By Khevin Barnes

Living in the era of Covid-19 is no stroll in the park for most of us here in Vail. It takes a good deal of stamina to deal with all of the unknowns that accompany our pandemic. And when we get sick, the variety of treatment protocols doesn’t make it any easier. There are endless ideas about remedies for our common conditions, and with so many seniors living in Vail it should come as no surprise that there are many non-life-threatening but bothersome ailments in circulation. Things have been tough lately with our Covid-19 lockdowns and the isolation that goes with it, and as a result more migraines, sleeplessness and other stress related conditions are appearing in ever-increasing numbers.

And if that isn’t enough to keep us awake at night, what about all of those drugs we’re offered, along with their confusing names? And who comes up with those names anyway? Drug companies spend vast amounts of money to create the various medicinal agents available to us, but they also spend millions to come up with the perfect name for the expensive chemicals in them. They want to sell those drugs after all, so they turn to human psychology to find out what consumers find appealing in the way of names.

An average drug naming project costs $250,000, and that doesn’t include the costs of registering, trademarking, and getting them approved in the various regulatory bodies. At the end of the project, pharma companies can spend up to $2.5 million on a brand name, and for no other reason than to get our attention.

New prescription drugs approved by the FDA have both a scientific name, known as the generic, and a name given by the manufacturer, known as the brand or trade name. Before a drug is approved by the FDA, the agency will carefully review the proposed brand name.

As an example let’s look at the drug Prozac. The generic name is fluoxetine. It’s a lot simpler to say fluoxetine than to say (RS)-N-methyl-3-phenyl-3-[4-(trifluoromethyl)phenoxy]propan-1-amine, which is the actual chemical component of the drug.

When a drug company researches and patents a drug, it gets to suggest what the name should be. It makes an application to the United States Adopted Names Council for final approval. And that is what those alien-looking words are that are designed to catch your eye in the health magazines and television commercials—you know, the ones that always end with those frightening warnings of the various side effects.

In a typical 30-minute show on network TV, you’ll usually get 3 breaks of about 2 or 3 minutes each. My wife and I watch very little broadcast television these days, but when we do log on to Lester Holt’s news program we prepare ourselves to watch just twenty two minutes of actual news and eight grueling minutes of pharmaceutical advertising, much of it ending with warnings of possible fatal side effects. Naturally the warnings that are required by law are always done quickly at the end of the commercials, in small print scrolling down the screen and often with some upbeat music and puppies or laughing children to smooth over the dire disclaimers. And then there’s that name, that word that drums up visions of health and healing spinning into view on the screen to remind us of a better future.
So, can these drugs be named whatever we dream up? Is there anything preventing a company from calling its active ingredient “CANCERCURITALL”? The answer is “Yes”, and it’s the U.S. Adopted Names Council. It has some strict rules, including the following:
“Prefixes that imply ‘better,’ ‘newer,’ or ‘more effective’; prefixes that evoke the name of the sponsor, dosage form, duration of action or rate of drug release should not be used.”
“Prefixes that refer to an anatomical connotation or medical condition are not acceptable.”
“Certain letters or sets of letters also aren’t allowed at the beginning of new generic names. These include me, str, x, and z.”

Z’s and X’s were very popular for a while. Remember Xanax and Zoloft? A list of naming rules, some of them odd, has evolved as well. The letters h, j, k, and w are off-limits because they lead to pronunciation problems in other languages. After all, a name that sounds perfectly fine in English might have bad or even obscene connotations elsewhere.

Even with the restrictions that trade names cannot imply efficacy, drug makers often select names with connotations aligned with a drug’s intended use. Vick’s “Dayquil” and “Nyquil” respectively suggest daytime or nighttime tranquility in treating cold and flu symptoms.
Being stuck at home during the Covid-19 pandemic invites us to come up with our own remedies for the various aches and pains in our lives. Many seniors in Vail are turning to home delivery for their prescription medicines rather than risk masking up for a visit to their primary care physicians. Personally, my own drug of choice has always been plain old Aspirin, or ‘acetylated salicylic acid’. And it’s hard to come up with a better name than that. And come to think of it, a dose right now might be appropriate. This whole name thing can be a bit of a headache.

Khevin Barnes is a health journalist living in the Del Webb community and a regular contributor to CURE magazine. He maintains a full medicine cabinet of mostly innocuous over-the-counter drugs and reckons that a little laughter really is the best medicine after all.

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