Use of brand names to identify medications can be confusing for healthcare professionals, much less patients! When I think about the two name naming system in the U.S., it really doesn’t enhance patient care and leads to confusion. Although the following case doesn’t involve look alike/sound alike, this gives me an opportunity to point out this nice reference of Confused Drug Names from ISMP – A 79 year old nursing home resident was struggling with significant COPD and was currently taking Advair 50/250 twice daily, along with scheduled Duonebs 3 times daily and as needed. Remember that Advair (fluticasone and salmeterol) is a combination inhaled corticosteroid and long acting beta-agonist. When I came across this case, I read the recent progress note from the physician about the resident’s struggles and the physician felt that a long acting anticholinergic would be beneficial (Spiriva – tiotropium was specifically mentioned).
In looking over this resident’s medication list, he was continued on the Advair, but there was an order for Dulera (mometasone and formoterol). You could imagine my confusion. This was clearly a case of brand name mix-up as obviously Dulera and Advair work via the exact same mechanism or action. Unfortunately, no one questioned this order, and the patient ended up paying for both for a significant period of time. Brand name medication confusion is something that happens and we need to be aware of it, if something doesn’t seem right, step up and ask questions!
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