Published April 14, 2005 in issue 0415 of the Hook

BY JOHN HONG

Mary Poppins said the longest word in English is supercalifragilisticespialidocious. I think the longest-named medicine is Hydrochlorothiazide. (And if you say it loud enough, you'll always sound precocious.)

Really, hydrochlorothiazide, aka HCTZ, is really not that hard to say. However, for most patients, pronouncing this medicine can be very intimidating. Most patients hate to say it. "Doc, I need a refill on my hydu-- chor-- whatever."

Medicines have two names: a generic and a brand name. For example, Sudafed (brand name) is an over-the-counter decongestant. If your doctor tells you to use Sudafed, you will probably think, "I could have told you that!" However, if you get a prescription for pseudoephedrine (the generic name), you might think you're receiving a high-tech decongestant. "My doctor rocks! She just prescribed me 'suedosomething'."

Brand names come from pharmaceutical companies that originally patent the drugs. There are many catchy names:

* Tripak (for three high-dose antibiotics, though it sounds more like a camping kit)

* Avapro (sounds like a pro-- for blood pressure)

* Actos (act on your diabetes, baby!)

* Lexapro (not a pro at the dictionary, but an antidepressant)

* Strattera (reach for the heavens with this ADHD pill)

* Valtrex (sounds like a dinosaur, but it's a herpes medication)

* Crestor (sounds like a toothpaste that lowers cholesterol), * Celebrex (be pain free and celebrate!)

* Novolog (a space aged insulin)

* Zyrtec (an antihistamine that sounds­ well, I'm not sure what it sounds like).

When I was teaching in D.C., I became a private investigator for a new influenza medication that was not even named yet. The investigation drug name was something like 34R2S7Z, but I called it R2D2 to make things simple. I think the medical director's name was C3PO.

Anyway, while attending an investigation meeting, we were asked to see if we could come up with a brand name for the medication. Since it was a flu pill, I came up with a few names: "FluAway," "BugBeGone," "One Flu Over the Cuckoo's Nest." Needless to say, my ideas weren't taken seriously. The name of the drug is now called "Tamiflu." When I heard the pill was named "Tamiflu," all I could think of was Tammy Faye Baker sick in bed with the flu­ in full makeup, with a Kleenex box by her side.

My brother is a pharmaceutical business manager in LA, and he told me that brand names are usually unique words. The brand name will not be a real word in any language. Makes sense to me. You wouldn't want your blood pressure medication to mean, "Heart Attack" in Asia, or your diabetes pill to mean "Sugar Daddy" in Africa.

Because most of my patients cannot pronounce their medications-- let alone remember the dosages-- I ask them to always bring their current prescription bottle to their office visits. Errors are made at the pharmacy too because some medicines sound very similar.

Celebrex, Celexa, and Zyprexa sound very similar. However, each medicine is very different. If you have arthritis and take Celexa (antidepressant) instead of Celebrex (pain pill), you might become very happy about your pain-- but I doubt it. This is why having your doctor call in a prescription has its risks.

Some patients think they'll be able to describe their medication to their physician. "Doctor, it's a little round white pill about yea big."

I think about one thousand medicines are little round pills, so this description usually isn't helpful. It is like describing what your mother looks like, "She's about five feet four, gray hair, and wears glasses. Do you know her?"

I wonder what would happen if a pharmaceutical company came out with a medicine that didn't have a name but a symbol, like the Artist Formerly Known As Prince.

Got a question? Dr. Hook wants to hear from you!

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