Rang and Dale's Pharmacology

Citation

Ritter, J. M., Flower, R. J., Henderson, G., Loke, Y. K., MacEwan, D., & Rang, H. P. (2019). Rang and Dale's Pharmacology (9th ed.). Elsevier.

Chapter Summary

The ninth edition has 60 chapters in six sections. The publisher describes it as combining core basic and clinical science, moving from a molecular understanding of receptors and drug actions to the clinical uses of key groups of drugs. This edition adds revised coverage of drugs for the central nervous system, cognitive enhancers, anti-infectives, biologicals and lifestyle drugs. Chapters use Key Points boxes and Clinical Uses boxes, a colour-coded layout and full-colour illustrations.

Section 1, Chapters 1–12: General Principles

What is pharmacology? (1); How drugs act: general principles (2); How drugs act: molecular aspects (3); How drugs act: cellular aspects, excitation, contraction and secretion (4); Biopharmaceuticals and gene therapy (5); Cell proliferation, apoptosis, repair and regeneration (6); Cellular mechanisms: host defence (7); Method and measurement in pharmacology (8); Absorption and distribution of drugs (9); Drug metabolism and elimination (10); Pharmacokinetics (11); and Individual variation, pharmacogenomics and personalised medicine (12). The section builds the framework in the order target, cell, method, then the body's handling of the drug, and ends on variation between patients.

Section 2, Chapters 13–21: Chemical Mediators

Chemical mediators and the autonomic nervous system (13); Cholinergic transmission (14); Noradrenergic transmission (15); 5-Hydroxytryptamine and the pharmacology of migraine (16); Purines (17); Local hormones 1: histamine and the biologically active lipids (18); Local hormones 2: peptides and proteins (19); Cannabinoids (20); and Nitric oxide and other gaseous mediators (21). The section follows the signalling molecules, starting with the autonomic nervous system and the two classical peripheral transmitters.

Section 3, Chapters 22–37: Drugs Affecting Major Organ Systems

The heart (22); The vascular system (23); Atherosclerosis and lipid metabolism (24); Haemostasis and thrombosis (25); Haemopoietic system (26); Anti-inflammatory and immunosuppressant drugs (27); Skin (28); Respiratory system (29); The kidney and urinary system (30); The gastrointestinal tract (31); The control of blood glucose and drug treatment of diabetes mellitus (32); Obesity (33); The pituitary and the adrenal cortex (34); Thyroid (35); The reproductive system (36); and Bone metabolism (37). This is the system-by-system core of therapeutic pharmacology: cardiovascular, blood, immune and inflammatory, respiratory, renal, gastrointestinal and endocrine drugs.

Section 4, Chapters 38–50: Nervous System

Chemical transmission and drug action in the nervous system (38); Amino acid transmitters (39); Other transmitters and modulators (40); Neurodegenerative diseases (41); General anaesthetic agents (42); Analgesic drugs (43); Local anaesthetics and other drugs affecting sodium channels (44); Anxiolytic and hypnotic drugs (45); Antiepileptic drugs (46); Antipsychotic drugs (47); Antidepressant drugs (48); CNS stimulants and psychotomimetic drugs (49); and Drug addiction, dependence and abuse (50). Three chapters on transmission and transmitters lead into the drug classes used in anaesthesia, pain, psychiatry and neurology.

Section 5, Chapters 51–57: Drugs Used for the Treatment of Infections and Cancer

Basic principles of antimicrobial chemotherapy (51); Antibacterial drugs (52); Antiviral drugs (53); Antifungal drugs (54); Antiprotozoal drugs (55); Anthelmintic drugs (56); and Anti-cancer drugs (57).

Section 6, Chapters 58–60: Special Topics

Harmful effects of drugs (58); Lifestyle drugs and drugs in sport (59); and Drug discovery and development (60).

Key Concepts

Section 1: General Principles

• Drug targets and mechanisms: the molecular and cellular basis of drug action, treated in separate chapters.
• Pharmacokinetics: absorption and distribution, then metabolism and elimination, then pharmacokinetics in a chapter of its own.
• Pharmacogenomics and personalised medicine: how genetic differences between patients change drug response.
• Biopharmaceuticals and gene therapy: protein and nucleic-acid therapeutics as a drug class.

