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Disposition of Toxic Drugs and Chemicals in Man, 8th Edition.

Disposition of Toxic Drugs and Chemicals in Man, 8th Edition.

Randall C. Baselt. Foster City, CA: Biomedical Publications, 2009, 1720 pp, $247.50. ISBN 978-09626523-7-0

When the eighth edition of "Baselt" thudded onto my desk as the mail cart sailed past my open door, I happened to be looking up oxycodone metabolism in my well used fifth edition ([C]2000). It was immediately obvious that the eighth edition was thicker and heavier than the fifth, and I was excited to see what the newest edition had to offer. Although the fifth edition lists only 2 oxycodone metabolites, I was pleased to see the eighth edition included structures for 6 metabolites. Clearly it is time for me to update my personal library, but what does the eighth edition offer that is not present in the seventh edition ([C]2004)?

The eighth edition of Baselt's text includes 222 new entries, bringing the total number to more than 950 compounds. New drugs included in the latest edition cover the spectrum of compounds recently approved for human use (antibiotics to vasodilators). The format for each entry is very similar to previous editions. Entries are listed alphabetically and consist of the compound name and chemical structure along with information regarding half-life, volume of distribution, fraction bound to protein, and dissociation constants. Because mass spectrometry is an essential component of toxicology today, I would like to see molecular weight (i.e., exact mass) data included in future editions. Also new in this edition is the inclusion of data on blood/plasma concentration ratios when known. In addition to this basic information, each listing includes the core data that makes Baselt's text essential for all toxicologists: occurrence and use, blood concentrations, metabolism and excretion, toxicity, analysis, and references. A quick scan of Baselt is often essential when I am consulted to help interpret toxicology results. I really like the concise entries that allow me to review basic pharmacodynamics while I am on the phone with other health care providers. This text provides a good general overview of most toxic compounds and has sufficient toxicology-related detail to answer many toxicology-related questions. When the answer is not immediately evident, Baselt provides a foundation for further inquiries.

Although the 222 new entries are nice, the more important question for me is: Has the author updated the existing entries to make them current? To examine this I randomly selected hydrocodone, clozapine, tacrolimus, and lead, figuring this list covered a wide range of compounds. I then compared entries in the seventh edition with the eighth edition. All of the entries I looked at were updated. For hydrocone, the updates included data on sustained-release formulations, a method for analyzing this compound by liquid chromatography--tandem mass spectrometry, and 2 new references. The eighth edition also included data on trough blood concentrations of clozapine and a reference to instability of clozapine stored in fluoridated blood, information not present in the seventh edition. For lead, the updated version included the new threshold limit value, which dropped from 0.15 mg/[m.sup.3] to 0.05 mg/[m.sup.3]. However, the lead entry still includes outdated information, such as the statement that "Generally, 0.40 mg/L is considered the upper limit of normal for blood lead," a concentration most toxicologists would now consider increased. New additions to the tacrolimus entry include data on blood/ plasma ratio, pharmacokinetics on extended-release formulations, blood concentrations encountered with dermal absorption, and new trough blood concentration data. There is also a new report, along with 4 other new references, on the powerful interaction between grapefruit juice ingestion and tacrolimus metabolism.

Third-person descriptions of key texts are limited to the likes of Tietz, Goodman and Gilman, and Ellenhorn. It is common to hear "Has anyone seen Baselt?" although Baselt himself has never been in my laboratory. The eighth edition continues the fine tradition of providing essential data for interpreting toxicology results and ensures that toxicologists worldwide will continue to search out this valuable reference.

Author Contributions: All authors confirmed they have contributed to the intellectual content of this paper and have met the following 3 requirements: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) draftingor revisingthe article for intellectual content; and (c) final approval of the published article.

Authors' Disclosures of Potential Conflicts of Interest: No authors declared any potential conflicts of interest.

Role of Sponsor: The funding organizations played no role in the design of study, choice of enrolled patients, review and interpretation of data, or preparation or approval of manuscript.

--Robert L. Fitzgerald

VA Medical Center/University of California, San Diego, CA

Previously published online at DOI: 10.1373/clinchem.2009.133827
COPYRIGHT 2009 American Association for Clinical Chemistry, Inc.
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Author:Fitzgerald, Robert L.
Publication:Clinical Chemistry
Date:Dec 1, 2009
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