15.4 Drugs.

The chemical name describes a drug in terms of its chemical structure.(p9) Chemical names are provided in the American Chemical Society’s Chemical Abstracts (information available at http://www.cas.org/PRINTED/printca.html) and can be listed in 1 of 2 ways; the first reflects the way in which Chemical Abstracts indexes inverted chemical names: hydrazinecarboxyimidamide, 2-[-(2,6-dichlorophenoxy)ethyl]-, sulfate, (2:1)The second is the uninverted form: 2-[-(2,6-dichlorophenoxy)ethyl] hydrazinecarboxyimidamide sulfate, (2:1)Both forms follow the recommendations of the International Union of Pure and Applied Chemistry and the International Union of Biochemistry and Molecular Biology. Each chemical is also designated a registry number with the Chemical Abstract Society (information available at ...Less

A code designation is a temporary designation assigned to a product by the institution or manufacturer and may be used to refer to a drug under development before a nonproprietary name has been assigned. Codes may be numeric, alphabetic, or alphanumeric; letters in alphanumeric codes designate the institution or manufacturer assigning the code designation of the drug, and are followed by numbers to designate the chemical compound.(p15)Once a nonproprietary name has been assigned, code designations become obsolete and are rarely used in medical publications. If both the code and the nonproprietary name are provided, such as in discussion of the ...Less

For combination products (mixtures), the names of the active ingredients should be provided. The proprietary name of the combination may be given in parentheses if necessary to clarify the product to which the article refers.pseudoephedrine hydrochloride and triprolidine hydrochloride (Actifed) povidone and hydroxyethylcellulose (Adsorbotear)If the list of active ingredients is too long to use when referring to the combination product, the active ingredients should be listed at first mention and either an abbreviation or the proprietary name used thereafter.The patient reported having taken several doses of Vanex HD, a liquid suspension of hydrocodone bitartrate, 10 mg, phenylephrine hydrochloride, 30 mg, ...Less

Some drugs have commonly used abbreviations, such as INH for isoniazid and TMP for trimethoprim. However, abbreviations may be used inconsistently or confused with other terms or be unfamiliar to some readers. Because of the potential for harm from erroneous interpretation of abbreviated drug names, abbreviations should not be used except in rare instances (eg, trimethoprim-sulfamethoxazole may not fit in a table heading and may need to be abbreviated, eg, TMP-SMX; in that case the expansion should be provided in a table footnote). ...Less

This brief summary of the drug development process is provided to help define the origins of different names used to identify drugs.Drugs intended for clinical use undergo several phases of development before they can be considered for human use. Animal studies are performed initially to assess pharmacologic and toxicologic effects. While clinical studies are being conducted, animal studies may continue to assess effects on reproduction, teratogenicity, and carcinogenicity.(p63)To perform clinical studies in the United States, the developer or manufacturer must obtain an investigational new drug (IND) approval from the US Food and Drug Administration (FDA).(p59) Once an IND application has ...Less

Some drug names, such as those used in topical preparations, include the percentage of active drug contained in the preparation. In these cases the percentage should be listed after the drug name.The patient was treated with adalapalene gel, 1%. Metronidazole lotion, 0.75%, was applied twice a day. ...Less

Physicians and other health care professionals, patients, researchers, manufacturers, and the public may refer to drugs by several names, including the nonproprietary name (often referred to as the generic name) and at least 1 proprietary (brand) or trademark name selected by the manufacturer of the drug. Other drug identifiers include chemical names, trivial (unofficial) names, and code designations.(pp12-15) However, only 1 drug name, the nonproprietary name, is regulated internationally to ensure consistent usage and no duplication with other drugs. Once a drug has been assigned a nonproprietary name, the nonproprietary name should always be used to refer to the drug. ...Less

Drugs often contain a pharmacologically inactive component, eg, a base, salt, or ester, that is not responsible for the drug’s mechanism of action but lends stability or other properties to the drug. Drugs with both an active and inactive component generally require a 2-part name that provides the active and inactive portion of the drug. Inorganic salts and simple organic acids are named in the order cation-anion (eg, sodium chloride, magnesium citrate). For more complex organic compounds, the active component is named first (eg, oxacillin sodium).(p1224)Pharmacologically inactive components are generally salts, esters, and complexes. Sodium, potassium, chloride, hydrochloride, sulfate, mesylate, ...Less

Herbals and dietary supplements do not receive INNs, and they are not regulated as drugs in many countries, including the United States (as mandated by the Dietary Supplement Health and Education Act, passed in 1994).In the United States, Congress has defined a dietary supplement as a product taken by mouth that contains a “dietary ingredient” intended to supplement the diet. The “dietary ingredients” in these products may include: vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites. Dietary supplements can also be extracts or concentrates, and may be found in many ...Less

Regimens that include multiple drugs may be referred to by an abbreviation after the nonproprietary names of the drugs have been provided at first mention (see also , Drug Abbreviations, and , Abbreviations, Clinical, Technical and Other Common Terms). Drug regimens used in oncology frequently are referred to by abbreviations of combinations of antineoplastic agents, but often the abbreviations are not derived from the INNs. For example, the letter O in MOPP is derived from Oncovin, the proprietary name for vincristine sulfate, and the A in ABVD is derived from Adriamycin, the proprietary name for doxorubicin hydrochloride. When the abbreviation ...Less