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[e-drug] Adrenalin - epinephrine (cont'd)

  • From: Kirsten Myhr <myhr@online.no>
  • Date: Sun, 20 Feb 2000 21:55:24 -0500 (EST)

E-drug: Adrenalin - epinephrine (cont'd)

When reading Mr Aronsen's article, it is difficult to understand that
epinephrine has even been suggested as the INN. Who's ever had an
epinephrine rush? And the risk of medication errors by confusing it
with ephedrine is of serious concern. According to data presented in
the article it is only in the USA that epinephrine is extensively (more
than 80 %) used in publications.

Standardisation of medical terminology is a very important issue and
we have not been very successful. Some journals e.g. provide both
terminologies such as kg/pounds, metre/inches and Celsius/Fahrenheit,
others ignore it and do not use the metric system at all. In Norway we
have had much confusion after trying to standardise on mg/ml instead
of percent because the use of the new units were not enforced
strongly enough (at least that's my view). In my opinion such lack of
standardisation must be responsible for many errors, even fatal ones,
not least now that health professionals move freely between many
countries and read international literature. The International Society of
Anaesthesiology (hope I got the name close to correct!) has even
recommended to introduce a colour coding for injections in order to
reduce errors. Not possible to do, but it is an example of the concern
amongst the medical community that drug names constitute a safety
problem as do the fact that health personnel do not always take the
time needed to read the label properly (as e.g. pharmacists advocating
standardisation to black text on white background insist they should).
Let's hope the standardisation of generic names will be more

I have been for shorter periods in many countries and seen many drug
donations from US companies. One major problem has been drug
names, unknown brand names and unknown generic names. Outside
USA few recognises names such as epinephrine, acetaminophen
(paracetamol) and albuterol (salbutamol). I was pleased to see that
except for adrenaline, the US will have to give up their names. The
current WHO ED-list uses epinephrine. I cannot remember if it was
always like that. May be they knew that epinephrine was proposed
INN name and the others not? Fortunately, that seems to be the only
American name used in the list.

I think we should fight for adrenaline! (and for standardisation)


Kirsten Myhr, MScPharm, MPH
Bygdøy alle 58B
0265 Oslo, Norway
Tel.: +47 22 56 05 85
e-mail: myhr@online.no
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