To attempt to cover a topic as extensive as ‘Adverse drug reactions’ in less than 300 pages is not merely ambitious; it is courageous. Those reference books on which we rely for detailed information about reported adverse reactions are barely portable, and have to be updated so frequently that an electronic format seems the inevitable solution. Shorter texts have tended to concentrate on classifications and mechanisms, supplemented by a collection of unmemorable tables. To write a book that combines the principles with sufficient detail to be useful at the bedside, or in the clinic or surgery, is difficult. It requires up-to-the-minute referencing, an understanding of the subject matter deep enough to make it sound simple, and a writing style that does not stupefy.
I chose to disregard the rather rash statement in the promotional blurb that claims this book is comprehensive; it clearly cannot be, and the editor's preface is more modest. Instead, I took as a yardstick the claim that it is ‘an indispensable resource …. for healthcare professionals striving to ensure that medicines are used safely’. Fourteen authors, mostly experienced pharmacists, have contributed to the chapters, which cover drug-induced disorders of the cardiovascular, respiratory, nervous and musculoskeletal systems, the gastrointestinal tract, the endocrine glands, the liver, kidney, skin and blood, as well as those affecting mental health and sexual function. Each ends with a case study that serves not only to illustrate the practical importance of the topic but also as a self-assessment opportunity.
The first sentence of the Preface, ‘Adverse drug reactions are a massive problem’, did not fill me with confidence and the Introduction, though workmanlike, was uninspiring. Yet as the remaining 12 chapters unfolded my perseverance was rewarded. I could not but admire the ease with which the authors explained concepts that I, too, have sometimes fought to express economically. I found myself learning more and more. The numerous tables that pepper the text do not claim to be exhaustive lists – their headings state ‘Some drugs that may cause ….’ – but I could identify no important omissions. The sections on NSAID gastrotoxicity and QT interval prolongation are especially clear, and there is very practical advice on how to investigate and manage suspected drug-induced hepatic and renal dysfunction. The references are up-to-the-minute and plentiful, yet rather intrusive owing to their Harvard style, though they have not been allowed to clutter the tables. All drug names are in international nomenclature and correctly spelt – in fact, I could find only a handful of spelling errors in the entire text.
The authors should be congratulated on succeeding where others have failed. This book is, indeed, an indispensable resource, to which I shall certainly refer both for information and for teaching material. I shall encourage my trainees to read it, too, so that we can all strive that bit harder to ensure that we use medicines safely. I suggest you buy a copy soon, before it goes out-of-date, and keep it handy – perhaps on the ward, chained to the notes trolley.