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Doody's Review ServiceReviewer: Melissa M. Ranieri, BS, PharmD (Temple University School of Pharmacy)
Description: This book covers pharmacokinetic dosing for clinically relevant drugs in an organized and complete fashion. It includes basic concepts in pharmacokinetics and pharmacodynamics, as well as detailed chapters on individual medications. Each chapter contains tables that provide a reference for certain pharmacokinetic concepts, as well as cases and examples that reinforce pharmacokinetic dosing methods.
Purpose: This is an important reference that teaches clinically relevant pharmacokinetic dosing and therapeutic drug monitoring tools. This second edition includes updated information on dosing immunosuppressants, as well as dosing concepts in pediatric and hemodialysis patients. The book is intended as an instructive tool in pharmacokinetics for healthcare practitioners who wish to learn these concepts and apply them in their clinical practice. The book satisfies its objectives, outlining important pharmacokinetic concepts in an organized and easy to understand fashion. It is also written by a pharmacist with extensive experience in pharmacokinetics and includes clinically pertinent pearls for individual drugs.
Audience: Clinical practitioners who wish to learn clinical pharmacokinetics are the intended audience, including pharmacists, physicians, nurse practitioners, and physician assistants. It includes information that is critical for practitioners to learn and apply to patient care as well as extensive examples and problems with solutions so readers can master the outlined pharmacokinetic concepts. The book can also be used by students who are learning pharmacokinetics and it would be an excellent text for teaching this course. Each chapter is well organized and includes basic as well as advanced pharmacokinetic information. However, the book truly succeeds in presenting this information in a way that is easy to comprehend. It is apparent that the text was written by a pharmacist with over 30 years of experience and who is a professor in pharmacokinetics at the University of Washington School of Medicine and Pharmacy. The information in each chapter is derived from the author's lectures in pharmacokinetics and includes clinically pertinent information for dosing important medications.
Features: Introductory chapters include basic concepts in pharmacokinetics and pharmacodynamics, but the majority of the book has chapters on individual medications. These chapters open with an overview of the drug, including indications, goal therapeutic ranges, adverse effects, and monitoring. Pharmacokinetic dosing methods are outlined with equations to calculate initial and subsequent dosing and extensive examples and problems allow readers to practice these calculations. One of the highlights of the book are the clinical pearls for individual drugs, including the optimal time to measure peak and trough concentrations, which side-effects are correlated with elevated peaks or troughs, and which drug concentrations are clinically relevant. Clinical manifestations of toxicity are also discusses, as well as factors that falsely elevate drug levels and detailed information on drug antidotes. Finally, drug interactions are included in each chapter, which alerts the reader which concomitant medications could affect the pharmacokinetics of the drug. Each chapter contains tables that summarize important information in an easy to reference manner, including half-life, volume of distribution, and clinical pearls in different disease states. Figures reinforce pharmacokinetic concepts that are outlined in the text.
Assessment: This second edition succeeds at providing updated information on pharmacokinetic concepts. The book presents information in a manner that allows readers to teach themselves about pharmacokinetic dosing and to update their knowledge about clinically relevant concepts for the medications. These concepts are critical because medications are far too often dosed without individual patient characteristics (weight, age, concomitant medications) in mind. It is important to individualize dosing based on pharmacokinetic methods, to monitor levels, and to adjust subsequent dosing based on peaks, troughs, renal, and hepatic function.