Fragile X/Cancer Cytogenetics

To begin with, Human Pharmacology is a moderately priced book that makes no pretense to be as encyclopedic as Goodman and Gilman. One of the main advantages of the book is its consistency of presentation. Each chapter is presented in five sections: (1) therapeutic overview; (2) mechanisms of action; (3) pharmacokinetics; (4) relation of mechanisms of action to clinical response; and (5) side effects, clinical problems, and toxicity. This arrangement allows the reader to develop a consistent and organized framework for understanding each major class of drugs. Human Phannacology is particularly good in presenting the mechanisms of action of each drug class. The generous use of color and diagrams, combined with concise and simple explanations, adds to the clarity of the presentations. This fact alone may allow the book to stand out, as mechanisms of action are, sadly, presented in a bland and enigmatic manner in most other texts. In addition, the authors make a genuine effort to relate the mechanism of action to the clinical response of the drug, which adds invaluably to the student's appreciation of the subject matter. As I forewarned in my caveat to this review, however, all texts have their shortcomings. Ironically, in Human Phannacology, one of its shortcomings stems from one of its strengths. In trying to present the mechanisms of action in as clear and simple a manner as possible, the authors have risked oversimplifying some of the processes and masked some of the complexities involved that are required for understanding the toxicity of some of the drugs. Despite the general clarity of the other sections in each chapter, the pharmacokinetics section often seems to be the most confusing. It is a hodgepodge collection of details, some ofwhich are important, some of which are not. The section is never divided into absorption, distribution, metabolism, and excretion, even when appropriate, and seldom divided into drug subclasses (e.g., antidepressants into tricyclics, second generation, and monoamine oxidase inhibitors), even if doing so would add greatly to the clarity of the section. In conclusion, I think it is obvious that Human Phannacology should not be used as a reference text. The clear and colorful presentation of its subject matter is obtained at the expense of pharmacokinetic and pharmacodynamic lack of detail. This presentation may, however, appeal to first-time students of the subject. I cannot help but think that this book may not be adequate for medical students who might desire a textbook with greater depth and substance.