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Pharmaceuticals and health policy
TIPS - Frhntary 1982
HI
Book Review Supplement __.-._--_~--__---__ Informativereading Pha~~euticais and Health Policy edited by Richard Rh, Andrew tterxkeimer, Cittlterirre Sten:t and Jasper WoodL*ock, Crmw: t ieim, f 98t. L17.95 Ix t 272 pages) ISBN 0 7099 060# 0 The purpose of this book. amhitious hut fa~i~tin~, is to cffttsider the processes, policies and practicesinvolved in the eventual provision. or in some cases the nonpruvisiott. of medicines to the consumer. i.e. the patient. The viewpoints of the wide variety of intetested parties. including the pharma. ceutica! industry, government regtdatory agencies, int~tional drug agencies. medical t~searctters,economists, sctciologists. physiciansand patients,are given in a seriesof articles. A book of this kind could have been made up of a seriesof disconnectedarticles hut great pain appearsto have been tukenro avoid this. A gtnup under the auspicesof the International ResearchGroup for Drug Legislattonand Programsagreedthe format
Worthwhile acquisition PsychatropicDN~s: PlasmaConcentration and Clinical Response edited by Gr&m D. Burrows and Trevor R. Norman, .Murcel Dekker. 1981. SFr. I50 (xiv t 52Spngex) IS&N ~S24~iUU96 Tinis book’s objective is to review the ~~~okinet~s and meta~l~~rn of psychotropicdrugs and to discussthe rela tionsbip between the Plasma (and other body fluids) concentrationsof such drugs and the clinical response(~~ra~utic and undesirable) obtttinedafter their adminis tration. The opening chapter helpfully surveys ~umhumoml transmitter in the CNS and the possible pharmacologicalbasis of the mechanism of action of psychotropic drugs, Two chaptersthen critically discuss the advantage%and disadvantagesof the numerousanalytical methods reported for the measurementof concentrationsof antidepressants (mainly tricyclics), antipsychotics (mainly phenothiazines) and antianxiety agents (mainly benzo.
and the authorsfor each chapter. Their contrihtttiottdid not end there. however, hince each chaprrr was circulated for commemIO an appropriate panel. It is cntphaGed. neverhelers, that the tInal respottsihility for lhe chapterslies with the author. The avowed aim of the buok is to be ‘not a pot-pottrri but a blend of experience. perspectiveand reason’. This could have rcsttltedin a hland. cosy XV& of platitudes which avoidedthe main iwues. It is muchto the creditofthc editon and authorsthatthir is not the case. issuesare addresed and the different points of view of ihr various interestedpatties are closely stated. In a review of this lengthit is notpos+le toexaminc critically eachchapterbutall are well-written and well-reasonedirrespective of whether the opinion5 expres.4 are sharedby the reader. The in~~uction (p~sumahly written hy the Editors) is masterly and extractsall the main issuesand deals with them critically. Thedifferent viewpointsof regulators.drug researchersand thosewho market drugsare examined as are the contrastingattitudesof clinical pharmacologistsand busy practic-
diazepines) in biological tluids. !vlun> reportedmethodsare mefully tabulated. Several of the subsequentchaptersdeal with the pharmacokineticsand metabolism of certainclassesof the psychotropicqent> and critically assessths &tempts made to correlate plasma drug levels with clinical response. The drug classes discubrd tricyclic antideptessants. include p~n~i~i~, butted and bettz* diazepines. As might be expected. cer. tain drugs an: treated in some depth, for exam* imipmtnine. arnit~~yli~. chlorpromazine and haloperidol. Similar chap ters are devote4to the newer rntidepresant zimeldineand the anti-manicagentlithium. An i~~sting chapteresamine~the relationshipbetween the levels of endogenous substancessuch as homovanillic acid and pmlactin (‘biochemical par&meters‘) and the levels ofchlo~mma~i~ in plasmaand cerebrospin;llfluid. Clinical purdmetcnare also as.sessed.In u chapter which review* the effects of ~~utiv~/hypn~~ti~drugs
~~ ~~ 7 _->
ing phyuictam. The pre*bure\ in technology-orientntedux-iette\ for ph+ cian+ to c~)~emrJte on ‘real medical prac(ice* po~Ghl~ at the csplme of. for examplc. un3al medicine are examined. and indeedtheneedto useme&cute* ratherthan preventive measures tr challengrd. Folk medicinesdrc not negiectedin the &hate. The tirst sentencein the Introductionthat the book ‘is for IboW ~ut~I~tati~ely concerned with the prrrvi~mnof medicines. i* pcrhap over-modest.It wdl make intrre\ting and inf~mnatite reading for a much aider audiencethan thk. ii any ringI+ ntc\\age i4 to be extractedit is perhap- this one: ‘The contlirt and confrontationwhich vemed tonvenhado~ the scene a year or t\h’nago uzem @ualf~ to be yiciding to a bpiritof mcanmgfuldeh2tr (if not co-operation)‘. All concernedmuIt hopr that this is indeedW. ROGERW RRIURlfTOWSk
