Drugs Handbook 2010

Abstract

In its promotional blurb, Drugs Handbook is described as ‘a valuable reference guide for student and qualified nurses, and also for students and practitioners in other healthcare professions’. It is a compact book, which would be practical in the ward environment. The bulk of the text is devoted to an alphabetically-arranged description of drugs available in the United Kingdom. These are catalogued first according to their approved names, and then separately by trade names. The latter is cross-referenced with the former, but this is not reciprocated. The authors have aimed to produce a practical reference handbook. With this in mind, I was disappointed that they chose to continue the tradition of referring the reader away from commonly used drugs to their more obscure prototypical relatives. The manner in which this is done generally leads one to believe that the drugs have no meaningful differences. By contrast, glucose and dextrose are given separate and slightly dissimilar entries, each listed as approved names, with the implication that they are different drugs. A student nurse holding a bag of 5% glucose would be informed that it was ‘A source of carbohydrate nutrition. Administered by mouth or intravenously as a dietary supplement’. This does not quite seem to encapsulate clinical reality. Similarly, one wonders about the extent to which the material has been reviewed and updated. The entry for atovaquone describes it as an agent active against ‘the malarial parasite Pneumocystis carnii (sic)’. Pneumocystis jirovecii is neither malarial nor a parasite, and has not been called Pneumocystis carinii since 2005. My main difficulty, however, is in working out who this book is really aimed at. Even if one ignores the understandable omission of dosing information, it is clearly not a prescribers' manual. However, for similar reasons, I doubt it would be sufficient to meet the demands of a qualified nurse, except perhaps to satisfy a passing curiosity about an unfamiliar drug. At times, the writing style suggests that a fairly novice student readership has been envisaged. Halothane, for example, may cause ‘slowing of the heart and fall in blood pressure’. Elsewhere, however, this style shifts to one that would have the students reaching for their dictionaries: atropine ‘blocks peripheral autonomic cholinergic nerve junctions. Causes dilatation of pupils, paralysis of ocular accommodation, tachycardia, reduced gut motility, decreased secretions and CNS stimulation’. In its underlying concept, the book appeals to me and I could envisage that for its target readership it might prove appealing. Exactly who this is, however, remains unclear in my mind. I should therefore defer to the guidance provided in the handbook's introductory paragraph: ‘This book has always been intended for the many health professionals other than clinicians who need information about the mechanism of action, therapeutic indications and unwanted effects of medicines … individuals will most appreciate this handbook as a source of information about medicines used in fields outside their areas of expertise’.