In the British Medical Journal for February 19 is an interesting discussion by Jeffrey K. Aronson of Oxford university concerning the proper nomenclature of adrenaline. He points out that, unless we choose to call this important hormone by its systematic chemical name of dihydroxyphenylmethylaminoethanol, we are left with the choice of adrenaline or epinephrine.
The existence of alternative approved names in different countries is both unnecessary and confusing, writes Dr Aronson. The British Approved Name adrenaline is familiar to us in our own literature, and we become aware of epinephrine only in literature emanating from North America or Japan. To complicate the issue, a European Commission directive shortly to be implemented requires member states to adopt International Non-proprietary Names for drugs. In compliance with this we shall be obliged to call our pressor hormone epinephrine. Dr Aronson argues that there are excellent reasons for persuading the European Community to resist this particular change in nomenclature, on the basis of usage, history, etymology and the need to avoid clinical medication errors.
The reason for opposing the name change is not just the unwillingness to Americanise our language. There are instances in which British Approved Names for drugs are being put forward for international adoption in preference to some US adopted names. To talk of epinephrine increases the risk of prescription and medication errors in many countries where adrenaline is now the preferred title. In an emergency, epinephrine has been confused with ephedrine.
In world medical and pharmaceutical literature the name adrenaline prevails for good reason. In common parlance we talk of "a surge of adrenaline" and never of "a surge of epinephrine", regrettable though the expression may be at the best of times. The receptors on which the hormone acts are classified as adrenoceptors. Derivative drugs are called isoprenaline or orciprenaline, for example, and the beta-keto derivative is universally called adrenolone. There is no such compound as epinephrone.
On the strength of such arguments the World Health Organisation would be well advised to revise its choice of an International Non-proprietary Name for dihydroxyphenylmethylaminoethanol to adrenaline, and similarly to adopt the name noradrenaline in place of norepinephrine. That ought to resolve the dilemma facing the European Commission and constitute a victory for logic and common sense.