacokinetics, drug interactions, and clinical toxicology. Most of the remaining chapters focus on the epidemiology, pathophysicology, clinical presentation, desired outcomes, treatment, and treatment evaluation of specific disease states. Annotation c. Book News, Inc., Portland, OR (booknews.com)

RATING

4 Stars! from Doody

AUTHOR DESCRIPTION

Dipiro, Joseph T., PharmD(Univ of Georgia)

Talbert, Robert L., PharmD(Univ of Texas) Yee, Gary C., PharmD(Univ of Nebraska)

Matzke, Gary R., PharmD(Univ of Pittsburgh)

Wells, Barbara G., PharmD(Idaho State Univ)

Posey, L. Michael, RPh(Pharmacy Editorial & News Services)

ACCREDITATION

Dipiro, Joseph T., PharmD(Univ of Georgia)

Talbert, Robert L., PharmD(Univ of Texas) Yee, Gary C., PharmD(Univ of Nebraska)

Matzke, Gary R., PharmD(Univ of Pittsburgh)

Wells, Barbara G., PharmD(Idaho State Univ)