28 February 2008

Drug name confusion

Platelets aggregating at the site of a wound.

Two or three years ago Dr Grumble was called to see a confused old lady on the ward. Confusion amongst old ladies in hospital is a common problem. The junior doctors were not too worried about that. But they were worried about something else - a low platelet count. The platelets were dangerously low. It was puzzling those looking after her. Now Dr Grumble is no haematologist but he does know where to start with problems like this. And he started with the drug chart. He went through the drugs one by one. He came across one he was not familiar with - you just cannot be familiar with them all. It was called hydroxycarbamide. "What's that for?" asked Dr Grumble. Nobody knew. "What is it?" Nobody knew. Nobody carries a BNF any more. That was one good use of the white coat but white coats are now a thing of the past. But we found a BNF somewhere and the BNF revealed all. Hydroxycarbamide is the new name for hydroxyurea. Hydroxyurea is used to lower platelets and the patient was taking it for essential thrombocytosis. Problem solved.

The culprit.

Changing drug names is not without risk. And it's especially problematic if the two names are really not very similar. Dr Crippen relates a similar problem here.

The real culprits.
This post was first published on 10th May 2007. Dr Crippen, it seems, is still having problems. By the way he is wrong about the spelling of 'fetus'.

1 comment:

PhD scientist said...

I cannot believe they have changed the name of "urea" to "carbamide", Dr Grumble. That truly defies all common sense.

I have a friend who cloned one of the first mammalian urea transporter proteins. He is a big cheese in urea physiology and goes to learned conferences in the US with all the other worldwide urea physiology gang. We have not come ONE SINGLE PERSON in the urea physiology and medicine world who says "carbamide". A significant number, I suspect, wouldn't even know it meant urea. And that's people who have spent years with said molecule.


Sometimes one suspects people change names simply to screw things up, or to make things more obscure on purpose*, but surely that can't be true for drug naming... Surely?


*An example of this used to be the US immigration service forms for applying for permanent residency. (Green Card status) There was a huge multi-page medical questionnaire, including "Have you ever suffered from XYZ..? Y/N" with fifty diseases. Several of these were not given the names ordinary people would recognise, and it was widely believed that the intent was to trip people up. For instance, "Hansen's Disease" was listed, but without the accompanying word "(leprosy)"