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Drugs may cause disease, or they may aggravate the morbidity of the
condition for which they are prescribed, and certain patients may
for one or other reason be particularly liable to drug injury. The
inextricable relationships between the toxic profiles of drugs, the
natural history of the diseases for which they are given, and the
adverse drug effects that may develop in the course of such
diseases are of considerable interest. It is the study of these
rather neglected aspects of pharmacology and therapeutics which has
formed the basis of this book. An explanation is required of the
approach and the style which have been followed. The monograph does
not purport to be comprehensive. Only important drug groups which
are commonly used in practice are considered. Emphasis has been
placed on achieving maximum benefit and safety of the appropriate
drugs in the management of common illnesses. When treatment fails,
either ab initio or subsequent to an initial response, the
risk-benefit relationship of drugs inevitably alters. For this
reason the main factors responsible for treatment failure have been
considered, with special attention to the possible contribution of
or implications for drug therapy in such a situation. Finally,
proposals have been put forward for improving the diagnosis and
reporting of adverse drug effects. In order to be practical and, as
far as possible, constructive it has been necessary for me to "take
a position" on numerous issues.
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