Therapeutic Area: The fourth edition of Applied Pharmacokinetics & Pharmacodynamics provides a long-awaited update to this key textbook on pharmacokinetic/pharmacodynamic (PK/PD) principles and their application to individualizing patient drug therapy.
Format: This hardcover book comprises 32 chapters, an appendix, and an index.
Audience: The principal audience for this text is clinical pharmacists and pharmacologists involved in initiating and monitoring therapies exhibiting a narrow therapeutic index. Students enrolled in professional pharmacy and pharmaceutical sciences graduate degree programs would also benefit from the PK/PD principles and clinical applications presented, although this is not an introductory text.
Purpose: The purpose of this text is to provide a comprehensive source of information on PK/PD principles and their application to individualizing drug therapy for the patient.
Content: The text is well organized, with the first part devoted to basic principles and the second part to individual monitored drugs. Part I includes 12 chapters covering basic concepts and principles. The introductory chapters provide an excellent overview of the rationale and processes involved in developing an individualized drug therapy regimen. Mathematical equations and modeling comprise a significant portion of the initial chapters; however, these are balanced with numerous clinical examples. Part II includes 20 chapters covering monitored drugs. Drugs with a narrow therapeutic index for which drug concentrations or PD indices are commonly available as well as those in which PK/PD relationships have shown improved efficacy (eg, antiretrovirals) are included. The chapters in Part II are divided into the following sections: clinical PK, PD, clinical application of PK data, analytical methods, prospectus, and case studies. Also included is an appendix that provides a summary of the outcome data, supporting the application of therapeutic drug monitoring.
Usability: Each chapter is well referenced and includes classic articles demonstrating basic principles as well as more up-to-date references provided for new drugs and concepts (pharmacogenetics, drug transporters).
Highlights: Chapters on pharmacogenetics, antivirals, and immunosuppressants provide new information and directions for application of PK/PD principles in clinical practice. Cases at the end of the monitored drug chapters are useful for illustrating clinical applications of data presented.
Limitations: The textbook is written at a more advanced level, requiring an understanding of basic PK principles. The text has a limited discussion of software programs available for clinical application of the PK/PD principles.
Comparison with Previous Edition: The new chapters include critical evaluations of methods for therapeutic drug monitoring, immunosuppressants (tacrolimus, mycophenolic acid, sirolimus), and antipsychotics. Specific drug chapters follow standardized formatting to include headings such as clinical pharmacokinetics, pharmacodynamics, clinical applications, analytical methods, prospectus, and the addition of case studies. Content has been updated to account for significant changes in practice patterns since the last edition (ie, reduced use of theophylline for asthma and digoxin for heart failure, expansion of immunosuppressants and antiviral sections).
Reviewer's Summary: This text is essential for clinical pharmacists and pharmacologists and a useful reference for students when used as a supplemental text to provide more extensive emphasis on introductory concepts.
Reviewer: Paul M Beringer PharmD BCPS FASHP, Associate Professor, School of Pharmacy, University of Southern California, Los Angeles, CA
