Wikipedia talk:WikiProject Pharmacology

February

It's a new month, so it's time to select the next WP:WikiProject Medicine/Collaboration of the Month#Nominations_for_the_next_MCOTM. Current nominations include two that related to WP:PHARM: Serotonin and Placebo. If you would be willing to help improve one of these, please sign your name in support of it. You can also nominate other articles that you think would be appropriate and you're willing to help out with. WhatamIdoing (talk) 18:18, 1 February 2011 (UTC)

Finasteride

I would be grateful if project members could have a look at recent additions to finasteride and decide whether these are appropriately sourced. JFW | T@lk 22:22, 8 February 2011 (UTC)

The dispute continues. Additional input would be much appreciated. --ἀνυπόδητος (talk) 13:41, 14 March 2011 (UTC)

Nomenclature of monoclonal antibodies

Nomenclature of monoclonal antibodies has been on GAN for over two months. Maybe somebody from the project interested would be willing to review it.--Garrondo (talk) 07:52, 10 February 2011 (UTC)

I'd do it only I am the nominator :-( ἀνυπόδητος (talk) 09:07, 10 February 2011 (UTC)

I didn't follow up to Anypodetos' reply on his talkpage when I offered to review it. Will review it later on tonight. JFW | T@lk 20:17, 10 February 2011 (UTC)

Two tough questions from JFW:

• Antibodies from hamsters (theoretically -e-) and primates (-i-) have never been assigned INNs. Do any sources explain why they were anticipated, and why none were assigned?

My guess is at Talk:Nomenclature of monoclonal antibodies/GA1, but does anyone know how to source that? --ἀνυπόδητος (talk) 19:50, 14 February 2011 (UTC)

This question has little to do with meeting WP:WIAGA, but the unacquainted reader will wonder why the various bodies went to such lengths to anticipate formal nomenclature for a group of drugs that never quite materialised! JFW | T@lk 22:31, 14 February 2011 (UTC)

Ipratropium

There is a discussion at Talk:Ipratropium about whether this should be the bromide form or not. 64.229.101.183 (talk) 23:46, 14 February 2011 (UTC)

This is related to the question whether other cationic drugs (Tiotropium, Ipratropium/salbutamol) should be moved. See discussion there. --ἀνυπόδητος (talk) 16:15, 15 February 2011 (UTC)

Just to reiterate here ... we typically name pharmaceutical drug pages based on the INN of the active species, rather than a salt form. But ambiguity arises for drugs where the active species is a cation and therefore can't exist except as a salt. In these cases the INN includes the salt in the name (always, or sometimes, I'm not sure). So do we stick with INNs including the salt, or name articles based just on the active species. And what should we do if there are multiple salt forms available for an active species that is ionic? -- Ed (Edgar181) 16:39, 15 February 2011 (UTC)

The general convention has been for many years not to mention the salt. JFW | T@lk 16:43, 15 February 2011 (UTC)

Do you happen to recall if this has been discussed/decided upon previously? If there is consensus, perhaps it should be mentioned in Wikipedia:WikiProject_Pharmacology/Style_guide. -- Ed (Edgar181) 17:04, 15 February 2011 (UTC)

Straight from the source:

An INN is usually designated for the active part of the molecule only, to avoid the multiplication of entries in cases where several salts, esters, etc. are actually used. In such cases, the user of the INN has to create a modified INN (INNM) himself ; mepyramine maleate (a salt of mepyramine with maleic acid) is an example of an INNM. When the creation of an INNM would require the use of a long or inconvenient name for the radical part of the INNM, the INN programme will select a short name for such a radical (for example, mesilate for methanesulfonate).

http://www.who.int/entity/medicines/services/inn/innguidance/en/index.html

However, WHO guidance distinguishes quaternary compounds.

VII. INNMs for quaternary substances

23. In accordance with item 5 of the "General principles" the INN for a quaternary substance will consist of two words, the cation and anion (the base) being named as separate components.

