ASHP’s clinical pearls (book review)

By Laurence A. Goldberg

Useful “pearls” for pharmacists

ASHP’s clinical pearls’, edited by Bruce R. Canaday. Pp ix+129. Price $42. Maryland: American Society of Health-System Pharmacists; 2009. ISBN 978 1 58528 218 0

A clinical pearl is intended to convey one idea, concept or fact that a clinical practitioner has found to be useful in daily practice but may not be widely known, understood, published or taught. Clinical pearls are an American Society of Health-System Pharmacists tradition, beginning as a series of presentations at an ASHP Midyear Clinical Meeting in 1988 and continuing at every winter meeting since that time.

This book attempts to capture, for the first time, the characteristics of these innovative presentations. Selected authors have been invited to expand on their original presentations to provide more depth than was possible during their oral presentations. There are 15 clinical pearls covering a wide variety of topics.

The book is easy to read and important messages are presented, although the reader may be put off by some of the light-hearted chapter titles. For example, a chapter entitled “Potter’s pain: Harry, Hogwarts and headaches: migraine prophylaxis in an adolescent and young adult population” starts with a clinical scenario, introduces the subject of headache, discusses therapeutic options and comes up with some suggestions for treatment.

In a chapter on glycaemic control in an intensive care unit, the author looks at the emerging evidence that strongly associates modest hyperglycaemia in critically ill patients with poorer outcomes and discusses the results from key studies carried out in Belgium, France and Germany. The author concludes by suggesting that tighter glycaemic control has been shown to reduce morbidity and mortality in critically ill patient, but asks how low we should go to maximise positive outcomes and minimise the risk of severe hypoglycaemia. This remains controversial.

Other chapters include warfarin–cotrimoxazole interactions, the dangers of gluten in medicines, ibuprofen for patent ductus arteriosus, hypo-response to erythropoietic-stimulating agents and the effect of soy supplementation on testosterone in healthy males.

At first sight, this book appears to be a potpourri of unrelated topics presented in a light-hearted way but, on reading it carefully, this proves not to be the case. ‘ASHP’s clinical pearls’ presents useful, ready-to-apply information that will help clinical pharmacists with their practice.


Laurence A. Goldberg is a pharmaceutical consultant in Bury, Lancashire

Citation: The Salvadore URI: 11071243

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