Edited by James McCormack, Glen Brown, Marc Levine, Robert Rangno and John Ruedy. 550 pp.
W.B. Saunders Company/Harcourt Brace & Company, Philadelphia; W.B. Saunders Canada, Toronto. 1996
ISBN 0-7216-4215-2
This textbook combines a disease-oriented and a drug-specific approach to therapeutics. It is intended to guide prescribers in initiating or altering drug therapy, and it incorporates issues concerning risk, benefit, quality of life and cost-effectiveness. Although the book appears to be intended for primary care clinicians, some of the topics covered concern conditions treated by specialists.
More than 50 clinical pharmacologists and pharmacists contributed to the book. The five editors ensured that each chapter conforms to a standard format and that the contents are evidence based.
The textbook consists of two parts. The first part is disease oriented; in each chapter the material is presented in response to nine standard questions, such as “What are my goals of treatment?” and “What drug should I use as initial treatment?” The diseases covered include not only those from internal medicine (e.g., cardiovascular, endocrine and gastrointestinal diseases) but also psychiatric, obstetric and gynecologic conditions. A separate chapter is devoted to AIDS-related illnesses. Dermatologic conditions such as psoriasis, acne and fungal infections are not covered, although bacterial cellulitis is discussed in the chapter on infectious diseases. The final chapter in part 1 is on drug-induced adverse reactions, mainly rashes, anaphylaxis and gastrointestinal reactions.
The second part of the book consists of monographs for most of the drugs referred to in the first part. However, some important drugs mentioned in the first part are missing (e.g., etidronate). The monographs are also organized as responses to standard questions (e.g., “When should I use this drug?” and “What route and dosage should I use?”).
The major strength of this book is its dual approach. Combining a disease-oriented therapeutics book with a compendium on drug products is brilliant. Readers are not burdened with the task of filtering information that is not required, yet supplementary information is at their fingertips. The table of contents is detailed and helpful but an index would have been beneficial.
A critical challenge for the authors is to keep such a broad therapeutics book up to date with the rapidly evolving literature. Although the book was published in 1996, some areas (such as new regimens to eradicate Helicobacter pylori infection and new evidence about prophylaxis of peptic ulcers caused by nonsteroidal anti-inflammatory drugs) already need updating.
In the past year, two other Canadian books on therapeutics — Therapeutic Choices and Drugs of Choice — have been published. These books are not as comprehensive or detailed as Drug Therapy. Therefore, Drug Therapy is a helpful resource when there is enough time to absorb its contents, whereas the two previously published books serve as quick references.
This book can be recommended as a useful resource for primary care practitioners or trainees.