Abstract
This first-edition soft-cover text provides a basic review of general principles of human drug metabolism and the impact of metabolism on therapeutic outcome. The book is designed for an undergraduate audience and assumes only a basic knowledge of biochemistry, physiology, and pharmacology. The 8 chapters introduce the concepts of therapeutic window, efficacy, and toxicity as a function of drug concentration and clearance, followed by an introduction to the physiologic roles of the major biotransformation enzyme systems. A more detailed discussion of phase I drug metabolism covers classification, structure, and function of the major human CYP families, mechanisms of induction and inhibition, and consequences for efficacy and safety of selected drug classes. Subsequent chapters introduce and provide a briefer discussion of the various enzyme systems involved in phase II metabolism as well as phase III efflux transporters. The final chapters discuss the effects of genetic polymorphisms, age, gender, diet, lifestyle choices, and intercurrent disease on drug metabolism, as well as potential toxicologic consequences of drug metabolism, including adverse drug reactions. The 4 appendices provide a brief introduction to tools and methods in drug metabolism research, a review of metabolism of illicit drugs, and a summary of CYP substrates, inhibitors, and inducers. There is also a brief discussion on how to prepare for and write university-level examinations, an unusual topic to find in a textbook but offering, in my opinion, useful advice. The book contains 71 figures, predominantly simple black-and-white diagrams, line drawings, chemical structures, and metabolic pathways.
The book is written in a colloquial style, intended to engage and entertain the student audience; however, the language is occasionally awkward and some meanings are ambiguous. Parts of the book are repetitious, and the author tends toward both overstatement and oversimplification at times. There is little discussion of pathology, apart from brief, highly simplified sections on necrosis, immunotoxicity, and carcinogenesis in the final chapter on the role of metabolism in drug toxicity. This book may be a useful introductory text for the intended audience of students studying pharmacology and toxicology, but aside from introducing the biochemistry of drug metabolism, may have limited utility for the veterinary pathologist.