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Adverse drug reactions remain a major cause of morbidity and even mortality, with some estimates of adverse reactions accounting for 10% of all hospital admissions. Recognising an adverse drug reaction requires a high degree of clinical suspicion, and access to a standard reference book such as this. This textbook is presented in a format of organ based adverse reactions, making the clinical presentation the entry point. This format has served it well since 1977 and is undoubtedly useful to clinicians, working from possible adverse reaction to possible causative drug. As a clinical pharmacologist, I tend to work the other way around, and so find it less satisfactory, although the high quality of the indexing helps.
The text itself has good general opening chapters, but the meat is in the organ based chapters; these are quite up to date with most having references from 1996 or 1997. The writing is easy to read. I was disappointed in some specific areas, for instance, the controversy concerning the risks of thromboembolism with various generations of oral contraceptives or factor V Leiden was not referred to, but the discussion of breast cancer and hormone replacement therapy was useful.
Is such a textbook still useful or are alternative resources superior, given the need for accurate up to date data? I think the answer is yes. I have not found a good up to date internet source of accurate information. Good text alternatives are Mayler's annual updates of adverse reaction reports, but they do not follow this clinical presentation based approach. I would certainly use this as a regular first source, before exploring others. It is rather expensive, and will remain a library resource for most.
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