Reviewer: Melissa M. Ranieri, BS, PharmD (Temple University School of Pharmacy)
Description: This is one of the most reputable references on drug interactions currently available. This latest edition includes thousands of drug-drug interactions and focuses on evidence-based clinical management and reduction in risk of patient harm.
Purpose: The title has evolved from Drug Interactions when it was first published over 40 years ago to the current iteration, with its emphasis on the overall analysis of the interaction, not only reviewing the published evidence supporting the interaction, but also contemplating patient-specific risk factors. In this way, it allows healthcare practitioners to extrapolate objective information and apply it to the specific situation they are encountering. An even larger focus is on management of interactions. Several management options are listed in each drug interaction monograph, which are designed to reduce the risk for patient harm. The purpose is to enable practitioners to quickly assess information on the existence of a drug interaction and to make an informed decision on how to best manage the interaction. Most importantly, the ultimate goal is to prevent and minimize any potential adverse outcomes.
Audience: This is designed for healthcare practitioners who prescribe, dispense, and administer medications. Therefore, physicians, physician assistants, pharmacists, nurses, and nurse practitioners will all benefit from this book. One of its most noteworthy features is how simple its drug interaction classification system is to reference. Based on the severity of the drug interaction, as well as the existence of potential alternatives, five management strategies are recommended. This system allows busy practitioners to research drug interactions in a fast and easy manner, as well as to implement an evidence-based strategy for risk reduction. Philip D. Hansten and John R. Horn are two of the most respected authors in the field of drug interactions, and their expertise shines through another edition.
Features: Over 2,500 drug interaction monographs are included in this edition and they include prescription, nonprescription, and herbal medications. A simple, five step-classification system of risk stratifies each interaction, with recommendations for management. Each management option is assigned a number, one through five, which is conveniently listed next to each drug interaction in the index. Each monograph is listed alphabetically and is organized with concise and clinically relevant information. A summary sentence opens the monograph, followed by patient-specific risk factors and mechanism of action. The clinical evaluation is helpful, with an assessment of the significance and likelihood of the interaction, including references to primary literature. Introductory chapters explain the types of pharmacokinetic interactions, with an inclusive table of cytochrome P540 enzyme inducers, inhibitors and substrates. The book does note that it does not cover drugs of abuse, as well as common pharmacodynamic interactions and anesthesiology medications.
Assessment: Any healthcare practitioner who prescribes, dispenses, or administers medications will find this reference invaluable. A focus on clinical management options allows information to be individualized based on patient-specific factors, with the overall goal of reducing potential adverse outcomes.