Drug nomenclature systems
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International Nonproprietary Names (INN) System and Global Drug Naming
The International Nonproprietary Names (INN) system, established by the World Health Organization (WHO) in the 1950s, is the main global standard for naming pharmaceutical substances. Its goal is to provide unique, universally recognized names for drugs, which helps ensure consistency in clinical development, licensing, prescribing, and pharmacovigilance across countries 145. The INN system uses "stems"—short name fragments that indicate the pharmacological group of a drug—to categorize substances. This approach has helped reduce medication errors and improve communication in healthcare 45.
However, the system is not without challenges. For example, the naming of monoclonal antibodies became problematic as the number of drugs ending in "-mab" grew, making it difficult to create new, distinct names. In response, the WHO revised the system in 2021, discontinuing the "-mab" stem and introducing four new stems: -tug, -bart, -mig, and -ment, to better accommodate new antibody-based drugs .
Types of Drug Names: Chemical, Nonproprietary, and Proprietary
Drugs typically have three main types of names:
- Chemical name: Describes the chemical structure of the drug and is used during early development.
- Nonproprietary (generic) name: Assigned by scientific authorities (such as WHO's INN) and used internationally.
- Proprietary (brand) name: Chosen by the manufacturer and used for marketing 59.
The use of different names for the same drug in various countries (e.g., acetaminophen in Canada vs. paracetamol in Britain) can cause confusion and increase the risk of medication errors. Standardizing names internationally is seen as a way to improve safety and clarity .
Nomenclature for Combination Drugs
Naming combination drugs—those containing more than one active ingredient—presents additional challenges. The INN system does not fully cover these products, leading to inconsistencies and potential prescribing errors. Experts recommend a standard approach: listing the INN of each component followed by dose information (e.g., "paracetamol + codeine"), to enhance clarity and safety, especially for widely used combinations .
Neuroscience-Based Nomenclature (NbN) for Psychotropic Drugs
Traditional drug classification systems, such as the Anatomical Therapeutic Chemical (ATC) system, often categorize psychotropic drugs by their clinical indication (e.g., "antidepressant" or "antipsychotic"). This can be misleading, as many drugs are used for multiple conditions and their mechanisms of action are not always reflected in their names 2378.
The Neuroscience-based Nomenclature (NbN) was developed to address these issues by classifying psychotropic drugs based on their pharmacological profile and mechanism of action, rather than just their clinical use. NbN aims to provide more precise, up-to-date information for prescribers, improve patient understanding, and support rational prescribing decisions 237. However, some experts argue that NbN can be overly complex and may not always be practical for clinicians, suggesting that a balance between simplicity and scientific accuracy is needed .
Stereochemistry in Drug Nomenclature
Most current nonproprietary drug names do not indicate the stereochemical properties of drugs, even though these properties can significantly affect drug action and safety. A new proposal suggests adding prefixes to drug names to indicate stereochemistry (e.g., [dex]-, [lev]-, [rac]-), which could improve clarity in drug information, therapy, and research .
Conclusion
Drug nomenclature systems are essential for safe and effective healthcare communication. The INN system provides a global standard, but ongoing challenges—such as naming new drug classes, combination products, and reflecting pharmacological mechanisms—require continuous updates and improvements. New approaches like the NbN for psychotropic drugs and proposals for stereochemically informative names aim to make drug naming more precise, informative, and useful for clinicians and patients alike 12345678+2 MORE.
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