International Nonproprietary Names Modified

(emphasis mine)

In short, the true INN for quaternary compounds (including ipratropium) includes the counterion. For non-quaternary compounds, the INN reflects only the active moiety. We should definitely align our style guide with this convention, which I have actually been following inadvertently for years. Fvasconcellos (t·c) 16:53, 4 March 2011 (UTC)

Where did you use that convention? I can't find a quaternary drug article titles (ehm) that include the counter ion. If we do include it, we should use the titles Tiotropium bromide, Ipratropium bromide/salbutamol and Butylscopolaminium bromide (?, that's the German INN) as well. Are there any others? And are you sure the titles need to be that complicated? --ἀνυπόδητος (talk) 20:16, 6 March 2011 (UTC)

Erm... I'm sure there are several.... I can't remember any off the top of my head, though :| I do know Ed has made several moves in the past that follow this convention: see our neuromuscular blocker articles, for instance. It may be a bit pedantic on my part, but I don't really see this as making the titles too complicated; just as the full implementation of a guideline we have long used. Fvasconcellos (t·c) 22:46, 10 March 2011 (UTC)

Okay, I finally have to agree. Unless there are any additional comments over the next few days, I'll move the pages and clarify this in our style guide. Cheers, ἀνυπόδητος (talk) 12:20, 11 March 2011 (UTC)

 Done. Butylscopolamine still needs to be moved; anyone know its INN? --ἀνυπόδητος (talk) 13:44, 17 March 2011 (UTC)

BOT

Have a bot error in templates of drugs...See contribs CheMoBot. 186.196.59.127 (talk) 12:57, 16 February 2011 (UTC)

Could you specify on this, eg., point to a page where CheMoBot has made an error? Thanks, ἀνυπόδητος (talk) 17:16, 16 February 2011 (UTC)

brand names: chlorhexidine

I am not a member of this project (nor do I wish to be), but I would like project input on the Chlorhexidine article. I looked it up because I'm using it in a prescription mouthwash, and I noticed that there was an Advertisement tag on the article. Looking into the history, I saw that Acdx had placed the tag on 8 October 2010, and had twice reverted removals of it with requests to explain before removing.

I looked at the article, removed the tag, and explained my reasoning (Talk). In further discussion, I found and cited a number of examples of "good articles" from this project's list that cite brand names. I've read the discussions on this page about brand names, and it seems to me that the Chlorhexidine article is well within such guidelines as I have seen here and inferred from the "good articles". But I'm no expert or project member. Would some member of the project please look at that article and that part of the Discussion page, and contribute a knowledgeable opinion? --Thnidu (talk) 01:02, 18 February 2011 (UTC)

Homeopathy

May I suggest that you remove the project banner from Homeopathy (edit | talk | history | protect | delete | links | watch | logs | views), as this is plainly nothing to do with pharmacology. I've yet to encounter a pharmacologist who greets dilutions of 1: 10⁴⁰⁰ with anything other than derision. Guy (Help!) 23:18, 20 February 2011 (UTC)

No objection. I think that not even homoeopaths talk of the "pharmacology" of their medicines. Pity to lose a Good Article, though ;-) ἀνυπόδητος (talk) 21:14, 21 February 2011 (UTC)

(outdent) I have been bold and went ahead and removed the wiki pharm project banner from homeopathy.--Literaturegeek | T@1k? 22:20, 21 February 2011 (UTC)

Good catch, it needs to be crystal clear that homeopathy is not a form of actual medicine or pharmacology in any way, shape or form. DubiousIrony ^yell 07:32, 24 February 2011 (UTC)

Of course it's a medicine: a great combination of psychotherapy and placebo effect. --ἀνυπόδητος (talk) 07:53, 24 February 2011 (UTC)

American Mock Trial Association

Is this a reliable source? --ἀνυπόδητος (talk) 18:07, 24 February 2011 (UTC)

I doubt that a college mock trial would be. But I reverted it, simply because the given url does not go to anything supporting the sentence it was supposed to source. --Tryptofish (talk) 21:05, 24 February 2011 (UTC)

Good act, Tryptofish. Mikael Häggström (talk) 18:42, 4 March 2011 (UTC)

Citation templates now support more identifiers

Recent changes were made to citations templates (such as {{citation}}, {{cite journal}}, {{cite web}}...). In addition to what was previously supported (bibcode, doi, jstor, isbn, ...), templates now support arXiv, ASIN, JFM, LCCN, MR, OL, OSTI, RFC, SSRN and Zbl. Before, you needed to place |id={{arxiv|0123.4567}} (or worse |url=http://arxiv.org/abs/0123.4567), now you can simply use |arxiv=0123.4567, likewise for |id={{JSTOR|0123456789}} and |url=http://www.jstor.org/stable/0123456789 → |jstor=0123456789.

