Brenner and Stevens' Pharmacology

Citation

Stevens, C. W. (2022). Brenner and Stevens' Pharmacology (6th ed.). Elsevier.

Chapter Summary

The sixth edition has forty-six chapters in seven sections and about 620 pages. The publisher places it between an outlined review and an encyclopedic reference: more detailed than the former, less overwhelming than the latter, and focused on the essential principles in a concise, easy-to-understand manner. It describes a consistent format for presenting the classification of drugs for each system or disease, together with full-colour illustrations, tables, drug-classification boxes, case studies and self-assessments in each chapter.

Section I, Principles of Pharmacology: Chapters 1–5

The five opening chapters are Introduction to Pharmacology and Drug Names; Pharmacokinetics or What the Body Does to the Drug; Pharmacodynamics or What the Drug Does to the Body; Drug Development and Drug Safety; and Toxicology Principles and the Treatment of Poisoning. The chapter titles state the book's framing of pharmacokinetics and pharmacodynamics in terms of what the body does to the drug and what the drug does to the body.

Section II, Autonomic and Neuromuscular Pharmacology: Chapters 6–9

Four chapters cover Parasympathetic, Neuromuscular Pharmacology, and Cholinergic Agonists; Cholinergic Receptor Antagonists; Sympathetic Neuropharmacology and Adrenergic Agonists; and Adrenergic Receptor Antagonists.

Section III, Cardiovascular, Renal, and Hematologic Pharmacology: Chapters 10–17

Eight chapters take drug classes for a clinical problem in turn: Antihypertensive Drugs; Antianginal Drugs; Drugs for the Treatment of Heart Failure; Diuretic Drugs; Drugs for Cardiac Dysrhythmia; Drugs for Hyperlipidemia; Antithrombotic and Thrombolytic Drugs; and Hematopoietic Drugs.

Section IV, Central Nervous System Pharmacology: Chapters 18–25

After an Introduction to Central Nervous System Pharmacology, the section covers Sedative-Hypnotic and Anxiolytic Drugs; Antiepileptic Drugs; Local and General Anesthetics; Psychotherapeutic Drugs; Opioid Analgesics and Antagonists; Drugs for Neurodegenerative Diseases; and Drugs of Abuse. The publisher highlights the opioid epidemic among the topics addressed.

Section V, Pharmacology of Respiratory and Other Systems: Chapters 26–30

This section covers Autacoid Drugs That Mimic Endogenous Substances; Pharmacological Treatment of Respiratory Disorders; Pharmacological Treatment of Gastrointestinal Disorders; Drugs for Headache Disorders; and Drugs for Pain, Inflammation, and Arthritic Disorders.

Section VI, Endocrine Pharmacology: Chapters 31–36

Six chapters treat Hypothalamic and Pituitary Hormone Drugs; Drugs for the Treatment of Thyroid Disorders; Adrenal Steroids and Related Drugs; Fertility and Reproduction Drugs; Drugs for the Treatment of Diabetes; and Drugs Affecting Calcium and Bone Formation.

Section VII, Antimicrobial and Chemotherapeutic Agents: Chapters 37–46

The final section, the longest, begins with Principles of Antimicrobial Chemotherapy and then moves through antibiotics that inhibit cell wall synthesis and protein synthesis, other antimicrobial agents such as quinolones and antifolate drugs, antimycobacterial drugs, antifungal, antiviral and antiparasitic drugs, and Antineoplastic Agents. It closes with Immunopharmacology, Biologicals, and Gene Therapy, whose title matches the publisher's description of an entirely new chapter on recent developments in immunopharmacology, including antivirals and vaccinations.

Key Concepts

Section I: Principles

• Pharmacokinetics: what the body does to the drug (Chapter 2).
• Pharmacodynamics: what the drug does to the body (Chapter 3).
• Drug development, safety and toxicology: Chapters 4–5.

Sections II–VI: Drug classes by system

• Cholinergic and adrenergic agonists and antagonists: the autonomic drug groups of Chapters 6–9.
• Drug classes by clinical problem: antihypertensive, antianginal, heart-failure, diuretic, antiarrhythmic, lipid-lowering and antithrombotic agents (Chapters 10–16).
• Central nervous system drug classes: Chapters 18–25, including opioids and drugs of abuse.
• Endocrine drugs: Chapters 31–36, including diabetes drugs.

Section VII: Antimicrobials and beyond

• Antimicrobial chemotherapy: Chapters 37–44.
• Antineoplastic agents, biologicals and gene therapy: Chapters 45–46.

Critical Analysis

Strengths

• A defined middle position. The publisher states that the book aims between an outline and an encyclopedia, and a Doody's review of the previous edition by Kenneth E. McCarson (University of Kansas Medical Center; score 93, four stars) calls it an excellent option for a course covering the scope of pharmacology and praises its balance of detail and brevity.
• Principles first. Section I establishes pharmacokinetics, pharmacodynamics, drug development and toxicology before any drug class, so later chapters can be read as applications.
• Course and examination orientation. The publisher describes tables, drug-classification boxes, case studies and self-assessments in every chapter, plus bonus eBook content: a glossary, chapter summaries, a list of featured drugs and 150 USMLE-style questions. It aims at course examinations and USMLE Step 1.
• Current coverage. The sixth edition adds more than 100 new drugs and indications, a new immunopharmacology chapter, and material on antiviral and monoclonal drugs for COVID-19, the opioid epidemic and gene therapy.

Limitations

• Not a reference-length work. By design it is shorter than comprehensive pharmacology texts, and a student who needs depth on a receptor or a mechanism will need another source.
• Heavy memorisation load in Sections III–VII. Thirty-seven of the forty-six chapters (Sections III–VII) survey drug classes by system or disease, which is the part of pharmacology that depends on recall. The drug-classification boxes and eBook materials help, but the volume of drug names remains.
• Some value sits in the eBook. The glossary, summaries, case studies, animations and the 150 self-assessment questions are described as bonus eBook content, not part of the printed pages.
• Little independent evidence for this edition. The published review quoted by the publisher concerns the previous edition, and no review of the sixth edition was found.

Where It Fits in the Course

Brenner and Stevens' Pharmacology is the mid-length main text in the pharmacology course list. Basic Concepts in Pharmacology and Medical Pharmacology at a Glance are shorter introductions: the first is organised around drug classes, the second presents each topic as a visual double-page spread, and either can be read before Brenner and Stevens for orientation or after it for revision. Katzung's Basic & Clinical Pharmacology and Rang and Dale's Pharmacology are the larger, more comprehensive texts, to be consulted for greater mechanistic or clinical depth.

Students who are also studying neuroscience can pair the central nervous system section (Chapters 18–25) with Molecular Neuropharmacology, which connects the molecular biology of neurons and synapses with drug actions and with neurological and psychiatric disease at a more specialist level.

How to Use This Book

The book is written for medical students and suits other health-professions students who need a clear grounding in drug classes. The publisher does not list prerequisites; physiology and biochemistry are the natural background, and some microbiology will help with the antimicrobial section.

A practical plan: read Section I (Chapters 1–5) carefully, since pharmacokinetics and pharmacodynamics underlie every later chapter. Then take the sections in the order the course follows organ systems, matching each drug chapter with the physiology and pathology being taught at the same time. Learn the classification boxes first, then the mechanism and the main uses of each class, and use the in-chapter self-assessments and the eBook questions to test recall. Because the book sets out to be concise, use a longer text only for topics that your course treats in depth.