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Doody's Review ServiceReviewer: Steven I. Shedlofsky, MD (University of Kentucky College of Medicine)
Description: This multiauthored book with over 50 contributors provides in-depth discussions of the liver toxicities of pharmaceutical agents in 30 chapters, with one of the chapters dealing with alternative medicine and another with occupational toxins. The chapters are loosely organized into sections on mechanisms of liver injury (10 chapters), diagnosis and management (2 chapters), hepatotoxicity of specific drugs (17 chapters), and regulatory perspectives (1 chapter).
Purpose: The purpose of the book is to provide an "authoritative, up-to-date volume" describing drug-induced liver disease that "will be of great interest to a broad audience." Considering the ever growing importance of drug therapy in clinical medicine, and that serious liver toxicity is the single most-common reason for drug withdrawals from the market, an accurate and current compendium of drug hepatotoxicities with an understanding of their basic mechanisms is quite important. Because most chapters are written by recognized experts, the contents as a whole provide excellent in-depth coverage of the topic.
Audience: But there is some concern as to whether the book is truly written for a "broad audience". This is not a reference book in the sense that one can easily access all the information about the liver toxicity of a particular agent in one place. And the range of information on each agent varies from very extensive descriptions to brief citations. This book is directed mainly to academic (and to a lesser extent private practice hepatologists) who do research and teach about hepatotoxicity and to whom patients are referred with drug-induced toxicities.
Features: The strength of this book is that it brings together in one place excellent discussions of drug-induced liver disease that are well referenced and well written. The histopathology chapter is particularly good with 53 figures of pathology and 15 tables. It's too bad these could not be in color. The last chapter on FDA regulatory policy is also very enlightening. A potential negative factor with regard to content is that there are very few references cited after 2000, suggesting that most chapters were written sometime in early 2001. Furthermore, because this book is multi-authored and has a section on mechanisms separate from effects of specific agents, there is a great deal of redundancy of information. This would not be a problem, except that the index fails to identify many cited pages and can't be depended on to find all the information on any particular drug or topic. Finally, there is great variability in how well various topics are covered.
Assessment: In summary, this book is a very worthy addition to the libraries of academic hepatologists, practicing hepatologists, and PhD liver investigators interested in hepatotoxicity. Although it might not serve well as a reference text, it is loaded with useful information and references. With its cost of $195, if one wanted a reference text, one might still consider the late Hy Zimmerman's 1999 text: Hepatotoxicity: The Adverse Effects of Drugs and Other Chemicals (ISBN 0781719526, $169).