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Clinical Assistant Professor, Assistant Research Scientist, and Head, Clinical Pharmacogenomics Laboratory, Department of Clinical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, MI; Clinical Pharmacist, University of Michigan Health System, Ann Arbor
Published Online, May 9, 2006. www.theannals.com, DOI 10.1345/aph.1G683
Audience: Human Drug Metabolism: An Introduction targets individuals with some understanding of life sciences, including students of pharmacology, pharmacy, biomolecular sciences, biochemistry, toxicology, dentistry, and medicine. Others targeted include postdoctoral students and professionals in the above or related fields.
Purpose: The stated purpose of the text is to serve as an accessible introduction to the topic of drug metabolism. It also seeks to highlight the clinical consequences of altered drug metabolism and to review the pharmacology and metabolism of illicit drugs.
Content: The book is divided into 8 chapters, including introductions to pharmacokinetics and biotransformation, phase I metabolism, induction and inhibition, phase II and III processes, factors that alter drug metabolism, and drug metabolism in toxicity. Additionally, 4 appendices contain information on laboratory methods for studying drug metabolism; metabolism of illicit drugs; examination preparation; and substrates, inhibitors, and inducers of the cytochrome P450 enzymes. Roughly two-thirds of the book is devoted to general drug metabolism concepts, while the remaining third covers mostly toxicology and related topics, along with information on laboratory methods and examination preparation. The overall organization is appropriate for the information included, but topics such as illicit drugs and examination preparation seem somewhat out of place.
Usability: The price is appropriate for the amount and level of information provided. Individual chapters are not referenced; instead, about 70 references are listed as suggested readings. While the included readings are current, there are relatively few provided, given the breadth of topics discussed.
Highlights: The introductory chapters provide a nice overview of biotransformation and of the cytochrome P450 enzymes in particular. Those with little or no clinical experience should find the discussions/examples of clinical relevance useful, and the emphasis on toxicology and drugs of abuse should be of particular interest to those whose studies or practice is focused in these areas. Another highlight is the inclusion of many figures that clearly illustrate important concepts.
Limitations: One of the book's biggest limitations is its lack of specific references. Related to this is the inclusion of only a few suggested readings. Consequently, the book's usability is diminished, a problem likely to have a greater impact on readers who are new to the topic. While certain aspects of the book may appeal to different users, the inclusion of relatively simplistic (and occasionally questionable) clinical examples and lack of a clear focus tend to diminish the overall usefulness of the text as a reference. Another limitation is the relatively little attention given to metabolic enzymes other than the cytochrome P450 enzymes, with only a few pages devoted to non-cytochrome P450 phase I enzymes. Additionally, several of these non-cytochrome P450 phase I enzymes that are discussed are, oddly, included in the chapter on phase II and III processes.
Comparison with Other Related Books: For those willing to spend a couple hundred dollars, there are more complete and better referenced books on human drug metabolism; however, some of these are very research-oriented or mechanistic, which would likely detract from their value as introductory texts. At least one other introductory book of similar size and price does exist, and, while it lacks the emphasis on toxicology and the appendix on examination preparation, it is better referenced and more focused.
Summary: The author has certainly achieved his goal of providing an accessible introduction to human drug metabolism. The lack of specific references and the questionable choice of content for the final third of the book will likely detract from its utility for most potential readers, particularly considering the availability of other, more highly focused, introductory texts on this topic.
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