The full list of supported identifiers is given here (with dummy values):

• John Smith (2000). "How to Put Things into Other Things". Journal of Foobar. 1 (2): 3–4. arXiv:0123456789. ASIN 0123456789. Bibcode:0123456789. doi:0123456789. ISBN 0123456789. ISSN 0123456789. JFM 0123456789. JSTOR 0123456789. LCCN 0123456789. MR 0123456789. OCLC 0123456789. OL 0123456789. OSTI 0123456789. PMC 0123456789. PMID 0123456789. RFC 0123456789. SSRN 0123456789. Zbl 0123456789. |id=____. {{cite journal}}: Check |arxiv= value (help); Check |asin= value (help); Check |bibcode= length (help); Check |doi= value (help); Check |issn= value (help); Check |jfm= value (help); Check |mr= value (help); Check |ol= value (help); Check |osti= value (help); Check |pmc= value (help); Check |pmid= value (help); Check |rfc= value (help); Check |ssrn= value (help); Check |zbl= value (help)

Obviously not all citations needs all parameters, but this streamlines the most popular ones and gives both better metadata and better appearances when printed. Headbomb {talk / contribs / physics / books} 03:12, 8 March 2011 (UTC)

Mefloquine

I've noticed that there is a single-purpose editor who has been making significant changes to the article mefloquine which appear to me to be quite one-sided. I don't know enough about this area to able to tell whether this is a good thing in terms of neutrality or not (is a formerly unbalanced article now becoming better, or is the article becoming skewed away from a neutral point of view?) If someone more knowledgeable could take a look, I think that would be helpful. Thank you. Deli nk (talk) 18:09, 11 March 2011 (UTC)

I'm more of a CNS person, so this is pretty far from my expertise, so it would be good if someone else would look. Based on the editor's comment on the article talk, I am somewhat inclined to think that this may be a good faith effort to be more NPOV, but I'm not really sure. The page is certainly a mess, though (multiple format problems, and becoming a quote farm), and needs a lot of fixing up. --Tryptofish (talk) 22:37, 11 March 2011 (UTC)

Initiative to bring in psychologists

People who watch this page may like to know about a new initiative to bring in psychologists. See Wikipedia Initiative from the American Psychological Society at WT:MED for more information, and keep an eye out for new editors who might need help when you encounter them in articles about psychoactive drugs, etc. WhatamIdoing (talk) 02:46, 15 March 2011 (UTC)

MedlinePlus

We currently link to medline plus when it is available in our disease and disorder boxes in the right upper corner of pages such as gout. Wondering if we should also be linking to medlineplus for medications. Here is the page for example for aspirin [1]. Doc James (talk · contribs · email) 10:12, 17 March 2011 (UTC)

That's a good source of information, but I'm starting to worry about list cruft. We already link to WHOCC (ATC codes), Mesh (CAS number), PubChem (twice), IUPHAR, DrugBank, ChemSpider, UNII, KEGG, ChEMBL and eMolecules. Question: How many identifiers do we need, and which? --ἀνυπόδητος (talk) 21:33, 17 March 2011 (UTC)

None of these provides clinical information on side effects, etc. This is primarily classification / chemistry stuff. We need more clinical information. Doc James (talk · contribs · email) 10:58, 18 March 2011 (UTC)

Style guide

Just in case some of you don't have Wikipedia:WikiProject Pharmacology/Style guide on their watchlists: Doc James is planning to bring all the medication articles into a consistent format. Comments on possible changes to the style guide would be welcome at Wikipedia talk:WikiProject Pharmacology/Style guide#Organizing the sections. All thumbs up for James! --ἀνυπόδητος (talk) 21:28, 17 March 2011 (UTC)

Reformatted our main page

I have reformatted our main page to make things line up better and I hope easier for others to edit. I found what was there before a little impenetrable and I have been at this a few years. Comments? Made it similar to WP:MED to hopefully increase cross pollination between the two groups. Doc James (talk · contribs · email) 22:06, 17 March 2011 (UTC)

