Development of an Established Name: Analyzing Stem Based United States Adopted Naming
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Development of an Established Name: Analyzing Stem Based United States Adopted Naming
Patrick M. Carpenter, MS, RPh Managing Director, abuliCure, Inc., Boston, Massachusetts Robyn A. Bruce, PharmD Pharmacist, Bioscrip Specialty Pharmacy, Boston, Massachusetts
Key Words Nonproprietary name; USAN; Stem; Name confusion; Medication errors Correspondence Address Patrick M. Carpenter, MS, RPh, 427 Shawmut Avenue, #5, Boston, MA 02118 (e-mail: [email protected]).
Objectives: This retrospective analysis classifies US adopted naming (USAN) stems based on how the stem is defined. This analysis seeks to identify “commonalities” among stems, discuss medication errors due to drug name issues, identify inconsistencies of the stem-based naming system, and discuss possible solutions to the problem, including education of health care providers. Methods: Stems were tagged by up to four descriptors, invented by the author, according to their definition(s). These descriptors are prototype, therapeutic use, mechanism of action, and composition. Unordered combinations of the four descriptors produced 15 possible subsets. A search of the USAN dictionary was conducted to identify drug names that misincorporated a stem. On the basis of the data collected, the authors were able to identify inconsistencies with the naming system. Results: Of the 383 stems on the USAN stem list, 312 (81.46%) were classified into one of the 15 subsets. The six most frequently occupied subsets account for 287 of the 312 stems originally clas-
INTRODUCTION The same drug can be identified by many different names. Each drug has a chemical name; a nonproprietary, or generic, name; an established name; and a brand, or proprietary, name. Most institutions use the established name to identify drugs, so it is imperative that these names for drugs promote their safe use. Studies evaluating the types and causes of medication errors, as well as the factors contributing to these errors, show that misleading drug names can cause problems, which are sometimes fatal. Phillips et al. reviewed deaths associated with medication errors, which were entered into the Food and Drug Administration’s (FDA) Adverse Event Reporting System (AERS) between 1993 and 1998. According to these reports, 469 deaths were attributed to
sified (91.99%). These six subsets, in order of decreasing frequency are prototype/use, mechanism of action (MOA), prototype, use/MOA, and prototype/MOA. Conclusion: Misincorporation of a stem into a drug name may result in confusion as to the nature and use of a drug. Proper incorporation of a stem into a drug name is easiest when the stem’s definition is simple, that is, fits only one descriptor. Since the ultimate goal of a drug name is to convey simple and useful information to a health care professional, stems should be incorporated correctly. Our data does not give enough information to support how drugs should be named (for example, only with stems that show MOA), but it clearly shows that drugs should not be named with stems that are misincorpor
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