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Drug interactions in infectious diseases
690
BOOK REVIEWS
illness, when to send patients to hospital and how to give advice to prevent illness. The lessons rely entirely on written or drawn posters, role plays, demonstrations, discussions and examination of patients. Clear precise instructions on the materials needed are given before starting each lesson. During and after each lesson, simple and practical guidelines enable the teacher to achieve maximum student participation and the students to practise what they have learned. Part 3 contains a number of appendices including reference charts, blow-by-blow accounts of how to practise or interpret the procedures described in the lessons and details of health problems only common in some areas. The final 2 appendices comprise a checklist to help the trainer observe and record the students’ progress in the weeks following each lesson and a list of medicines with dosage and uses. No manual can cover all illness or health care problems. Birth and neonatal problems are omitted, probably deliberately. In the lesson on tuberculosis, mention should have been made about the detection of tuberculous meningitis and miliary tuberculosis and, in its prevention, about contact tracing and breastfeeding. Whooping cough and tetanus are not included. The detection, assessment and management of disabilities, particularly deafness, are not covered. The authors encourage comments on the teaching methods employed in this manual. They invite contributions on other methods tried by the users who I have no doubt will find the book an extremely valuable asset in their teaching and learning practice. A glossary, list of useful resources and references and an index complete the text. The book is presumably available at minimal cost and I would recommend it wholeheartedly to all primary health care trainers and workers. Paget Stanfield Inverlussa Bridgend Callander Perthshire FK17 8AG, UK Drug Interactions in Infectious Diseases. S. C. Piscitelli & K. A. Rodvold (editors). Totowa, NJ: Humana Press, 2001. xii + 363~~. Price US$ 99.50. ISBN o-896-03750-9. Drug interactions most commonly reported are those between 2 drugs, yet today’s polypharmacy means that the opportunity for drug-drug interactions is almost endless. Moreover, drugs may interact with food, beverages, alternative medicines and environmental chemicals. Disease states may alter the magnitude and duration of the pharmacological response. Interactions among drugs may arise through alterations in drug absorption and disposition, i.e., pharmacokinetics, or by direct competition at sites of action or indirectly through altered physiological mechanisms, i.e., pharmacodynamics. This collection of articles examines a substantial number of drug interactions, highlights their medical importance and suggests ways in which they might be avoided. Much of this book relates to HIV disease. This is not unreasonable when one considers the multitude of drug combinations used, not only against the virus but also in the management of opportunistic infections. However, the relatively small amount of information on the potential for drug interactions in parasitic disease may dismay the tropical physician. I would refer them to the recent article by Giao, I’. T. & de Vries, P. J. (2001: Clinical Pharmacokinetics, 40, 343-373) whose extensive literature survey suggests the authors of this volume would find little difficultv in acquiring sufficient information in this area for an additional chapter. However, that point aside I found the information contained in this volume invaluable.