It would've been nice if you would have DISCUSSED this first on the talk page rather than unilaterally deciding on the format yourself. What gives you the right to just come in here and change everything? The previous format with columns was easier to find stuff and required less vertical scrolling. WTF? (talk) 13:20, 31 March 2011 (UTC)

Potassium iodide

With all the hysteria about radioactive fallout, it might be good to expand potassium iodide to better cover the effects of taking excessive amounts of it. 65.95.13.139 (talk) 13:25, 18 March 2011 (UTC)

Archiver

It looks like we need an automatic one for this page. And opposed? Doc James (talk · contribs · email) 14:36, 18 March 2011 (UTC)

I have no clue what in the heck an "archeiver" is? You're going to have to explain that one. Do you mean an archiver? If so, no need to re-invent the wheel here. I think there are several automated talk page archive bots out there. WTF? (talk) 13:29, 31 March 2011 (UTC)

Yes and I was suggesting we us one of the many out there... --Doc James (talk · contribs · email) 02:15, 1 April 2011 (UTC)

This is probably the most commonly used archive bot out there. They request that we get a consensus among users that this is needed prior to requesting it. Do we have consensus that we want this? WTF? (talk) 14:19, 1 April 2011 (UTC)

Yes I think it would be useful. Doc James (talk · contribs · email) 15:13, 1 April 2011 (UTC)

Recent "drug" → "medication" changes

I haven't been around much, but I have spotted some moves and content changes switching "drug" to "medication", such as moving Anti-diabetic drug to Anti-diabetic medication (quite a while ago, actually). I'm not sure this is an adequate change, particularly without discussion.

As Wikipedia very broadly follows WHO terminology and our drug categorization is closely modeled on the ATC, I believe keeping the term "drug" where it has long been established, particularly in article titles and categories, would be most appropriate. We sort of had this debate eons ago, back when the project was called WP:DRUGS and the {{Drugbox}} was still in development—perhaps it is time to rekindle it? Fvasconcellos (t·c) 19:14, 25 March 2011 (UTC)

Medications IMO should be the prefered term --Doc James (talk · contribs · email) 20:11, 25 March 2011 (UTC)

If that page covers insulin, which is a biologic rather than a drug, then the page move was an improvement. WhatamIdoing (talk) 23:17, 25 March 2011 (UTC)

Could you clarify this for a non-native speaker? I always thought that "drug" = "Medikament" (German), but this doesn't seem to be the case from your comment. Are monoclonal antibodies drugs? And what about low weight heparin? --ἀνυπόδητος (talk) 08:15, 26 March 2011 (UTC)

At least in US English, "drug", when spoken by the general public, carries a connotation of illegal/narcotic drugs, whereas "medication" clearly refers to medically appropriate use of, well, drugs. (To my understanding, "biologics" are a sub-class of "drugs". I guess that WhatamIdoing is getting at the distinction between synthetics and naturally-occurring substances, but in my opinion that's a subtle one.) I don't feel strongly either way about these renames. "Medication" has the advantage of being better understood by the general readership, for the reason above, whereas "drug" serves the purpose of not talking down to our audience. --Tryptofish (talk) 18:41, 26 March 2011 (UTC)

As I understand it (i.e., probably not very well), biologics are not generally drugs in the usual sense. Whole blood is a biologic; nobody would call that a drug.

Monoclonal antibodies and heparin seem to be biologics.

In the US, the short answer is that if you're dealing with CDER at the FDA, it's a "drug", and if you're dealing with CBER, it's a "biologic". WhatamIdoing (talk) 19:35, 26 March 2011 (UTC)

Ah, the vagaries of language (if not of the FDA). I agree that no one relatively few people would call whole blood, or oxygen, a drug, but heparin might well be called one, and quinine or bacitracin, definitely so. --Tryptofish (talk) 22:27, 26 March 2011 (UTC)

I recall hearing that the FDA 'rationalized' the system a couple of years ago (i.e., they traded a bunch of products between the two groups, so that things that are biologics by any reasonably standard definition, but "feel like" drugs, are now in CDER). I haven't looked up heparin's regulatory status, but there's a link on my user page to CDER's list, if you want to find out. If it's (1) on the market and (2) not in the Orange Book, then it's regulated as a biologic. WhatamIdoing (talk) 23:23, 26 March 2011 (UTC)

