Edited by C. J.Van Boxtel, B.Santoso & I. R.Edwards Published by John Wiley & Sons Ltd , 2001 . Pages 717 , Price $160 US , ISBN 0-471-89927-5

I thoroughly enjoyed reviewing this book and learned a great deal in the process. The editors state that the ‘ultimate goal of this book is to give expert guidance on how to treat patients’, based on the best possible evidence-based information. Whilst this book is strongly targeted to students and medical practitioners from developing countries (where Clinical Pharmacology expertise and teaching are relatively scarce), the subject matter is universal and relevant to all environments. One of the important messages throughout the text is encapsulated in the title, that all effective treatments carry risks.

The book is logically organized into three sections. Most chapters are well referenced and the information in many is put into an appropriate historical perspective. The first section (divided into two parts) deals firstly with societal aspects of Clinical Pharmacology: the overall burden of drug-induced disease and how this might be reduced; pharmacoepidemiology; pharmacoeconomics; national drug policy and regulation processes; the inevitable tensions between the pharmaceutical industry and regulatory authorities; essential drug lists; international harmonization; sources of drug information; drug development. The second part of this section focuses on individualizing treatment: principles of pharmacokinetics, pharmacodynamics, adverse drug reactions, drug interactions; treating the very young and old; drug misuse and poisoning. Some of the chapters in this section also contain excellent practical therapeutic advice.

Section two contains pharmacodynamic and pharmacokinetic information for all the important drug classes. The reader will need to have a reasonable grasp of physiology, pathology, microbiology, and cellular and molecular biology to be able to assimilate and understand this substantial body of facts. This section serves as a prelude to the next section, which deals very well with therapeutics of important disease states. The material in the third section is generally up-to-date and the philosophy of evidence-based information is heavily emphasized, with the Cochrane Collaboration database featuring prominently.

What are some of the deficiencies of this book? As with many multiauthor works, there are some inconsistencies of style and occasional repetition of material. Some chapters would have benefited from better proof reading. A few references are needlessly old (for example, the 1992 edition of Goodman & Gilman). There is the occasional error of fact (for example, quinidine is stated to be an inducer of CYP2D6). Some graphs are incompletely labelled. There is no chapter which specifically deals with immunization. These shortcomings, however, are trivial in the context of the overall strengths of the book and would be easily remedied in future editions.

Does this book achieve its purpose? I believe that it does admirably and would be a valuable resource for undergraduate medical and pharmacy students, and postgraduate trainees in Clinical Pharmacology in all parts of the world. It would also be valuable for established practitioners. It provides an excellent balance between ‘societal’ pharmacology, drug information and therapeutics. Does it provide value for money? The book is relatively expensive. I doubt if students or many graduates, especially those from developing countries, would be prepared to pay the price.

The editors are internationally known clinical pharmacologists, who have gathered some 60 authors from 5 continents. This has resulted in perspectives and insights which, to my knowledge, are not currently available in one source. They should be congratulated for producing what will hopefully become a standard text in Clinical Pharmacology.