We were excited to open this little package that arrived by air freight. The book is pocket-sized, smaller than many mobile phones, and weighs <9 ounces. The introduction states that this fifth edition has been revised completely and updated, with obsolete drugs removed, although oddly halothane, trichloroethylene, and ether earned print space once more. As in previous editions, this is not a book about care principles but rather a summary of the regular pharmacologic therapies used in anesthesia and intensive care. The 184 drugs included in the book are presented in alphabetical order, and each drug is summarized over 1 to 2 pages. The introductory section explains how to use this book and that each drug is presented in a standard format that includes uses, chemical presentation, main action, routes of administration, and effects. Some, but not all, drugs have special points presented, such as drug interactions. This edition continues the style adopted in the 4th edition to minimize chapter space by combining drug groups together, for example, thrombolytics, selective serotonin reuptake inhibitors, and angiotensin II receptor antagonists. The book uses two indexes, one listing all medications by drug derivation and the other listing medical uses. The medication index does not include all drugs presented in the book. For example, dexmedetomidine is on page 94, and losartan is described in the angiotensin II receptor antagonist chapter, yet neither one appears in the medication index. In the medical indications index, “thrombolytic therapy” refers the reader to the heparin page rather than to thrombolytics. This book is geared to the UK consumer, presenting adrenaline rather than epinephrine and listing scopolamine as hyoscine. There are notable omissions of drugs that may be administered frequently, such as hydromorphone, calcium salts, and vancomycin. Concerningly, a review of the fourth edition of this book1 noted that the recommended neuraxial dose of diamorphine was high and had not been amended since the third edition, and this high dose remains present in this fifth edition. In the current edition, the recommended dose of dexmedetomidine is written as 1 mg/kg, too high by a factor of 1000. We used this book during operating room and intensive care unit shifts and in the preoperative clinic. Drugs we encountered in the operating room and the intensive care unit were presented clearly; however, we required an alternative information source for considerations in renal and hepatic impairment; the special points section could be used to present this information. In addition, a drip table such as appears in some other handbooks would be a nice addition as an appendix. It is not an easy task to update a concise book and to include all the relevant drugs that may be encountered by the anesthesiologist or critical care physician, particularly during the preoperative assessment. We were curious to see which daily medications the patient may be taking were included in this updated edition. Angiotensin-converting enzyme inhibitors have potential interactions with anesthesia, as noted in the special points section, but not all drugs had perioperative recommendations. Metformin, for example, is presented, but without presurgery recommendations. We specifically noticed that monoamine oxidase inhibitors and chemotherapeutics such as doxorubicin were not presented in the book despite their potential for significant consequences on the perioperative course. Furthermore, it may be useful to refer the reader to updated guidelines regarding neuraxial anesthesia for patients using anticoagulant and antiplatelet therapies. In summary, this is a succinct and portable book that presents many anesthesia and intensive care drugs in addition to some commonly administered daily medications listed in alphabetical order and presented in a clear and logical format. Do you need this book and do you need to upgrade if you already have it? This book summarizes the essential clinical pharmacology of drugs of interest used by the anesthesia provider and critical care physician. Given that it is increasingly easy to search for relevant drug information using the ubiquitous mobile device, however, every drug that appears in this handy alternative requires accurate and ample information. The many Web-based and mobile app-based databases include all of the drugs in the pharmacopeia and address more advanced problems encountered during perioperative and critical care, such as interactions and dose adjustments for organ impairment, that were not consistently included in this book. Carolyn F. Weiniger, MB ChBShimon Firman, MDDepartment of Anesthesiology and Critical Care MedicineHadassah Hebrew University Medical CenterJerusalem, Israel[email protected]