Can you speak pharmacish?

Modern medicine – one of humanities greatest on-going endeavours and saviour of countless lives. But have you ever actually read a medicine bottle? Russ Swan gives us a lesson in ‘pharmacish’ to help us along… WHAT is your lab working on, right now? If you happen to be in a research laboratory, the chances are that at least some of your projects involve the development of new drugs. Pushing back the frontiers of science, moving the battle lines in the war against disease, that sort of thing. If, on the other hand, you are in a clinical lab, it's quite likely you are identifying the need for medicines, or checking on their effects and side-effects.

Either way, a large proportion of laboratories are in the medicine business. We are all drug dealers in one form or another, in that we deal with drugs on a routine basis. But what do we call them, those molecules which define our careers?

Because I'm the 'sciencey' one in the family, I've recently been drafted in to look over the extensive list of medications prescribed to an elderly relative. I Am Not A Doctor, I told them. I Am Not A Pharmacist, I added. Doesn’t matter, just have a look, came the rejoinder.

It was like a moment from a science fiction movie: landing on an alien planet to discover some ancient and utterly incomprehensible script which held the key to the next plot development – if only we could work out what it means.

I recognised the letters, of course, and even some collections of letters. A few of the couple of dozen or so chemical compounds presented themselves with teasing stubs of almost-familiar terms – somethingstatin, or somethingcillin. "Ah yes, I see, hmmm" I nodded sagely. This seemed to satisfy the assembled throng, and I was at last allowed a cup of tea.

But my curiosity was piqued. Here was a new and unrecognised modern foreign language, begging to be deciphered.

The first problem to be encountered is that medicines don’t just have a name, oh no. That would be too simple. The trademarked name created by the drug company is just the start, and is simply a marketing label which sits on top of a generic name. If I were to go around calling myself Nigel (Russ), people might quickly think I was a bit of a loon. They might think so anyway, but that is a different issue. Yet nobody in the medical profession seems to think it odd for a potentially life-saving chemical to be called Integrilin (eptifibatide).

Scratch the surface, and it gets more complex yet. As a scientist, I want to know what is actually inside these curiously-shaped and multi-coloured nodules of medication – but looking deeper only makes it worse. Among the several chemical synonyms for that particular drug, chosen at random, is L-Cysteinamide, N6-(aminoiminomethyl)-N2-(3-mercapto-1-oxopropyl)-L-lysylglycyl-L-alpha-aspartyl-L-tryptophy-L-prolyl-, cyclic (1-6)-disulfide. I don’t know about you, but I don’t feel particularly enlightened.

I have on my bookshelf a copy of the British Pharmacopoeia which, as you will know, contains a list and description of all medicines approved for use in the UK. It is a fascinating volume into which I periodically dip for a little quiet reading, or to reprise the method of preparation for nitroglycerin. My copy isn't quite the current edition (a six-volume set costing £1000), but a junkshop discovery published in 1914 and originally retailing at a couple of shillings. In contrast to today's unintelligible lists of generic and trademarked names compounded by multihyphenated chemical compound names, this is a treasury of Latin terms like Physostigminae Sulphas and Spiritus Ammoniae Fetidus.

Its lists of tinctures and unguents is a world away from our modern pharmacy, and yet its language is just as foreign to most of us as the modern dialect of Pharmacish. While the romantic in me might yearn for the more lyrical, even poetic terms used to describe medicines in the days before World Wars, there is no way I'd forego the enormous advances in medical science that have presaged today's lumbering, complex, and often ugly drug names. Especially when a family member's wellbeing hinges on just those chemicals.

So, what is your lab working on? In all probability, it's known only as XF4341 or some equally meaningless project label. As long as it works, that's alright by me. Perhaps, one day, a lab will come up with a new compound that improves mental perception of long multisyllable medical names, and also improves motor functions of the tongue and lips, to enable drug names to be used in casual conversation. I'd like to suggest that this new drug be named Kevin.