Drug Nomenclature

The existence of many names for each drug, even when the names are reduced to a minimum, has led to a lamentable and confusing situation in drug nomenclature (see Appendix I in the 11th edition of the parent text ). In addition to its formal chemical name, a new drug is usually assigned a code name by the pharmaceutical manufacturer. If the drug appears promising and the manufacturer wishes to place it on the market, a U.S. adopted name (USAN) is selected by the USAN Council, which is jointly sponsored by the American Medical Association, the American Pharmaceutical Association, and the United States Pharmacopeial Convention, Inc. This nonproprietary name often is referred to as the generic name. If the drug is eventually admitted to the United States Pharmacopeia (see below), the USAN becomes the official name. However, the nonproprietary and official names of an older drug may differ. Subsequently, the drug also will be assigned a proprietary name, or trademark, by the manufacturer. If more than one company markets the drug, then it may have several proprietary names. If mixtures of the drug with other agents are marketed, each such mixture also may have a separate proprietary name.

There is increasing worldwide adoption of the same nonproprietary name for each therapeutic substance. For newer drugs, the USAN is usually adopted for the nonproprietary name in other countries, but this is not true for older drugs. International agreement on drug names is mediated through the World Health Organization and the pertinent health agencies of the cooperating countries.

Except for a few drugs such as levodopa and dextroamphetamine, nonproprietary names usually give no indication of the drug's stereochemistry. This issue becomes important when a drug's different diastereomers produce different pharmacologic effects, as is the case with labetalol (see Chapters 10 and 32).

The nonproprietary or official name of a drug should be used whenever possible, and such a practice has been adopted in this book. The use of the nonproprietary name is clearly less confusing when the drug is available under multiple proprietary names and when the nonproprietary name more readily identifies the drug with its pharmacological class. The facile argument for the proprietary name is that it is frequently more easily pronounced and remembered as a result of advertising. For purposes of identification, representative proprietary names, designated by smallcap type, appear throughout the text and in the index. Not all proprietary names for drugs are included because the number of proprietary names for a single drug may be large and because proprietary names differ from country to country.

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