The book opens with an introductory chapter that overviews the type and significance of drug interactions, and a second chapter that discusses putative mechanisms. The following articles focus on HIV (2 chapters), tuberculosis, a variety of antibiotics and antifungal agents. Drug-food interactions are reviewed (although there is no reference to the huge drug-food interactions that occur with halofantrine or benzimidazole anthelmintics), as are the effects of drugs on regulation of expression of drug metabolizing enzymes and cytokine activity. Finally there are chapters dealing with the circumvention of drug interactions and, in my view most important of all, how to design studies that investigate the magnitude of drug interactions in vivo. Reading this volume indicates that there are a vast number of examples of drug interactions of undoubted clinical significance. Where it is understood, the mechanism is detailed and approaches to alternative therapy are described. Also highlighted are the benefits of multiple therapy where drug-drug interactions are harnessed to the advantage of the physician. The ritonavir-saquinavir interaction is given particular emphasis. The case reports contained within most of the chapters are very useful. I would recommend this book to anyone involved in the management of infectious disease. While I accept that the subject is moving so quickly that keeping abreast of the literature is difficult, this volume is as comprehensive as anything currently available. Geoffrey Edwards Department of Pharmacology and Therapeutics The University of Liverpool and Liverpool School of Tropical Medicine, Liverpool, UK Antimalarial Chemotherapy: Mechanisms of Action, Resistance, and New Directions in Drug Discovery. P. J. Rosenthal (editor). Totowa, NJ: Humana Press, 2001. xiS396pp. Price USsb135.00. ISBN O-89603-670-7. The drug therapy of malaria is both a rapidly evolving field and one with a long history. Central to the history of pharmaco-therapeutics, the evolution of antimalarial research and treatment is scientifically interesting and full of excellent teaching examples. A monograph on the subject does not have to struggle for material and, in concept at least, the layout of a volume does not pose too many problems for a skilful editor. That is not to say that the compilation of expert knowledge in readable review essay form is easy for either contributor or editor and this volume shows evidence of hard mental graft by all involved. The editor, Philip Rosenthal, has assembled a broad range of malaria research talents to cover the monograph’s themes from the history of antimalarial drugs and early usage (interestingly reviewed by Meshnick and Dobson), through reviews of drug action and resistance mechanisms to overviews of the prospects for new compounds. The role of genomic and post-genomic research in generating new targets based on our rapidly growing understanding of the parasite’s ‘metabalome’ is also covered in some depth. There is in fact a great deal of interesting malaria biology within this volume and, although the central theme is chemotherapy, drug discovery and development are so central to the scientific history of malaria that this volume has interesting things to say about most aspects of malariology from ague to zygote. The referencing of all the 20 chapters is very extensive and although there is some inevitable overlap, particularly in the chapters on the quinolines, this is a wellplanned and reasonably well-illustrated text. All the chapters can be profitably read by advanced students and the volume as a whole is a valuable resource for professional malariologists. It contains some material with insights of a depth that cannot readily be found in
BOOK REVIEWS
illness, when to send patients to hospital and how to give advice to prevent illness. The lessons rely entirely on written or drawn posters, role plays, demonstrations, discussions and examination of patients. Clear precise instructions on the materials needed are given before starting each lesson. During and after each lesson, simple and practical guidelines enable the teacher to achieve maximum student participation and the students to practise what they have learned. Part 3 contains a number of appendices including reference charts, blow-by-blow accounts of how to practise or interpret the procedures described in the lessons and details of health problems only common in some areas. The final 2 appendices comprise a checklist to help the trainer observe and record the students’ progress in the weeks following each lesson and a list of medicines with dosage and uses. No manual can cover all illness or health care problems. Birth and neonatal problems are omitted, probably deliberately. In the lesson on tuberculosis, mention should have been made about the detection of tuberculous meningitis and miliary tuberculosis and, in its prevention, about contact tracing and breastfeeding. Whooping cough and tetanus are not included. The detection, assessment and management of disabilities, particularly deafness, are not covered. The authors encourage comments on the teaching methods employed in this manual. They invite contributions on other methods tried by the users who I have no doubt will find the book an extremely valuable asset in their teaching and learning practice. A glossary, list of useful resources and references and an index complete the text. The book is presumably available at minimal cost and I would recommend it wholeheartedly to all primary health care trainers and workers. Paget Stanfield Inverlussa Bridgend Callander Perthshire FK17 8AG, UK Drug Interactions in Infectious Diseases. S. C. Piscitelli & K. A. Rodvold (editors). Totowa, NJ: Humana Press, 2001. xii + 363~~. Price US$ 99.50. ISBN o-896-03750-9. Drug interactions most commonly reported are those between 2 drugs, yet today’s polypharmacy means that the opportunity for drug-drug interactions is almost endless. Moreover, drugs may interact with food, beverages, alternative medicines and environmental chemicals. Disease states may alter the magnitude and duration of the pharmacological response. Interactions among drugs may arise through alterations in drug absorption and disposition, i.e., pharmacokinetics, or by direct competition at sites of action or indirectly through altered physiological mechanisms, i.e., pharmacodynamics. This collection of articles examines a substantial number of drug interactions, highlights their medical importance and suggests ways in which they might be avoided. Much of this book relates to HIV disease. This is not unreasonable when one considers the multitude of drug combinations used, not only against the virus but also in the management of opportunistic infections. However, the relatively small amount of information on the potential for drug interactions in parasitic disease may dismay the tropical physician. I would refer them to the recent article by Giao, I’. T. & de Vries, P. J. (2001: Clinical Pharmacokinetics, 40, 343-373) whose extensive literature survey suggests the authors of this volume would find little difficultv in acquiring sufficient information in this area for an additional chapter. However, that point aside I found the information contained in this volume invaluable.
