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Doody's Review ServiceReviewer: Michael R Jacobs, BS, PharmD (Temple University School of Pharmacy)
Description: This is the second edition of a book, first published in 2004, that provides an overview of how drugs are discovered and the path that a compound takes on its way to final approval for human use. Each chapter contains a case study, review questions and answers, and a summary of important points. The book includes a number of "exhibits" designed to expand and clarify specific issues to assist readers by providing a context or application for the information in certain sections. The exhibits vary substantially in meeting this goal. Also included are nine appendixes, a list of acronyms, a glossary, and an index.
Purpose: While the objective of providing an overview of the drug approval process is worthy, it is also a monumental undertaking. The breadth of topics covered is substantial and includes the basics of drug-receptor interactions, small and large molecule drug discovery, preclinical testing, clinical trials, regulatory issues, and good manufacturing practices. Volumes have been written on each of these topics; consequently the depth to which they are covered in this book is limited. Even so, the author has provided the promised overview.
Audience: The book is intended for academic and industry researchers and healthcare policy makers, as well as students in the health professions. It may be most useful for individuals unfamiliar with the complexities of the drug development process and those who may work in the pharmaceutical industry who would like to understand the challenges outside of their own area of expertise. The author has over 25 years of experience in the pharmaceutical industry in managerial positions.
Features: The book lays the groundwork with the basics of drug-receptor interactions and brief discussions of potential drug targets such as various enzymes. Thereafter, animal studies and other preclinical testing are described, followed by a review of the various phases of human trials. Regulatory authorities (i.e. the ministries and agencies that regulate drug development) and regulatory applications (how drugs are approved) are addressed in two separate chapters and might have been combined. The information provided about regulatory authorities is somewhat unbalanced, with nearly four pages devoted to the U.S. FDA while the Canadian system, Health Canada, is covered in a single paragraph. The glossary has fewer than 100 entries and it is unclear why some were selected for inclusion (such as otitis media and re-stenosis), which have little to do with the general drug discovery process itself. The nine appendixes vary considerably in their relevance to the drug development process. For example, one appendix contains 27 "selected" drugs, their class, and mechanisms of action. In this section, antagonist and blocker are used interchangeably, and the mechanisms of action are not always very descriptive ("diazepam acts as a central nervous system depressant"). Furthermore, some of the information is duplicated in Table 2.4. The general biomarkers appendix lists common laboratory tests, which does not reflect the current use of this phrase, and the acronyms do not always relate to drug development (e.g. TM = traditional medicine and IOC = International Olympic Committee). The book contains more misspellings than I am accustomed to seeing, inconsistencies in the information presented (figures depicting drug movement through the body), oversimplification of some concepts (time-concentration curves), and some misinformation (albuterol described as a beta-2 antagonist).
Assessment: The author took on a substantial challenge in writing this book. Several books would be required to cover the breadth of material available here. However, it does serve the purpose of revealing to those outside of the pharmaceutical industry the complexities of bringing a drug to market. Those more familiar with drug development may find only certain chapters outside of their area of expertise to be useful. Rapid changes in drug development technology support the need for a second edition.