Pharmacology and Pharmacotherapeutics

In addition to including new matter in this edition, the authors have pruned it of obsolete material in order to make it crisp and readable. To the authors, "new" does not mean that which has merely been mentioned in the recent literature, but that which has reached the stage of peer acceptance and practical utility. New figures and summary tables have been added to permit easy understanding of the subject; and the matter has been re-arranged in several places in order to bring it in line with the current concepts about the concerned topics. The authors have attempted to maintain the standard of information in the book at a level suitable to a wide readership, for they are aware that it is read and referred to by medical, dental and pharmacy students and teachers, by medical practitioners and by students of alternative medicine. Therapeutic applications and discussions are presented in such a way as to provide a better understanding of the subject and stimulate further the therapeutic capability of the students. The time frame for teaching the new MBBS curriculum in anatomy, physiology and biochemistry in India has been reduced to two terms; as a result, the MBBS students may often start learning pharmacology with inadequate background in those subjects. It is hoped that the background information on pathophysiology appearing throughout the book will help the whole range of students to understand the rational use of drugs more easily. The cost of medical services in India is increasing day by day. This book has consistently emphasized the cost-effectiveness of drugs while prescribing in daily practice. Prescribing a new drug such as a COX2 inhibitor instead of paracetamol, or a cephalosporin in place of co-trimoxazole is not justified. Similarly, discarding the old drugs, which have stood the test of time in favour of newer agents with marginal benefits and at a much higher cost, merely because they are promoted heavily is highly improper. For when that happens, patient compliance is likely to be poor, and the patient may remain treated inadequately or get no treatment at all. We earnestly believe that this aspect of drug therapy needs to be emphasized during therapeutic discussions with the students. This is all the more important now that the Indian market is being flooded with so called new drugs, many of which are only old wine in new bottle. There are over 70,000 formulations available in India as against about 350 drugs suggested by the WHO essential drugs list. Many of them are expensive and me-too. There are many look-alike and sound-alike formulations that can result in the wrong formulation being prescribed or supplied; and ultimately, it is the patient who suffers. Good pharmacotherapy is based on "What is generally known as the five rights: right drug, right dose, right route, right time and right patient" (Mehta S. and Gogatay NJ, J. Postgrad, Med. 51 (1): 3, 2005). "Irrational prescribing habit is difficult to cure; however, prevention is possible". This can be best achieved by proper grooming of the young minds at the undergraduate level. This is what "pharmacology and pharmacotherapeutics" is all about.