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Cardiac drug safety: a bench to bedside approach (book review)

Learn about cardiac drug safety

‘Cardiac drug safety: a bench to bedside approach’, by Matthew J. Killeen. Pp xii+174. Price £48.  Singapore: World Scientific; 2012. ISBN 981 4317 45 4


This book sets out to inform scientists and practising clinicians alike of the developments in the understanding of the myocardial cellular physiology and how this relates to use of drugs. Although entitled “Cardiac drug safety”, the focus of the book is electro-physiology, with particular reference to the pro-rhythmic effects of drugs on the heart which may result in ventricular arrhythmias and sudden cardiac death.

The layout is clear and concise, with the opening chapters describing the cellular basis of cardiac electrophysiology and relating this to the pharmacological effects of medicines on cardiac myocytes and the mechanisms of cardiac arrhythmia. This is illustrated by reference to both medicines developed to manage cardiac arrhythmias and non-cardiac medicines that have been shown to have an effect on the cardiac action potential.

The examples used make this more relevant to the practitioner and explain why some non-cardiac medicines can (and do) have potentially life-threatening adverse cardiac effects. The latter part of the book outlines the processes that have been put in place to try to ensure that the lessons learnt from drug withdrawals from the market due to adverse cardiac effects are used so that new drugs under development have preclinical testing to reduce the risk of the same problems in the future. In any area of research there are always ongoing unanswered questions. The author acknowledges this and includes chapters on the less well researched areas of paediatric cardiac safety and drug-induced atrial fibrillation, as well as outlining areas for the direction of future research and research models.

Overall I found this an interesting read. However, due to the specialist nature of the book I think the target audience would be those with an underlying knowledge of clinical cardiology and an interest the electrophysiology rather than the generalist pharmacy practitioner.

Alison Warren is lead pharmacist, cardiology and specialised services division, at Brighton and Sussex University Hospitals NHS Trust

Citation: The Pharmaceutical Journal URI: 11110891

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