Book reviews

Clinical Pharmacy

Authors: Dr H P Tipnis and Dr Amrita Bajaj
Publisher: Career Publications
Pages: 700

Price: Rs 550‘Clinical Pharmacy’ is a comprehensive book meant to encompass the requirements and understand clinical pharmacy in the new environment of patient oriented pharmacy practice in the country. Beginning with a foreword by Prof. Dr. Kokate, it includes topics like Patient Care, Patient Counselling and Compliance and moves towards Disease State Management, Dosage Regimen, which form the basic foundation of Clinical Pharmacy. It also talks about advanced steps of Drug - Drug Interaction, Adverse Drug Reactions, Clinical Pharmacokinetics and Clinical Trials and Therapeutic Drug Monitoring, making readers more aware about these not - so - known areas. Other essential areas like Computer Applications, Drug Information Services and Statistics as applied to Clinical Data Analysis are also included.

The book is primarily aimed at meeting the needs of students of clinical pharmacy and prepare them for examination. It will also be useful for teachers.

The chapter on patient care has guidelines for obtaining authorisation for pharmacist’s notations in the patient medical record by the American Society of Hospital Pharmacists (ASHP). It also talks of adverse drug reactions in elderly and has tables about some common drug disease interactions in them. There is provided a drug information sheet for patient counselling that has special instructions to be followed and directions to take medications in the chapter on Patient Counselling and Monitoring.

The chapter on Drugs in Use, apart from other details, also has a list of Top 100 drugs in India (2001).

Also has a chapter on Investigational Drugs, Clinical Research and Clinical Trials that explains what needs to be done in all the phases and how. The book also gives tables on Therapeutic drug Monitoring and other graphs and examples for better comprehension.

The book has been written in a simple and easy to understand style and language and includes clinical data analysis, and examples and therefore, seems to be a good investment. The only negative aspect that comes to mind after going through the book is that though with a hardbound cover, the quality of pages inside could have been better and the few typos could have been avoided.

By Megha Lodha meghalodha@express2.indexp.co.in

A Guide to Understanding Dietary Supplements

By Shawn M Talbott

The Haworth Press, Inc., NY Softcover $34.95, ISBN 0-7890-1456-4, Hardcover $79.95, ISBN 0-7890-1455-6, pp. 740.

IT is estimated that 60 per cent of adult Americans use dietary supplements every day. The need for a thorough examination of the hundreds of products in the market was long overdue. This comprehensive guide presents straightforward analyses from a consumer’s perspective, giving the facts that more than 140 botanical, chemical and product supplements are in use for a wide range of health conditions and body dysfunction and from preventing cancer, heart disease, diabetes, depression, etc.

United States Department of Agriculture survey has shown that more than 70 percent of Americans fail to achieve daily recommended levels for many vitamins and minerals, which also stands equally good to peoples of other parts of the world. It presents a more realistic view of dietary supplements as neither miracle cure nor nutritional sham, but as consumer products to be accepted or rejected based on scientific fact and not on fitness fantasy.

This book contains 17 chapters and the first chapter deals an overview of the dietary supplement industry and the dietary supplement health and education act (DSHEA) and about dietary supplements and their importance; the second chapter deals in detail with the product development process for dietary supplements.

Drug development including consumer product and new product development approaches, etc.; the third chapter deals with the critical evaluation of dietary supplements its history of use and safety and FDA guidance based on scientific review of health claims; the fourth chapter with the supplements for weight loss and exercise versus diet, etc.; the fifth chapter deals with sports supplements and ergogenic aids; the sixth chapter with supplements for boosting energy levels such as; ginseng. roayl jelly, bee pollen, B-complex, vitamins, vitamin B1 (thiamine), rhodiola. nicotinamide adenine dinucleotide (NADH); the seventh chapter deals with supplements for bone health such as; calcium, magnesium, boron, Vitamin D, Vitamin K; the eight chapter deals with supplements for joint health and causes of arthritis and conventional dietary supplement treatments; the ninth chapter deals with. supplements for mood and brain health and use of St. John’s wort, 5-hydroxytryptophan (5-HTP), choline and ginkgo; the tenth chapter deals with supplements for heart health with controlling free radical damage and use of soy, garlic, hawthorn, vitamin B6, vitamin B12, folic acid. niacin. alfalfa; the eleventh chapter deals with the supplements for immune system support and the use of echinacea, astragalus, vitamin A, glutamine, zinc, colostrum. b-glucans and cat’s claw; the twelfth chapter deals with supplements for antioxidant protection and eye health key.