The book opens with an introductory chapter that overviews the type and significance of drug interactions, and a second chapter that discusses putative mechanisms. The following articles focus on HIV (2 chapters), tuberculosis, a variety of antibiotics and antifungal agents. Drug-food interactions are reviewed (although there is no reference to the huge drug-food interactions that occur with halofantrine or benzimidazole anthelmintics), as are the effects of drugs on regulation of expression of drug metabolizing enzymes and cytokine activity. Finally there are chapters dealing with the circumvention of drug interactions and, in my view most important of all, how to design studies that investigate the magnitude of drug interactions in vivo. Reading this volume indicates that there are a vast number of examples of drug interactions of undoubted clinical significance. Where it is understood, the mechanism is detailed and approaches to alternative therapy are described. Also highlighted are the benefits of multiple therapy where drug-drug interactions are harnessed to the advantage of the physician. The ritonavir-saquinavir interaction is given particular emphasis. The case reports contained within most of the chapters are very useful. I would recommend this book to anyone involved in the management of infectious disease. While I accept that the subject is moving so quickly that keeping abreast of the literature is difficult, this volume is as comprehensive as anything currently available. Geoffrey Edwards Department of Pharmacology and Therapeutics The University of Liverpool and Liverpool School of Tropical Medicine, Liverpool, UK Antimalarial Chemotherapy: Mechanisms of Action, Resistance, and New Directions in Drug Discovery. P. J. Rosenthal (editor). Totowa, NJ: Humana Press, 2001. xiS396pp. Price USsb135.00. ISBN O-89603-670-7. The drug therapy of malaria is both a rapidly evolving field and one with a long history. Central to the history of pharmaco-therapeutics, the evolution of antimalarial research and treatment is scientifically interesting and full of excellent teaching examples. A monograph on the subject does not have to struggle for material and, in concept at least, the layout of a volume does not pose too many problems for a skilful editor. That is not to say that the compilation of expert knowledge in readable review essay form is easy for either contributor or editor and this volume shows evidence of hard mental graft by all involved. The editor, Philip Rosenthal, has assembled a broad range of malaria research talents to cover the monograph’s themes from the history of antimalarial drugs and early usage (interestingly reviewed by Meshnick and Dobson), through reviews of drug action and resistance mechanisms to overviews of the prospects for new compounds. The role of genomic and post-genomic research in generating new targets based on our rapidly growing understanding of the parasite’s ‘metabalome’ is also covered in some depth. There is in fact a great deal of interesting malaria biology within this volume and, although the central theme is chemotherapy, drug discovery and development are so central to the scientific history of malaria that this volume has interesting things to say about most aspects of malariology from ague to zygote. The referencing of all the 20 chapters is very extensive and although there is some inevitable overlap, particularly in the chapters on the quinolines, this is a wellplanned and reasonably well-illustrated text. All the chapters can be profitably read by advanced students and the volume as a whole is a valuable resource for professional malariologists. It contains some material with insights of a depth that cannot readily be found in