Clinical Pharmacology [antikvár]

Preface 'For your own satisfaction and for mine, please read this preface.'* This book is about the scientific basis and practice of drug therapy. It is particularly intended for medical students in their clinical years, but it contains many more facts and details than a student either needs or should attempt to learn. The general aspects of the how and why of drugs are for students. The practical details are to help them when they begin to prescribe on their own responsibility after graduating, and the book is offered as a guide to this. Thus students should read selectively, and we hope it will not be too difficult for them to do so. We would particularly suggest that students should read Chapters 1 to 10 and those parts of other chapters covering general background, principles or mechanisms of action. Unfortunately we have been unable to contrive everywhere clearly to separate these sections from the more detailed facts required for such guidance in practical prescribing as we have attempted. In addition we hope that the book may be of use to some more experienced doctors in reminding them of general progress and practice in fields with which, perhaps, they are no longer primarily concerned, but which have not lost interest or all importance for them. Justification. We believe that doctors who understand something of how drugs get into the body, of how they produce their effects, of their fate and of how evidence of therapeutic effect is assessed, will choose drugs more skilfully and use * St. Francis of Sales: preface to Introduction to the Devout Life (1609). them more successfully than those who do not. They will less often expose patients to the risks of useless therapy and they will also avoid more of the hazards of adverse effects due to interaction with the patient, the disease and with other drugs. They will be less likely to mistake the ill-effects of drugs for natural disease and more likely to recognise antagonism or synergism when it unexpectedly arises either from prescribed or from self-medication. This book represents an attempt to provide pharmacological knowledge that is both interesting and useful to the physician. Most books of moderate size either confine themselves to discussing the pharmacology of drugs without giving enough information for them to be selected and used effectively, or else they confine themselves to practical therapeutics and ignore ±e pharmacological background. It is too much to expect the now heavily burdened student to consult and integrate two works, one not always clearly related to clinical practice and the other often as arbitrary and as empirical as a cookery book. This book is offered as a reasoruihly brief solution to the problem of combining practical clinical utility with some account of the principles of pharmacology on which clinical practice rests. It might be thought that the existence of big multi-author books in which each chapter is t An author and critic (Philip Larkin: 1922-85) has told that he judged fiction by the criteria, 'Could I read it? If I could read it, did I believe it? If I believed it, did I care about it? And if I cared about it, what was the quality of my caring, and did it last?' It would be presumptuous of authors of a textbook to aspire to satisfy the criteria for good fiction, so we will only say that we have been mindful of these in writing this book. DRL, PNB.