The antioxidants like; lutein/ zeaxanthin, a-lipoic acid, bilberry (blueberry), b-carotene, selenium, polyphenols, bioflavonoids, vitamin E, vitamin C, grape seed extract (GSE) and pine bark extract (PBE); the thirteenth chapter deals with supplements for gastrointestinal health supplements such as; fibre, Aloe vera, ginger, fructo oligosaccharides (FOS), slippery elm, capsicum (cayenne), etc.; the fourteenth chapter deals with the supplements for male health with diseases like; enlarged prostate gland, low libido and supplements for sexual health, saw palmetto, pygeum, yohimbe (quebracho) and maca; the fifteenth chapter deals with the supplements for female health for menopause and premenstrual syndrome and use of damiana, black cohosh, dong quai, flaxseed (linseed oil), evening primrose oil, red clover, vitex (chasteberry), uva ursi / bearberry, horse chestnut and cranberry; the sixteenth chapter deals with cancer dietary supplements like; green tea. milk thistle, schisandra, shark cartilage (bovine tracheal cartilage) and the last seventeenth chapter deals with the supplements for that may help support during diabetes like, chromium, vanadium banaba leaf (corosolic acid), fenugreek, gymnema (gurmar).

A useful dietary supplement master chart is given with 140 botanicals and chemical ingredients as nutrition products for 14 different health conditions, ailments and diseases along with a comprehensive index and a reference notes is given.

It is quite interesting to note that some plants being used as dietary supplements are also found in India and countries such as; these are; Ginkgo biloba (Ginkgo) Valerian, Glycine max (soybean) Allium sativum (garlic), Medicago sativa (alfa alfa), Perilla frutescens (peulla); Aloe vera (aloe), Zingiber officinalis (ginger), Rumex crispus (yellow dark), Capsicum annum (capsicum), Oeonothera biennis (evening prim rose), Vitex agnus-castu (vitex), Centella asiatica (gotu kola), Camellia sinensis (green tea leaves), Silybum marianum (milk thistle), Trigonella foenum-graceum (fenugreek), Gymnema sylvestre (gurmar), etc.

Indeed this book is a good health dietary compendium for those individuals, who are conscious about their health and it is no doubt also an asset to the libraries.

By Dr N C Shah
(A retired Lucknow based scientist)

Herbal Medicine

By Rowena K Richter, MPH, MBA. 2003

The Haworth Herbal Press Inc, NY. Softcover $19.95 ISBN 0-7890-1620-6, Hardcover $39.95, ISBN 0-7890-1619-2. pp. 238

HERBAL medicines or products mostly in developing countries have become public health objectives on the following main issues:

Firstly to mimise the risk of adverse events, ie, these should be harmless;

Secondly to enhance the population wide benefits of the potential favourable contributions;

Thirdly to seek ways to develop and provide incentives for a system that allows distinctions to be made among herbal products and treatments on a sound scientific footing. This publication for the first time examines the above stated issues and their solutions. It contains a thorough historical account of botanical regulation in USA, including an insight into the development of the most pertinent current law, the Dietary Supplement Health and Education Act (DSHEA) of 1994, covered up in detail.

In a nutshell it also describes the complicated regulatory landscape for herbal products in the United States, Canada, Germany, France and the United Kingdom and compares different regulatory strategies, then provides a thoughtful and balanced discussion of the potential benefits and risks of using herbal products.

Not only this, it also demonstrate how herbal medicines could contribute more to consumer health or the public health risks associated with the current regulatory situation; analysing the public health issues related to safety, research, clinical practice, consumer interests, business, media and federal government; offering key, high-impact recommendations for future policy. This book is for those who deal with herbal medicines or interested in herbal medicines directly or indirectly. Not only this, it also opens avenues in the developing countries like India, Pakistan, etc where there are no laws and legislations in particular for the quality standards of the herbal products.

— Dr N C Shah