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Book Review: Analytical Procedures for Therapeutic Drug Monitoring and Emergency Toxicology

This handbook is a concise, referenced, and easily accessible compilation of clinical and pharmacological data on the use and effects of drugs on the fetus, infant, and child. It is divided into six chapters: Teratogenesis, Drugs Excreted in Breast Milk, Adverse Drug Reactions in Children, Pediatric Poisoning, Drug Dosing in Neonates, and Drug Dosing in Children. The greatest strengths of this handbook are the tables of drug effects on the fetus and on drug excretion in breast milk. These tables are very complete and would be extremely useful to the practitioner who is often confronted with questions in these areas. The teratology table contains information, where available, on dosage, route of administration, indication, stages of pregnancy, delivery method, adverse effects, cases of adverse effects per total population, a significance rating, and references. The breast-milk table contains the number of patients, effects on infants, maternal dose, route of administration, milk concentration, interval between dose and sample, a significance rating, and references. All of these data are not contained in every citation used, but the tables represent the best available in any text or handbook. The dosage tables in the fifth and sixth chapters reflect a combination of manufacturers' recommendations and excerpts from Shirkey's Pediatric Drug Handbook. They are less useful than their sources, but are certainly adequate. The chapter on adverse drug reactions in children presents many examples of reactions that occur either predominantly or exclusively in pediatric patients. The reactions cited are important, practical, and well referenced. The chapter on toxicology contains basic information about the management of poisonings, but would not be useful for those without a good background in the area. Most of the information is correct, but is superficial and incomplete in parts. For example, in the discussion of induced vomiting, apomorphine is not mentioned. And although hemodialysis is discussed, exchange transfusion and peritoneal dialysis, which are much more commonly used to treat children, are not. A table on antidotes is provided, but is largely unnecessary since most of the agents contained are not used for children. Problems in Pediatric Drug Therapy is a cross-breed between a text and a handbook and does not succeed in being either. It does not succeed in being a text because it is both incomplete and superficial. It does not succeed as a handbook because of its price. While the book is edited and written by well-known persons in the fields of pediatric pharmacotherapeutics and'toxicology, its usefulness and practicality are severely limited by its format. LITERATURE