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Stephens’ Detection of New Adverse Drug


Reactions

Article in British Journal of Clinical Pharmacology · June 2004


Impact Factor: 3.88 · DOI: 10.1111/j.1365-2125.2004.02121.x

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Jeffrey K Aronson
University of Oxford
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Retrieved on: 20 May 2016
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James Lind who published his ence source on this important an extensive list of references at
groundbreaking A Treatise of the process. It offers doctors in train- the end ofeach chapter plus mate-
Scurvy in 1753, which described ing as well as professionals in the rials for further reading. There is
his 1747 experiment that showed pharmaceutical industry a broad also a list of useful web sites in
the efficacy of fruits in the treat- perspective on this process. Appendix II to direct readers to a
ment of scurvy. wealth of other resources. The
"While serving as ship's surgeon Reviewed by bibliography is quite up-to-date,
on the HMNS Salisbury in 1747, Tsung 0. Cheng, MD with several references published
Lind had the occasion to deal with Professor ofMedicine in 2003 and a few even in 2004.
an outbreak of scurvy among the The George Washington University I have only two criticisms.
crew. He selected 12 afflicted sea- Medical Center First, very little was written about
men, taking care that 'Their cases Washington, DC the interactions between herbs
were as similar as I could have and drugs. Only a couple of pages
them.' They were divided into six (69 to 71) dealt with herbal-drug
pairs, and each pair was given a dif- Stephens' Detection of interactions. Although mention
ferent treatment. Two sailors was made, it was scattered
received oranges and lemons as a New Adverse Drug throughout the book, e.g., St.
supplement to their diet; another Reactions John's Wort on p. 116 and ginseng
pair had apple cider added to theirs. Edited by John Talbot and on p. 71. As the authors stated (p.
The remaining four pairs had four Patrick Waller; February 2004; 69) that 13% of the public used
of the then-current treatments used ISBN: 0-470-84552-X; 762 pages; herbal remedies at least once a
in His Majesty's Navy: a selection $195 month, with 10% using them at
of tonics, purgatives and 'acidula- least weekly, it would, therefore,
tives.' As now is well-known, the Although this is the fifth edi- be a great help if a complete chap-
sailors receiving citrus fruits recov- tion ofStephens 'Detection ofNew ter had been written . Perhaps this
ered quickly and were actually able Adverse Drug Reactions, it is the could be done in the next edition.
to return to duty. Those receiving first time that I had an opportunity Second, no mention was made
cider recovered more slowly, and to review the book since its first of food-drug interactions. Adverse
the recipients of other nostrums publication in 1985. As Brecken- drug reactions have been identified
showed no improvement until the ridge said in his foreword, the fact as significant factors responsible
ship reached port. Lind's remark- that this book is now in its fifth edi- for patients' morbidity and mortali-
ably modern book is widely consid- tion speaks volumes for its success ty. The German Pharmacists Asso-
ered to be the first formal publica- and value to a multiplicity ofread- ciation (Apothekerverband) lists
tion of a prospective, controlled ers. This is the first edition where 315 pharmaceuticals that interact
clinical trial" (Hammerschmidt Dr. Stephens has not been the prin- with foods. Therefore, not only
DE: 250 years of controlled clinical cipal author and editor. But drug-drug or herb-drug interactions
trials: where it all began. JLab Clin Stephens has still made a signifi- should gamer physicians' attention,
Med. 2004; 143:68-69). cant contribution to this fifth edi- but also food-drug interactions
On p. 306, the correct spelling tion in the form of two large chap- have to be kept in mind.
or transliteration of the ancestor ters (Chapter 1: Introduction and In spite of these limitations, this
of Chinese drug lore is Shen Chapter 15: Ethical Issues in Drug is an outstanding textbook, particu-
Nong, not Sheng Nong, for At*)v Safety) and the coauthoring of larly for aficionados of drug safety,
and his period are circa 2,820- another chapter (Chapter 4: Clini- drug interactions and adverse drug
2,696 BC rather than 3,500 BC as cal Trials: Collection of Safety reactions. As Breckenridge said so
stated in the book. But these quib- Data and Establishing the Adverse aptly in the foreword, "the concept
bles should not detract from a fine Drug Reaction Profile). of balancing risk with benefit, a
job the author has done in achiev- This multiauthored book con- theme to which the book correctly
ing the stated goals. tains 16 chapters. It covers the repeatedly returns remains the
Every consumer takes for issues and problems involved in bedrock of drug therapy."
granted that a pill or tablet pre- the detection of new, adverse drug
scribed by a physician is going to reactions throughout the lifecycle Reviewed by
make him or her better. Little does of a drug from animal studies to Tsung 0. Cheng, MD
the patient realize the process the clinical trials, its introduction to Professor ofMedicine
pill or tablet goes through from its the market, followed by wide clin- The George Washington University
discovery to its final approval for ical use and eventual decline in Medical Center
use. This book is a practical refer- use or withdrawal. The book has Washington, DC

JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION VOL. 97, NO. 3, MARCH 2005 427