Encouraging Language Development

Many paediatricians with a special interest in the use ofdrugs in children have waited a long time for a textbook that covers all that is currently known in the field of paediatric pharmacology, and most of them will not be disappointed as this book presents a comprehensive overview of the subject. Many of the contributors, each a recognised authority on his subject, have not been afraid to point to the many gaps that exist in our knowledge. I found this a refreshingly honest and useful approach and one that should stimulate the research-minded reader. Criticism that there is a lack of information and that the book has been compiled too early can, I think, be refuted by the overwhelming need for the practising clinician to have such information to hand. The contents are rightly limited to clinical pharmacology, but the practising clinician looking for guidance will be pleased by the therapeutically orientated style of the chapters-for example, anticonvulsant usage, use of antipyretics, etc. The areas covered are broad-for example, pharmacological principles, compliance, ethics, adverse effects, poisoning, and the usual major drug classes, but a chapter on antihypertensive drugs would have been useful. Most books can be criticised and this one is no exception. Much of the information is duplicated and in the first two chapters, different abbreviations are used for dose, elimination rate constant, and volume of distribution. With careful editing it should have been possible to avoid the repetition that is a feature of this and of many other multiauthor texts. It suggests a lack ofconsideration of chapter content, an unwillingness to alter an authoritative contribution, or an inability to provide adequate cross referencing. With lack of data on many subjects recourse to studies on adults is often necessary, but I think this should have been better clarified especially in areas where a difference between ages is most likely to exist. Also, some chapters-for example, the one on drugs in human milk-are of greater theoretical than practical help as the author has given data on a fairly small number of drugs compared with a large total for which information, though limited, is available. Paediatricians on this side of the Atlantic will be surprised by the mention of tetracycline and oral contraceptives until they remember the different patient populations existing elsewhere. Likewise the preponderance of information on theophylline preparations for the treatment of asthma reflects the natural history of drug (un)availability in the USA rather than the balance of experience of such drug use here. These are not major criticisms; this is a good book which may be a little large as a forerunner in the open market of a specialty subject here. Nevertheless, general acknowledgement of the principles and use here will be bound to enhance our approach and will greatly benefit our drug-receiving child population. Acknowledging its deficiencies, I warmly recommend it.