[e-drug] Use of stems in International Nonproprietary Names

[stein@lyftingsmo.no]

E-DRUG: Use of stems in International Nonproprietary Names (2)
---------------------------------------------------------

WHO has used an old WHO-internal pharmacological classification to group INN 
(International Nonproprietary Name) stems. I have criticised WHO for not using the 
ATC (Anatomical Therapeutic Chemical) classification system for medicines for this.
http://www.who.int/medicines/library/qsm/stemdoc2004.pdf 
http://www.whocc.no/atcddd/

I have had some responses off list, but I choose to send my reply to E-drug.

There are many sides to the question about which classification system should be 
used to classify INN stems.

Whether it is called classification or nomenclature does not change the question.

Since we are talking about stems and not substances, only 3rd and 4th level of ATC 
is relevant. Assigning 5th level ATC to phase I or II substances is not relevant in this 
connection.

Some stems and substances have several effects, and consequently more than one 
ATC code. Aspirin is one example. This classification 'problem' is the same for all 
classification systems. The solution is to use the most important or the most used 
code, or to list the item under all the codes that is assigned to it.

If the classification system used by WHO in this connection has superiority to ATC, 
then this superiority should be specified.

If ATC is equal, then it is a problem if a guidelines-making organisation like WHO 
does not follow recommendations from another part of the same organisation.
This is perhaps the most worrying side of this matter.

The fact that the ATC system is sometimes wrongly used should not be a hindrance 
to practical and correct use of it.

It is understandable that old traditions and systems are followed. But having been 
made aware that relevant recommendations exist, even issued by a closely related 
part of WHO, then the work should start to adapt to these recommendations.

Stein Lyftingsmo
Hospital Pharmacy of Elverum, Norway
stein@lyftingsmo.no
www.lyftingsmo.no
[Thanks Stein.  Please could you supply a few more examples so we can get a better 'picture'? BS]