Sections 2–3: Mediators and Organ Systems

• Autonomic transmission: cholinergic and noradrenergic pathways as the basis for many drug classes.
• Local hormones: histamine, lipid mediators, peptides, purines, cannabinoids and gaseous mediators.
• Drug treatment by organ system: heart, vessels, blood, kidney, gut, endocrine and reproductive systems.

Sections 4–6: Nervous System, Infection and Cancer, Special Topics

• Central nervous system drugs: from anaesthetics and analgesics to antiepileptic, antipsychotic and antidepressant drugs.
• Antimicrobial chemotherapy: principles first, then drugs for bacteria, viruses, fungi, protozoa and helminths.
• Harmful effects of drugs: adverse effects as a subject in its own right.
• Drug discovery and development: how new drugs are found and brought to use.

Critical Analysis

Strengths

• One book from molecule to clinic. The publisher stresses coverage from receptor-level mechanisms to clinical uses, and the six-section structure follows that arc, with general principles first and the clinical drug groups later.
• Learning aids built into the layout. Key Points boxes, Clinical Uses boxes, a colour-coded layout and illustrations help with navigation and revision, and online material includes more than 100 chapter-specific multiple-choice questions and six cases for self-assessment.
• Coverage updated for this edition. The publisher lists significantly revised coverage of CNS drugs, cognitive enhancers, anti-infectives, biologicals and lifestyle drugs, and a separate chapter on harmful effects of drugs.
• A reviewer's endorsement of level. In Doody's Review Service, Carol L. Beck (Thomas Jefferson University) judged the book well suited to a graduate-level pharmacology course for MS, PhD or MD/PhD students.

Limitations

• Length and breadth. Sixty chapters make it a comprehensive text; readers who need a first overview or a short exam revision text may find it too large to read straight through.
• Mechanism-led, not a prescribing manual. The book moves from mechanism to the clinical uses of groups of drugs; doses, monitoring and local prescribing practice must come from a formulary or national guidance.
• British-style conventions. Spelling and some terminology (for example "haemostasis", "personalised") follow UK usage, which readers elsewhere should keep in mind when matching terms to local curricula.
• Reviewer level. The Doody's review frames the book as suited to a graduate-level course, so it may exceed the needs of a first-year undergraduate course.

Where It Fits in the Course

The pharmacology list offers books at several depths. Medical Pharmacology at a Glance is a short visual introduction in double-page spreads, and Stringer's Basic Concepts in Pharmacology is a short introduction organized by drug class; either is a sensible first read before this book. Brenner and Stevens' Pharmacology is a mid-length medical pharmacology textbook that goes system by system with clinical boxes.

Rang and Dale and Katzung's Basic & Clinical Pharmacology are the two comprehensive texts. Katzung is organized by drug group and pairs basic mechanisms with clinical use through prototype drugs, case studies and review questions; Rang and Dale is organized by principle, mediator and organ system, with separate chapters on receptors, cellular mechanisms and drug discovery. Choose one as the main text and consult the other for a second explanation of a difficult topic. For the neuropharmacology chapters (Section 4), Molecular Neuropharmacology in the neuroscience list gives a deeper molecular treatment.

How to Use This Book

The book suits medical, pharmacy, biomedical-science and graduate students who want an explanation of why drugs work, not only a list of what they do. A background in physiology and biochemistry is helpful, and cell biology makes Section 1 easier.

A practical plan: read Section 1 first, especially Chapters 2, 3 and 9–12, since later chapters use their vocabulary of receptors, kinetics and variability. Then work through the other sections in the order of your course, starting each with its Key Points boxes and returning to the Clinical Uses boxes. Section 2 (Chapters 13–15) is the base for autonomic and cardiovascular pharmacology; Sections 3 and 4 hold the drug-class chapters that most courses draw on. Use Chapter 58 as the checklist for adverse effects and the online questions and cases for revision. Pair the text with a formulary so that each mechanism is matched to a real drug, dose and monitoring plan.