What’s in a name?
By Dr. David Keegan

Like many of my colleagues, I’ve pretty much tried all of the time to stay away from the use of brand names for prescription medications. I diligently write out enoxaparin, lansoprazole and even clarithromycin, in favour of their snappier brand monikers. I’m certainly not alone in this approach, being a strategy widely held to reduce influence from pharmaceutical marketing.

The two key exceptions to this strategy occur when a particular brand name preparation is preferable to other available generic versions (an infrequent occurence), and when a combination preparation is required. There is certainly no one in this country who finds it easier to write sulphamethoxazole/trimethoprim, than to simply prescribe Septra DS. And as a result, the rather frequently needed combination of acetaminophen 325mg/codeine 30mg tends to be prescribed as Atasol 30s. It gets quite automatic that when someone needs short term analgesia stronger than acetaminophen alone, you write a script for Atasol 30s. At least in Newfoundland.

When I first started working as a resident again in London, on caring for patients with fractures, I would happily write the familiar Atasol 30s, only to find patients getting angry that I hadn’t prescribed them Tylenol 3s. Nurses would call me to clarify my written drug order on this completely foreign entity of Atasol 30s, with me trying to plead its identical composition to Tylenol 3. Discussions with fellow trainees would frequently end up with confusion surrounding this new mysterious drug I had mentioned. Eventually, I have had to place the veneer of the better-marketed Tylenol 3 over the previously ingrained Atasol 30.

This is not an experience unique to me: it seems that whenever two Memorial graduates meet on the mainland, it is almost a requirement to have a chuckling conversation about the Atasol 30/Tylenol 3 issue. There are still days, though finally getting rare, during which I utter the old familiar phrase, but now I automatically catch myself, ending up saying things like, “Could you please give that man two Atasol 30s, I mean Tylenol 3s?” But it has been some time now since this has happened.

Then, quite startling, a week ago I was working at the Children’s Hospital emergency, when I saw an empty Atasol 30 box lying on the counter. I looked at it, blinked twice and slowly picked it up, almost reverently as though it was a sacred artifact. I grinned a little at this unexpected reminder of home and surmised that the Atasol people had somehow won the hospital contract.

I kept the box, taking it home.

Author’s note: I have been very honoured by the kind comments I received from many people after the conclusion of my column last year – thank you very much. I feel even more honoured that, after further honing of MUNMED’s vision, I have been invited back, helping to bring to life the voice of expatriate alumni. It’s great to be home.