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Doody's Review ServiceReviewer: Jeffrey L. Apfelbaum, MD (University of Chicago Pritzker School of Medicine)
Description: In this first edition, the authors and editors provide a particularly comprehensive overview of both the mechanistic details of anesthetic drug action and the clinical context in which these anesthetic agents are used. Unlike many general textbooks in the medical specialty of anesthesiology, the editors have been extremely successful in focusing the chapter authors to be comprehensive in their consideration of the principles of drug action, the physiologic substrates of drug action, and the clinical application or pharmacologic basis of drug action.
Purpose: The editors state that they have designed this book to provide anesthesia trainees with a broad integrated introduction to the basic science and clinical use of drugs in the medical specialty of anesthesiology, as well as to provide practicing anesthesiologists with an enhanced understanding of the mechanisms of drug action and a conceptual framework with which to approach new drugs. Furthermore, they have intended to provide basic scientists with a clinical context to help understand the relevance of their work, and to provide a framework to direct future investigations in clinical studies to address clinically important questions as well as to resolve therapeutic deficiencies and discrepancies. The editors have succeeded in spectacular fashion in achieving the goals they have established in their design of this book.
Audience: As the editors suggest, trainees can read the book as a whole and get an in-depth background on anesthetic pharmacology. For practicing anesthesiologists, individual chapters are designed to stand on their own and can provide quick but thorough references for specific organ systems or classes of drugs. Additionally, the "practical aspects of drug use" section at the end of each chapter can serve as a quick reference for questions of immediate importance. For basic scientists, the book is designed to help them understand the clinical implications of their work and to spark investigation to address clinically important questions.
Features: This book serves as a complete and extraordinarily comprehensive reference for pharmacologic and physiologic issues of concern to anesthesiologists. It is organized into three sections. The initial section provides detailed theoretical and practical information about pharmacokinetics, pharmacodynamics, and cell signaling pathways. The second section focuses on the physiology of processes central to the actions of agents used in anesthesia and provides a detailed review of molecular, cellular, and integrated physiology. The third section covers the various classes of anesthetic agents and adjunctive agents organized according to their primary purpose. Although the emphasis of this section is on drugs primarily used as anesthetics, it also deals with sedatives/hypnotics, antibiotics, and chemotherapeutic agents. As an aid to the reader, each chapter has the same structure, and includes sections on mechanisms of action, clinical pharmacology, adverse effects, practical aspects of drug use, and dosage and administration guidelines. The editors have assembled 110 individual authors with expertise in both basic science and clinical medicine to serve as the principle authors. The collective background and expertise of these authors make them extraordinarily well-qualified as authorities in the field. Although the vast majority of contributors are from the United States, the book has a decidedly international flavor with contributors from Japan, Germany, France, United Kingdom, Canada, Australia, the Netherlands, Switzerland, and Israel.
Assessment: This is an extraordinarily well written and comprehensive book of exceptional quality; it fills a unique niche in bridging the chasm between basic science and clinical medicine in the medical specialty of anesthesiology. It is an invaluable addition to the library of any practitioner of the medical specialty of anesthesiology.