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Clinical Pharmacist, Mount Sinai Hospital, Toronto, Ontario, Canada
Published Online, October 30, 2007. www.theannals.com, DOI 10.1345/aph.1K423
Audience: This text is intended for a variety of healthcare practitioners, including allergists, pharmacologists, immunologists, epidemiologists, specialty practitioners, clinical pharmacists, and internists.
Purpose: Drug Hypersensitivity's purpose is to provide a comprehensive source of information on drug hypersensitivity, focusing on related topics not previously addressed in detail, such as immune pathogenesis, immunogenetic aspects, new diagnostic possibilities, treatments, and desensitization. The text extrapolates from animal models to target the immunologic and genetic aspects of drug hypersensitivity, making it appropriate for any courses on immunology and/or drug-induced disease.
Content: Organized in 5 sections, the book is further divided into a total of 33 chapters. The first section (2 chapters) is dedicated to epidemiology of drug allergies, with a focus on severe cutaneous adverse reactions. The second section (12 chapters) focuses on pathomechanisms, as well as genetics and animal models. This section also dedicates 3 chapters to the discussion of HIV drug hypersensitivity. The third section (13 chapters) concentrates on clinical manifestations such as anaphylaxis, drug allergic liver injury, blood dyscrasias, and drug-induced interstitial nephritis. Other more specific topics include perioperative anaphylaxis, as well as allergy and pseudoallergy in children. The last 2 sections pertain to diagnosis, with 2 chapters on in vitro testing and 2 chapters on desensitization, and discuss antibiotics, chemotherapy agents, and monoclonal antibodies. Chapters are structured consistently and include tables, colored figures, and photos where appropriate. The text is indexed by subject and also includes an author index.
Usability: Chapters are individually referenced, and references are up-to-date (often more recent than 2003). The text is competitively priced.
Highlights: The text provides detailed explanations of immune pathomechanisms and genetics of drug hypersensitivity not ordinarily covered in other texts. This text also focuses on specific topics related to drug hypersensitivity such as HIV, perioperative anaphylaxis, drug desensitization in oncology, and in vitro tests for diagnosis. Colored figures and photos aid in the understanding and diagnosis of drug hypersensitivity.
Limitations: Because the text covers such a wide scope of topics, the depth of information provided is limited. The target audience may find only specific chapters of interest; in the case of the practicing physician, for example, the text provides minimal direction in terms of specific management of patients who present with drug hypersensitivity. The chapters within a section could have been better organized to follow a more logical sequence of topics. A number of chapters are oddly devoted to specific drugs (eg, abacavir, nevirapine); instead, they could have been combined into a separate section on HIV or into existing chapters.
Comparison with Other Related Books: There are limited published textbooks dedicated to the pathomechanisms and genetic aspects of drug hypersensitivity. Other texts on drug hypersensitivity are often specific to a given organ or drug class and are vague with respect to the complex immune pathogenesis of drug hypersensitivity.
Summary: This text, with a detailed immunologic focus, is a useful reference for the understanding of drug hypersensitivity. It may be used either as a practical reference by the specialized practitioner or pharmacology and immunology researcher, or as a supplemental text for instruction in upper-level pharmacology and immunology courses.
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