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Doody's Review ServiceReviewer: Lawrence Stilwell Betts, MD, PhD (Eastern Virginia Medical School)
Description: This is the first pocketable companion to the three-pound Goldfrank's Toxicologic Emergencies, 8th edition (McGraw-Hill, 2006). It is excellent for its intended use as a companion to the main text.
Purpose: The purpose is to provide physicians with a smaller, clinically focused companion to the main textbook. This manual is for ready use at a patient's bedside or for an overview of medical toxicology for housestaff, medical/pharmacy/nursing students, and other individuals who do not need the in-depth treatment or references/citations offered by the main text. This is more than a bedside aid — it contains a wealth of information on the current practice of clinical toxicology. Wonderful!
Audience: It is intended for students of medicine, pharmacy, and nursing, residents in emergency medicine, internal medicine, pediatrics, preventive medicine, critical care, family practice, as well as fellows in medical and clinical toxicology, attending physicians and faculty, and graduate pharmacists, nurses, and toxicologists. It provides the vast majority of clinical information needed to evaluate and manage a potentially poisoned patient and provides an excellent overview of clinical toxicology. With telephone access to poison information/control centers, this is an essential tool for differential diagnosis for clinicians without training in medical toxicology. As a smaller companion, it does not include references, but it is unusual (strange) to read a medical book without references. (It can be assumed that housestaff will say that they read it in Goldfrank's and, for many attendings, that will suffice!)
Features: The manual covers the entire spectrum of toxicology from the history of poisons and poisonings to the evaluation and treatment of patients possibly experiencing signs and symptoms of a chemically-induced etiology. Specific toxicants, antidotes, and therapeutic interventions are discussed in significant detail. The range of toxic agents includes prescription and over-the-counter drugs, natural products, substances of abuse, household and commercial products, occupational and environmental chemicals, chemically-related disasters, and "military" agents of mass casualty. Briefly, aspects of the poison information/control movement and epidemiology of poisonings in the United States and around the world are also addressed. Clinically relevant and current information is concisely provided in a well organized manner. Explanations of the current and past use of antidotes and therapeutic interventions are provided, all in a readable and enjoyable style. A single-page Table of Antidotes in Brief gives the page number for the antidotes and antagonists which are discussed at the end of relevant chapters. The lack of references could be considered a shortcoming, but the manual is intended as a companion to the larger text making this omission understandable and acceptable. I have but a SINGLE negative comment (professional pet peeve) that arises from my professional training as a scientist and then a physician, and perhaps my age! From the 1960s I have been taught, and I continue to teach, that the term "toxin" is reserved for chemicals of biologic origin. The term "toxicant" is the general term that includes all chemicals, regardless of source; toxins are a subset of this group. As all chemicals are toxic as a consequence of dose (Paracelsus, 1493-1541), we should generally use the term "toxicant" when associating a chemical and its toxic effects. This is consistent with the Public Health Security and Bioterrorism Preparedness and Response Act of 2002 (Pub. L. 107-188) and the Federal government's use of the term "toxin." Under the Act, a toxin is defined as "the toxic material of plants, animals, microorganisms, viruses, fungi, or infectious substances, or a recombinant molecule, whatever its origin or method of production: (1) any poisonous substance or biological product that may be engineered as a result of biotechnology produced by a living organism; or (2) any poisonous isomer or biological product, homolog, or derivative of such a substance. "
Assessment: This portable companion version of the excellent, but much larger, more comprehensive, web-enhanced, and referenced main text is an absolute bargain and an essential component of any medical library. It is an up-to-date, pocket-sized book of tome proportions. There are a few other small books that address clinical toxicology, but this one simply does it best. For those requiring additional information, the main text is needed to find the references for each topic, but for those looking for general information about each listed topic and who can accept that it is found in Goldfrank's, this is the one small book to possess.