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ASA: Anaesthesiologists Often Confuse Generic and Trade Names of Drugs By Jill Stein SAN FRANCISCO, CA -- October 19, 2003 -- The identification of a drug by its generic and trade name is frequently a source of error among anaesthesiologists, investigators reported here on October 14th at the 2003 Annual Meeting of the American Society of Anesthesiologists. "Stronger efforts must be made to teach anaesthesiologists early in their training how to identify a drug by its generic and trade name," said Vivek Moitra, MD, University of Chicago Hospitals, Chicago, Illinois, United States. Dr. Moitra's group conducted a study to determine whether the generic or trade name of a drug affects how accurately a drug is identified and used peri-operatively. For the trial, eight attending anesthesiologists, 10 second- and third-year anaesthesiology residents, and 10 first-year anaesthesiology residents completed a multiple-choice questionnaire that provided a list of 14 commonly prescribed medications arranged alphabetically by generic names. Participants were asked to select indications (e.g., platelet inhibitor, anti-hypertensive, etc.) and peri-operative recommendations (e.g., discontinue for 7 days, continue, etc.) and were then given a similar list to complete using the trade names of the same 14 drugs. Results showed that all attendings, 75% of second- and third-year residents, and 90% of first-year residents knew that Norvasc was an antihypertensive. Although 75% of attendings, 100% of second- and third-year residents, and 70% of first-year residents would continue Norvasc peri-operatively, only 62.5% of attendings, and 80% of first-year residents said they would continue the drug when it was identified as amlodipine. Because there was a discrepancy between the identification of amlodipine and Norvasc, the authors say they were not surprised to find that 75% of attendings, 100% of second- and third-year residents, and 70% of first-year residents said they would continue Norvasc. Only 62.5% of attendings, 70% of second- and third-year residents, and 80% of first-year residents, however, said they would continue amlodipine. Similarly, 50% of attendings and second- and third-year residents, and 20% of first-year residents said they would add the anti-hypertensive atenolol peri-operatively; but when it was identified by its trade name -- Tenormin -- only 37.5% of attendings and 10% of third-, second-and first-year residents said they would add it. Seventy five percent of attendings, 60% of second- and third-year residents, and 40% of first-year residents described phenelzine as an antidepressant. Only 50% of attendings, 40% of second- and third-year residents, and 10% of first-year residents, however, identified Nardil as an antidepressant. In addition, 25% of attendings, 20% of second- and third-year residents, and 60% of first-year residents misidentified Nardil as primarily an anti-hypertensive. Dr. Moitra said that a drug's spelling might be a factor in the confusion. Nardil, for example, which is a monoamine oxidase inhibitor, ends in "-il", which is a common ending for the generic names of angiotensin-converting enzyme inhibitors. Finally, Dr. Moitra said that doctors need improved access to drug information. "A busy practice does not allow time for going to a Physician's Desk Reference and rummaging through a 900-page book." [Study title: A Drug by Any Other Name: Generic Versus Trade Names. Abstract A-1357] E-mail this page to a friend or colleague! To print, use this version