Book Review
Pharmacology and
Sharma HL, Sharma KK. Principles of Pharmacology,
1st ed. Hyderabad, India: Paras Medical Publishers;
2007 (977 pp). Price US $50.00. ISBN 81-8191-
176-8.
DOI: 10.1177/1074248408320286
When I, a cardiologist, received the Principles of
Pharmacology (by Sharma and Sharma) from the Journal
for the review, I wondered, why me? Nonetheless, I went
through the cardiovascular pharmacology part of the
book. Trust me, I could not resist reading other chapters.
Looking at the vast scope and interdisciplinary demands
of the subject of pharmacology, it is rather commendable
that these two authors have provided a comprehensive
and integrated narration, with substantial uniformity and
continuum. They write in an engaging style and a reader-
friendly language. With colorful and simple schematic
diagrams and illustrations, and frequent anecdotes to
explain the complicated issues, the text has become quiet
riveting.
The contents of the book are divided into 13 sections
and 75 chapters. The whole text has been written with a
theme in mind, emphasizing more on basic understanding
and concepts rather than stacking the facts. The
sequence of chapters and sections is carefully planned
and follows the theme. The first chapter on “General
Principles of Pharmacology” provides definitions and dis-
ciplines, drug categories and nomenclature, nature and
sources of drugs followed by the dosage and forms of
drugs. The next chapter covers drug administration and
biotransportation, especially the description of biological
barriers that a drug must cross to reach its site of action,
is very effectively presented. In pharmacokinetics, the
authors discuss drug absorption and distribution (includ-
ing bioavailability), metabolism and excretion (including
kinetics of drug elimination) and emphasizing on drugs
likely to be excreted through breast milk or likely to cross
placental barrier in pregnancy. Next to come is pharma-
codynamics wherein the authors discuss drug actions
including the site and mechanism of action, receptor
function followed by bioassays. To encompass emerging
trends, they also incorporate topics such as evaluation of
new drugs, protocols of clinical trials, and the concept of
essential medicines and rational use of drugs. The
Journal of Cardiovascular
Therapeutics
Volume 13 Number 3
September 2008 233-234
© 2008 Sage Publications
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authors have summarized the efforts of the World Health
Organization to meet the health care needs of population
and also suggest a procedure of selecting a preferred
drug. The first section concludes with a chapter on laws
governing the drugs.
Section 2, on drugs affecting the autonomic nervous
system (ANS), is placed next to “General Pharmacology”
and prior to other sections allows students to integrate
and correlate their knowledge of autonomic pharmacol-
ogy with the actions of drugs on cardiovascular, nervous,
gastrointestinal, and respiratory systems. The introduc-
tory chapter of this section summarizes the relevant
anatomical, physiological, and neurotransmitter–recep-
tor interactions. Section 3 on drugs acting on somatic
nervous system, being interrelated to ANS, seems to
carry a natural sequence. After providing a pharmacolog-
ical background of ANS, the authors describe the drugs
acting on renal and cardiovascular system in Section 4.
The heart and kidney together have provided a futuristic
theme, and it was virtually a treat to go through the
whole section, particularly the chapters on the role of
vasoactive peptides—their agonists and antagonists;
nitric oxide donors and inhibitors; antagonists of
renin–angiotensin– aldosterone system; drug therapy of
cardiac arrhythmias, and hypercholesterolemia and dys-
lipidemia. Having discussed some autacoids in Section 4,
the authors expand the information on the other auta-
coids and link it with drug therapy of inflammation in
Section 5.
Sections 6 and 7 discuss gastrointestinal and central
nervous systems, respectively. In Chapter 22, on intro-
duction to central nervous system (CNS), the information
provided on γ-aminobutyric acid (GABA), glutamate (par-
ticularly NMDA, N-methyl D-aspartate), and glycine
receptors is interesting, as also the discussion of various
types of mental illnesses. The drugs affecting endocrine
system are covered in the Section 8 followed by drugs act-
ing on respiratory system in Section 9. The preferential
placement of endocrines over respiratory system also cor-
roborates well with their thematic approach. Having cov-
ered β2 agonists and ipratropium in Section 2, mast cell
stabilizers and leukotriene antagonists in Section 5,
codeine substitutes in Section 7, and corticosteroids in
Section 8, it becomes easier to grasp pharmacological
management of bronchial asthma and chronic obstructive
233
234 Journal of Cardiovascular Pharmacology and Therapeutics / Vol. 13, No. 3, September 2008
pulmonary disease (COPD) in Section 9. The section on
endocrines also deals with important new topics such as
Gn-RH agonist and antagonists (Chapter 46). Section 10
covers drugs acting on blood and blood-forming organs,
where the authors discuss erythropoietin, thrombopoi-
etin, granulocyte colony stimulating factor (G-CSF),
granulocyte-macrophage colony stimulating factor (GM-
CSF), and interleukins. Section 11 covers chemotherapy
of microbial diseases. The introductory chapter carries
classification of different bacteria and the diseases; char-
acteristics and classification of viruses (Chapters 63 and
64), fungi (Chapter 62), and helminthes (Chapter 65) are
very relevant. Section 12 on cancer chemotherapy is
probably the best section, where the authors provide con-
solidated information on 100 plus anticancer drugs in
one table. This section also deals with relevant informa-
tion on cell cycle and classification of different types of
cancer. The coverage of monoclonal antibodies is impres-
sive. The last section of the book describes some “special
topics.” In this section, Chapter 72 on contrast media for
radiological investigations deserves special mention
because it is a relatively untouched topic in pharmacology
textbooks. Similarly praiseworthy is an update on
immunomodulation and immunoltherapy in Chapter 71,
and geriatric pharmacology in Chapter 74. Another
notable feature of this book is a section on “Future
Prospects” at the end of every chapter. This highlights the
current research trends, suggests what can be done, and
what new drugs are in the pipeline.
I would fail in my duty if I do not mention some limitations
of this book. Because I saw a departure from routine in this
pharmacology book, I expected to see a chapter on gene ther-
apy and discussion of stem cells. A chapter on prescription
writing is also conspicuous by its absence. In Chapter 8, the
ethical guidelines in human trials need to be elaborated, and
if not separately, the authors could have included pharma-
covigilance in the same chapter. The drug schedules pre-
scribed under Controlled Substance Act (CSA) of the United
States of America need wider coverage in Chapter 10, giving
list of some important drugs in every drug schedule. Though
the doses of all important drugs have been provided, yet they
are missing for diuretics and calcium channel blockers.
Spelling mistakes and some oversight errors are glaring at
many places in the text, and the book could have done with
better copyediting.
Overall, it is an excellent treatise in every sense. This
is one of the very first textbooks written and produced in
India, which I believe may have significant international
appeal. Admirably, the authors have actually followed a
method of teaching rather than a method of instruction in
this book. Several questions, which arise in students’
mind, are foreseen and addressed in the book. The lan-
guage is simple but captivating. Even though the whole
text was not relevant for me, I feel rewarded having been
asked and having done the review.
Jagat Narula, MD, PhD, FACC, FRCP
University of California, Irvine