Prescribed reading

Pharmacology teachers have a hard time of it. Outside the medical world, the nature of pharmacology as a discipline is barely understood; inside, it is barely acknowledged. Pharmacology is the study of the actions of drugs. For medical students, that usually means a knowledge of the actions of compounds such as beta-blockers or antibiotics. But scientists in other medical disciplines often claim that such material is merely an extension of physiology or pathology, hardly a discipline in its own right. Understand how blood clots, and you understand how anti-coagulant drugs work: this is (they claim) the province of the pathologist or the haematologist. What is left that can unequivocally be called pharmacology is the study of the principles of drug action - how drugs may be absorbed into, and eliminated from, the body; how they interact with receptors on cell surfaces or elsewhere to produce their effects. But such subjects are not intrinsically exciting to the average student. Mention receptor theory or pharmacokinetics to the average undergraduate in medicine or pharmacology and you will quickly become aware of eyes glazing over.

Pharmacology texts reflect this attitude: they are usually compendia of data on drugs, with the basic principles of drug action relegated to an introductory chapter.

This book might help to make the principles of pharmacology more interesting. It is written by an experienced teacher, who knows the value of anecdote in helping students to remember and appreciates the use of practical examples to illustrate a principle. It is filled with insights into the history of drug therapy and practical examples with common drugs. The author guides his readers through the basic principles of drug action, keeping them company with entertaining tales from the history of pharmacology and from the medical casebooks.

This is not a textbook of medical pharmacology; the author himself says so. There is no list of 100 anti-hypertensive drugs, no comparative table of a dozen different beta-blockers: in this sense, it does not cover the ground of a basic medical pharmacology course. There is instead a simple, effective introduction to the principles of pharmacology - a brief history of how drugs evolved from plant remedies, explanations of how drugs are absorbed and eliminated, how they interact with receptors, how addiction and abuse may develop. There are also chapters on the development of new drugs, including a thoughtful exposition on the advantages and disadvantages of the use of animals in drug research. In all, an unusual, and very readable, introductory text.

It is, however, American and thus has some drawbacks for students brought up in other traditions. Drugs are identified by their United States names, and there is a whole chapter covering US legislation on substance abuse.

Unusually, it is a single-author work, and inevitably some will quarrel with the author's choice of examples and favourite topics: but the advantages of a consistency of style and of a gradual development of the subject matter in this book easily outweigh the quirks of one man's interpretation.

Introduction to Pharmacology is aimed at first-year pharmacology students. Medical students learn lists of drugs as if their lives depended on it, and this book will not supply the raw material for them. It would be a pity, though, if they were to ignore it: this book will provide clearer and more memorable insights into the mechanisms of drug action than will many standard medical pharmacology texts, and students and practitioners of medicine will be the better for having read it.

Paul Dennis is tutor in pharmacology, Oxford University Medical School.