Abstract
The ninth edition of Randall C Baselt's well-respected reference book arrived recently. The monographs have increased by 30%, with some 280 new drugs or chemicals being added. New compounds include antifungal agents (anidulafungin and micafungin), antivirals (amtricitabine and famciclovir), dietary supplements (resveratrol and tryptophan), environmental contaminants (bisphenol A), explosives (cyclonite and trinitrotoluene), therapeutic monoclonal antibodies (etanercept and infliximab) and topical vasoconstrictors (tetrahydrozoline and xylometazoline).
The book presents concise 1–4-page monographs on a wide range of drugs and chemicals that are most frequently encountered in human poisoning. Each monograph has a chemical structure and brief description of pharmacokinetic values (half-life, distribution volume, fraction bound to plasma proteins and blood:plasma ratio), as well as sections on occurrence and usage, blood concentrations, metabolism and excretion pathways, toxicity and methods of analysis. The metabolic pathways are often shown as chemical structures, making them informative and easy to follow. Many monographs have simple summary tables of therapeutic and/or toxic concentrations in a range of different tissues, including blood, brain, liver, bile, kidney, vitreous and gastric contents. The different sections for each drug are detailed, yet tersely written and well referenced. A scan of selected old monographs such as tetrahydrocannabinol, venlafaxine, oxycodone, methadone and d-methamphetamine showed that new references have been added since the last edition in 2009.
Baselt's text is a must for any clinical biochemistry laboratory dealing with therapeutic drug monitoring, testing for drugs of abuse and/or identifying drugs taken in overdose. It provides an excellent starting place for directing further detailed investigation of the literature. It is also invaluable in dealing with telephone or email enquiries from clients who are trying to understand and interpret laboratory drug monitoring or screening results.