Preface

This is the 14th edition of book that began as a collaboration between two friends and professors at Yale, Louis Goodman and Alfred Gilman. Over the years, “G&G” has been acclaimed as the “blue bible” of pharmacology. Surely much of that acclaim reflects the book’s purpose, delineated by the original authors and steadily adhered to over 81 years: to correlate pharmacology with related medical sciences, to reinterpret the actions and uses of drugs in light of advances in medicine and the basic biomedical sciences, to emphasize the application of pharmacodynamics to therapeutics, and to create a book that would be useful to students of pharmacology and to healthcare practitioners.

Following these principles is demanding: the sheer volume and unremitting growth of knowledge in the basic biomedical sciences and their clinical applications continue to amaze, challenging editors and contributors who are trying to produce a one-volume work, and surely challenging students. To create a book that reflects our times, we have updated all chapters and have added five new chapters: drug response and the gastrointestinal biome, pharmacovigilance, the blood-brain barrier (it is not simply a lipid sheath), cannabinoids, and immunotherapies for cancer, plus a novel appendix on drug-drug interactions. Advances in immunomodulation are presented in most sections. In addition, we have continued to reach out to younger contributors who are on the forefront of pharmacological investigation and clinical practice. As a result, we have, in this edition, 56 new contributors, drawn from diverse backgrounds, who will ensure the book’s vigor into the future.

A multi-authored work such as Goodman & Gilman grows by accretion, deletion, addition, replacement, and repair. The current text reflects over eight decades of such activity, with wisdom, memorable pearls, new material, and flashes of wit, hopefully edited to meet the present and to be forward looking. End-of-chapter notes acknowledge retired contributors to the 13th edition, but I am happy to acknowledge that several generations of editors and contributors have helped to bring this 14th edition to its present form. As in the 13th edition, we have used a larger page size, no extract type, and more mechanistic figures as we attempt to explain the pharmacodynamics of new agents. Some readers have complained that the book is getting too complex. We believe that a thorough understanding of a drug’s actions and interactions at multiple physiological sites and with other drugs is essential to modern therapeutics. However, we also prominently summarize the mechanisms of action, ADME, and clinical use of individual agents and drug classes. Not wanting to favor one manufacturer’s product over that of another, we continue generally to avoid using trade names except as needed to distinguish multiple formulations of the same agent that have distinct pharmacokinetic or pharmacodynamic properties or that are known only by a trade name. The full text is available online at many medical, pharmacy, and nursing schools by institutional subscription to AccessMedicine.com and AccessPharmacy.com, where we publish regular updates. Feel free to contact the editors by email if you have comments on the book or the websites.

Editing this book brings to mind a number of larger issues, both positive and negative, relating to health care; among them: the remarkable explosion of molecular genetic techniques, the proliferation of therapeutic agents affecting the immune system, and the power of computer-aided drug design; antibiotic resistance promoted by the continuing misuse and overuse of antibiotics in healthcare and animal husbandry; the adverse environmental effects of human activity to life on Earth; the effects of global warming and the sheer size of the human population on global health and nutrition; the ease with which infectious diseases can spread around the world; the fragility of truth and fact, and the difficulty of promoting health based on science and data in the face of determined conspiracy theories and political ideology. A better world is possible.

A number of people have contributed to the preparation of this edition of Goodman & Gilman. Many thanks to: my co-editor, Bjorn Knollmann, and to the clinical pharmacology fellows at Vanderbilt whom he recruited to read the first drafts of chapters as they honed their editorial skills; our attentive publisher at McGraw Hill, Michael Weitz, and his colleagues Christina Thomas and Melinda Avelar; consulting pharmacist Nelda Murri; Nitesh Sharma at KnowledgeWorks Global Ltd, who tirelessly oversaw the transformation of Word documents into a printed book; Jason McAlexander of MPS North America, whose rapid-response artwork brightens the pages; and the eagle-eyed Becky Hainz-Baxter, who saw what the editors had missed.

My special thanks to Lynne Larson, a novelist, artist, and grants management specialist who managed this enterprise and kept the editors organized. Lynne managed the production of the 11th edition of Goodman & Gilman when I first became the editor, when everything was done with hard copy and Word files submitted by mail, when galley proofs were actual long sheets of paper on which corrections were handwritten and then transcribed to new Word files. I was delighted when Lynne agreed to manage this all-electronic project. We would not have this 14th edition without her.