HI
Book Review Supplement __.-._--_~--__---__ Informativereading Pha~~euticais and Health Policy edited by Richard Rh, Andrew tterxkeimer, Cittlterirre Sten:t and Jasper WoodL*ock, Crmw: t ieim, f 98t. L17.95 Ix t 272 pages) ISBN 0 7099 060# 0 The purpose of this book. amhitious hut fa~i~tin~, is to cffttsider the processes, policies and practicesinvolved in the eventual provision. or in some cases the nonpruvisiott. of medicines to the consumer. i.e. the patient. The viewpoints of the wide variety of intetested parties. including the pharma. ceutica! industry, government regtdatory agencies, int~tional drug agencies. medical t~searctters,economists, sctciologists. physiciansand patients,are given in a seriesof articles. A book of this kind could have been made up of a seriesof disconnectedarticles hut great pain appearsto have been tukenro avoid this. A gtnup under the auspicesof the International ResearchGroup for Drug Legislattonand Programsagreedthe format
Worthwhile acquisition PsychatropicDN~s: PlasmaConcentration and Clinical Response edited by Gr&m D. Burrows and Trevor R. Norman, .Murcel Dekker. 1981. SFr. I50 (xiv t 52Spngex) IS&N ~S24~iUU96 Tinis book’s objective is to review the ~~~okinet~s and meta~l~~rn of psychotropicdrugs and to discussthe rela tionsbip between the Plasma (and other body fluids) concentrationsof such drugs and the clinical response(~~ra~utic and undesirable) obtttinedafter their adminis tration. The opening chapter helpfully surveys ~umhumoml transmitter in the CNS and the possible pharmacologicalbasis of the mechanism of action of psychotropic drugs, Two chaptersthen critically discuss the advantage%and disadvantagesof the numerousanalytical methods reported for the measurementof concentrationsof antidepressants (mainly tricyclics), antipsychotics (mainly phenothiazines) and antianxiety agents (mainly benzo.
and the authorsfor each chapter. Their contrihtttiottdid not end there. however, hince each chaprrr was circulated for commemIO an appropriate panel. It is cntphaGed. neverhelers, that the tInal respottsihility for lhe chapterslies with the author. The avowed aim of the buok is to be ‘not a pot-pottrri but a blend of experience. perspectiveand reason’. This could have rcsttltedin a hland. cosy XV& of platitudes which avoidedthe main iwues. It is muchto the creditofthc editon and authorsthatthir is not the case. issuesare addresed and the different points of view of ihr various interestedpatties are closely stated. In a review of this lengthit is notpos+le toexaminc critically eachchapterbutall are well-written and well-reasonedirrespective of whether the opinion5 expres.4 are sharedby the reader. The in~~uction (p~sumahly written hy the Editors) is masterly and extractsall the main issuesand deals with them critically. Thedifferent viewpointsof regulators.drug researchersand thosewho market drugsare examined as are the contrastingattitudesof clinical pharmacologistsand busy practic-
diazepines) in biological tluids. !vlun> reportedmethodsare mefully tabulated. Several of the subsequentchaptersdeal with the pharmacokineticsand metabolism of certainclassesof the psychotropicqent> and critically assessths &tempts made to correlate plasma drug levels with clinical response. The drug classes discubrd tricyclic antideptessants. include p~n~i~i~, butted and bettz* diazepines. As might be expected. cer. tain drugs an: treated in some depth, for exam* imipmtnine. arnit~~yli~. chlorpromazine and haloperidol. Similar chap ters are devote4to the newer rntidepresant zimeldineand the anti-manicagentlithium. An i~~sting chapteresamine~the relationshipbetween the levels of endogenous substancessuch as homovanillic acid and pmlactin (‘biochemical par&meters‘) and the levels ofchlo~mma~i~ in plasmaand cerebrospin;llfluid. Clinical purdmetcnare also as.sessed.In u chapter which review* the effects of ~~utiv~/hypn~~ti~drugs
~~ ~~ 7 _->
ing phyuictam. The pre*bure\ in technology-orientntedux-iette\ for ph+ cian+ to c~)~emrJte on ‘real medical prac(ice* po~Ghl~ at the csplme of. for examplc. un3al medicine are examined. and indeedtheneedto useme&cute* ratherthan preventive measures tr challengrd. Folk medicinesdrc not negiectedin the &hate. The tirst sentencein the Introductionthat the book ‘is for IboW ~ut~I~tati~ely concerned with the prrrvi~mnof medicines. i* pcrhap over-modest.It wdl make intrre\ting and inf~mnatite reading for a much aider audiencethan thk. ii any ringI+ ntc\\age i4 to be extractedit is perhap- this one: ‘The contlirt and confrontationwhich vemed tonvenhado~ the scene a year or t\h’nago uzem @ualf~ to be yiciding to a bpiritof mcanmgfuldeh2tr (if not co-operation)‘. All concernedmuIt hopr that this is indeedW. ROGERW RRIURlfTOWSk