|  Identifying the need for a reference source on drugs which
extended beyond those agents included in the British Pharmacopoeia, William
Martindale
set about producing the Extra Pharmacopoeia (Martindale). In 1883 he
published the first edition — a sizable book of 313 pages. He went
on to produce a further nine editions up until his death in 1902 at which
point his son, also a pharmacist, took on the task of regularly updating
the book every two or three years. When he died, the Pharmaceutical Society
had the foresight to purchase all the rights of producing and selling
the book with a view to perpetuating what had by then become a comprehensive
book on drugs and their use. Today, Martindale enjoys the status of a
highly prestigious publication, regarded as a valuable resource world-wide.
Sean Sweetman (the editor) and his team have ably delivered a new, 134th
edition. Martindale is now of course much bigger (2,784 large pages of
small print) and these days is also available in electronic form.
At first, the task of reviewing the new edition seemed as challenging
to me as Sean Sweetman’s must have been to produce it. After much
thought I decided to adopt two approaches. First, I focused on the format,
style, presentation and overall content, assessed by browsing through
its numerous pages. Secondly, I subjected the book to a number of “tests” designed
to mimic how it would be used in practice — as a reference source.
The format is little changed from previous editions. This is pleasing
since, like others who have regularly used the book for some years, I
have got used to its layout and the format of monographs. I have always
thought it a little strange that the various uses of a drug are detailed
half way through a monograph rather than at the beginning. But I, and
probably other seasoned users, have become used to the adverse effects
appearing first followed by the clinical indications for the drug. The
content for each of the 5,300 monographs has been completely revised
and updated. This is apparent from browsing through and was also proved
by the more objective tests which I subjected the book to (see later).
I particularly like the introductions to each therapeutic area. These
provide a well researched and well written overview of the disease and
the role of drug therapy. These, too, are up to date and reflect current
opinion and practice. Clearly, thorough evaluations of recently published
studies, guidelines and reviews have been carried out in the preparation
of this information.
For the second part of my review I used Martindale to provide answers
or information on 60 questions spanning various aspects of drugs and
their use. These included adverse effects, dosages for specific indications,
drug stability, herbal remedies, outlines of disease management, intravenous
drug compatibilities and composition of foreign products. The book performed
well. It was rare that little or no information was found relevant to
the question. In the vast majority of cases the necessary details were
found quickly and were judged to be accurate; during the exercise I found
no errors at all.
On two occasions I failed to find the information I was looking for.
The first, surprisingly, was the composition of Hartmann’s solution;
no entry was found in the extensive index under “H” or under “C” for
compound sodium lactate infusion. I did locate brief information on sodium
lactate (under the subheading for sodium bicarbonate) but no mention
of Hartmann’s or its administration as an intravenous infusion.
The only other occasion where I did not immediately find the information
I wanted was when looking up Antegren; there is no entry in the index.
The name has been in widespread use for a couple of years now (49,000
hits on Google) and to date has been used rather than the drug’s
other name, natalizumab. The information I sought is in Martindale (under
natalizumab), but I had to use another reference source first to ascertain
this alternative name for the drug.
Despite these two examples, I hold the view that Martindale is comprehensive
and I rapidly found the information needed for the other 58 questions.
In all cases the information was correct and up to date. The book’s
coverage of non-UK products is superb with information from more than
30 countries included. Previous editions have rarely let me down when
trying to ascertain the constituents of medicines that a patient has
acquired abroad. All of the foreign products used to test the new edition
were traced.
Martindale is an immensely valuable book; the new edition lives up to
expectations and reinforces its widely acclaimed reputation. All pharmacists
should have access to this valuable resource, either in book form or
electronically.
Charles Tugwell
|
The
Pharmaceutical Journal