BIOPHARMACEUTICS & DRUG DISPOSITION, VOL. 5, 303-304 (1984)

BOOK REVIEWS

CLINICAL PHARMACOKINETICS, J. Wartak. Praeger Publishers, New York, 1983. No. of pages: 216. Price: $35.00. DRUG DOSAGE AND ADMINISTRATION, J. Wartak. Univers- ity Park Press, Baltimore, 1983. No. of pages: 173. Price: $32.50. DRUG ASSAY, S. M. Kalman and D. R. Clark. Masson Publishing USA Inc., New York, 1979. No. of pages: 192. Price: $26.00.

One of the features of the discipline of pharmacokinetics is the odd relationships it engenders among the worlds of clinical medicine, pharmacology, and pharmacy. If ever three areas of interest needed to be intertwined, these are the three, yet the entanglement as it currently exists is com- plicated by knots of maximum resistance, broken threads, and a high degree of paral- lelism combined with zero cross-linking. This is illustrated by the publication of these three books.

As Wartak points out in his preface, pharmacokinetics receives scant attention in pharmacology courses in medical schools. However, most physicians now recognize the contribution pharmaco- kinetics can make to patient care. In the hospitals pharmacokinetic monitoring services can involve either welcome or grudging acceptance of advice .from pharmacists and/or laboratory scientists to prescribers, and even lovebate relation- ships between advisors and advisees. In the pharmacy schools, massive indoctrination of students takes place concerning the role of pharmacokinetics in modern medicine, often with no presentation of clinical evidence for this belief. In fact, two worlds of pharmacokinetics have built up, one among astute physicians generally specializing in clinical pharmacology, and the other among academic pharmacists. Considering the numbers involved in both

@ 1984 by John Wiley & Sons, Ltd.

groups, the interface between the two is small.

These two groups are each developing their own tertiary literature, which consists of reiterated, commonly-held, beliefs in a constant output of review articles and books which make little or no reference to original literature or to controversies in their subjects. The three books reviewed here are part of the tertiary literature of pharmacokinetics written with physicians in mind. Joseph Wartak has chosen to contribute two books to the literature, intended to be used as a pair, but, supris- ingly, produced by different publishers. The first of the two, Clinical Pharma- cokinetics, is intended 'to provide the es- sential theoretical information on pharma- cokinetics and to illustrate how pharma- cokinetic parameters. . . can be employed'. It is actually well done, providing an exhaustive and basically correct collection of equations in a clear and concise way. It suffers from all of the standard problems of tertiary literature in this field, such as confusion of serum and plasma, naive acceptance of clearance concepts and re- levance of models, and perpetration of the idea that semilogarithmic graphs of con- centration against time have constant slopes. It is a little unbalanced, in that detailed consideration of digoxin kinetics and kinetics in renal failure are presented in a book not fundamentally devoted to examples. It also has not been checked very well-at least one figure appears twice, and extensive use of computer output sheets has led to some errors in diagrams. Nevertheless, it is good reading.

Wartak's second book is much more concerned with the practice of therapeu- tics, with pharmacokinetic references. It deals with dosage forms and their use in different patient groups, pharmacokinetic

304 BOOK REVIEWS

principles applicable to rational use of dosage forms, and monitoring, and pre- sents decision trees for therapeutic plan- ning. The book is sold with a pharma- cokinetic slide-rule to aid prescribing for different age groups and in renal failure. This book is a mixture of overlap with Clinical Pharmacokinetics, and physician wisdom.

Kalman and Clark have written at a more trivial level, with physicians and analysts in mind. They have attempted to review both drug assay methods and clinical monitoring procedures, with a structure centred around chapters on the commonly-monitored drugs. One third of the book is an appendix, comprising a compilation of information relevant to

monitoring. This book is very superficial, and will be of little importance to the discriminating investigator. The copyright is dated 1979, but the book has only recently come to the attention of its poten- tial audience. It is out of date. It is also disastrously manufactured, with for example, exotic diagrams prepared too large for the page size and partially obli- terated, not in the binding, but by a publi- cation method which masked the sides of certain diagrams which intruded into the margin near the binding. A half chemical formula drawn in a type of neo-gothic script is a sight to be seen. It is not a sight to justify spending the cost of this book.

STEPHEN H. CURRY University of Florida