Handbook of Drugs in Intensive Care: An A-Z Guide

Abstract

This book does exactly what it says on the cover. It is small enough to carry, is concise (269 pages), and contains all essential information on most drugs used in critical care. With new drugs being introduced and with more patients surviving with complex co-morbidity, a sound knowledge of pharmaco-dynamics and kinetics is required, and a quick reference guide is essential. The third edition of this popular pocket reference book provides such a reference for doctors, nurses and pharmacists. This latest edition follows successful earlier formats with three sections, the positions of which are sadly not indicated on the foredge. First, more than 120 drugs are described alphabetically by nonproprietary name. Concise information on uses, administration, contraindications, side effects, cautions, and use during organ failure is provided. In the second section there is a section of 'short notes', including pharmacokinetics and monitoring, with specific reference to the critically ill; the management of various clinical scenarios, such as status epilepticus and hyper-kalaemia; and the use of antiarrhythmics, inotropes, sedative drugs and renal replacement. However, some of these short notes, such as the clinical description of the technique of pleuradhesis or the management of anaphylaxis, do not seem to fit into a book concerned primarily with pharmacology, and we would not have looked for them here if we had wanted an update. Other short notes are very relevant and helpful, such as a comparison table of steroid potency, and dose changes in renal failure, but these are not cross-referenced from the applicable drugs in the first section, and so they may be missed by many casual readers. In the final section there is a selection of charts, including reference charts for ideal body weight, creatinine clearance and a comprehensive coloured compatibility chart. Once again, cross-referencing to some of these charts within the book would be very helpful. There have been additions to earlier editions, with the inclusion of nearly 30 new drugs including terlipressin and drotrecogin alpha (activated). The compatibility charts have also been enlarged and printed in colour to aid quick reference. These changes result in a book that is easy to read and contains a good balance of information. A notable absence is information on the mechanism of action of each drug. This would not only tell us how the drug works but also how it may produce unwanted effects. Paw and Park have successfully updated their excellent quick reference guide, which should continue to aid and inform doctors, nurses and pharmacists in their daily clinical practice in intensive care.