Principles and Practices of Pharmacology for Anaesthetists,4th edition T. N. Calvey and N. E. Williams Blackwell Science: Oxford, UK, 2001, 357 pp; indexed, illustrated ISBN: 0–632–05605–3; Price £79.50
This is the fourth edition of a deservedly highly successful textbook of pharmacology for anaesthetists. I well remember the first edition in 1982. In my opinion, the strength of the book has always been its ability to put across clearly and unambiguously the principles of pharmacology, especially pharmacokinetics. This knowledge is needed to use drugs effectively, especially when we are confronted with new techniques of delivery, such as target-controlled infusion with propofol and new drugs, such as remifentanil.
How does the new edition compare with its predecessors? First of all, it is larger and the text layout remains rather formal and old fashioned. There are few illustrations and these are mainly confined to line drawings relating to drug and receptor action. This means that there may be in places up to 13 pages of uninterrupted text. This, together with its length, may well put off the intended readership, e.g. those studying for primary examination of the Fellowship of the Royal College of Anaesthetists. This would be a pity as the information contained is generally excellent. It is also pertinent to consider whether the transition from a small textbook to a book of this size should not have demanded the inclusion of references in the text, as is generally the case in Kaufman and Taberner's larger, but similarly priced Pharmacology in the Practise of Anaesthesia (1996). Calvey and Williams prefer a further reading list at the end of each chapter. The danger of the latter approach is to engender a tendency to didacticism and also to be out of date. For example, the chapter on anticoagulants has a further reading list with a mean reference date of 1991. In the chapter on diabetes management during surgery, the now mainly discarded Alberti regime is given prominence over the more commonly used insulin syringe pump.
There are several omissions in the coverage of both subjects and drugs. For example, there is no discussion on heart failure and bronchial asthma and use of drugs and implications for anaesthesia. However, the management of angina and hypertension is given due prominence. There is also no mention of antibiotics or drug treatment of endocrine disease, both common questions for examination candidates. I think these should have been included in a book of this size.
What of the competition? Peck and Williams' Pharmacology for Anaesthesia and Intensive Care (2000) covers most of the same ground and is a similar size to the first edition of Calvey and Williams. It is clearly and concisely written, well presented and up to date. It is also considerably cheaper at £27.50. On the other end of the scale is the aforementioned Kaufman and Taberner, which is similarly priced (£79.00), comprehensive and well referenced, but nearly double the size of Calvey and Williams. Other possibilities include the combined Pharmacology and Physiology approach of Stoelting or McCaughey and colleagues.
Who should buy this book? It is still an excellent and outstanding treatise on Pharmacology and I read it from cover to cover with increasing admiration and interest. It certainly taught me a thing or two. However, for examination candidates it may now seem too daunting, so I feel that Peck and Williams would now be a better bet as it also includes a copy of QBase Anaesthesia on CD-ROM containing multiple choice questions. However, from the departmental purchase point of view, Calvey and Williams is a must and will keep its place as one of the pre-eminent texts on pharmacology for anaesthetists.
D. W. Green