From Mr R. N. Longshaw, MRPharmS
SIR,-It's true! I'm forced to admit it. My wife and I have both turned into "pharmacists of a certain age". How de we know? It was like this: it was a warm evening in May and I was sitting quietly ruminating, as one does, on matters professional while keeping half any eye on Have I got news for you, when suddenly the erudite comments were made inaudible by my wife asking, "What's in Benadryl?".
Quick as a flash I replied, "Diphenhydramine", knowing instinctively after many, many years of marriage that, lactose, magnesium stearate, and so on, was not the answer required.
"Wrong!" she roared, gleefully.
Not being one to lose an argument without a fight, I consulted our ancient copy of Martindale (26th edition) and proved my point with an alacrity not normally demonstrated at that time of the evening, only to be trumped with that day's copy of the PJ, in which my wife had found a full-page advertisement for Benadryl, described thus: "Contains acrivastine."
I do believe that Warner Lambert needs to be taken to task and not simply because I lost an argument with my wife, which is bad enough, but because what it has done could, in my view, be dangerous.
It is the principle of using trade names to describe different active ingredients which is dangerous. Medicines are not ordinary items of commerce and trade names should be restricted to the active ingredient or ingredients which the product originally contained. To argue, as we have seen previously in professional publications, that trade names are no more than a brand which can be used as a marketeer sees fit is, in the context of medicines, quite without sense.
We have different perspectives on this situation as my wife works in community pharmacy whereas I work in hospital. In primary care, the risk is in inadvertently prescribing the wrong drug, whereas in hospital, because generic dispensing is universal, the risk is in dispensing the wrong drug. In my case (and I expect that of most hospital colleagues) I "translate" trade names into approved names almost without conscious thought. The use of a trade name for different drugs produces yet another risk which must be managed in prescribing and dispensing processes. This is why we believe that trade names for medicines should be treated as unique.
Failing this it would be sensible to have a defined period before a trade name could be reused to describe another active ingredient.
How long? Long enough so that rather than be "pharmacists of a certain age" we can become "venerable icons of times past".
R. N. Longshaw
Chief Pharmacist, The Freeman Hospital, Newcastle upon Tyne