If you look in the Merriam Webster dictionary, drugs include, "a substance other than food intended to affect the structure or function of the body." So that includes toothpaste, biologics, herbal remedies and homoeopathic "remedies". MW describes "medication" as a synonym for drug. If you want a more precise word you may want "pharmaceutical" or "medical drug". I don't know if you want do drop drug just because it has an illegal connotation in some uses, because currently that connotation only comes from the context. 24.77.80.153 (talk) 03:13, 13 May 2011 (UTC)

I agree that drug often implies illegal status and medication / medicine is more clear which is why I suggest we use it.Doc James (talk · contribs · email) 23:19, 26 March 2011 (UTC)

I disagree. Drug is a neutral term. We fill prescriptions at drug stores and speak of drug companies that make legitimate products. My nursing drug reference has the words "Drug Guide" on the cover in large type. Medication seems to presuppose that these things are being used in a medical context. It also sounds like a euphemism. A quick search on britannica.com reveals an entry for "drug," but not for "medication." — Preceding unsigned comment added by Nburns1980 (talk • contribs) 05:53, 2 April 2011 (UTC)

Redirect of brand names to generics?

Was a bot every made to do this? Uptodate / Lexicomp has a great database brand names to generic names.--Doc James (talk · contribs ·email) 04:09, 26 March 2011 (UTC)

There is PotatoBot. It added such a redirecting function after a previous discussion now archived here.

Still, help is appreciated in fixing entries on its log of names that could not be redirected automatically. Mikael Häggström (talk) 05:06, 26 March 2011 (UTC)

Drugbox: which way do we want to go?

Please comment at Template talk:Drugbox#Drugbox/Chembox merger vs. two infoboxes. --ἀνυπόδητος (talk) 14:36, 26 March 2011 (UTC)

Wikipedia talk:WikiProject Pharmacology/Style guide might also be of interest. --ἀνυπόδητος (talk) 10:11, 27 March 2011 (UTC)

Free reference accounts for busy content editors

Content-oriented editors may wish to apply for a free "Credo" account. See Wikipedia:Credo accounts for the requirements, which include having more than 3,000 edits in the main namespace and having been an editor for >12 months. Four hundred accounts are on offer, and only about one-third have been requested so far. It's possible that people who don't quite qualify might be able to get any "leftover" accounts.

Credo seems to offer online access to major reference works, such as medical dictionaries. It does not seem to offer access to peer-reviewed journal articles. WhatamIdoing (talk) 17:52, 26 March 2011 (UTC)

Taskforce

Should WP:PHARM be a taskforce of WP:MED similarly to EMS, etc? Discussion is taking place here WT:MED --Doc James (talk · contribs · email) 10:39, 27 March 2011 (UTC)

I'd intuitively oppose this, but are there any rules about the difference between a WikiProject and a Taskforce? --ἀνυπόδητος (talk) 10:43, 27 March 2011 (UTC)

We have this Wikipedia:Task_force. But it is probably just a technically really.--Doc James (talk · contribs · email) 11:01, 27 March 2011 (UTC)

In practical terms, you would typically move the existing PHARM pages to something like "WP:WikiProject Medicine/Pharmacology task force" (leaving behind a complete set of redirects) and merge WikiProject infrastructure, e.g., talk-page banners and WP:1.0 assessment categories. The primary (in this instance, probably small) advantage is that you can dump the routine administrative work on the existing processes at WPMED.

It should not be done unless the people here actually want it to be done. WPMED is emphatically not interested in 'hostile takeovers'. WhatamIdoing (talk) 16:02, 31 March 2011 (UTC)

Strong Oppose This group is not a puppet of WP:MED. WTF? (talk) 13:32, 31 March 2011 (UTC)

Project page design

Wiki.Tango.Foxtrot has objected to the new design of the project page. The stated objection was "no consensus", which of course is specious and anti-policy, since it's not necessary to get permission to edit in advance—especially when multiple project participants worked on the changes without expressing any objections, which is itself proof of consensus.

However, I strongly suspect that there's some sort of substantive objection, since an experienced editor like Wiki.Tango.Foxtrot wouldn't believe that project members were somehow required to get advance permission to make changes to their own project page.

Wiki.Tango.Foxtrot, can you tell us what you don't like about the changes? It is certainly a dramatic change: What do you think the problems with the new version are? WhatamIdoing (talk) 16:18, 31 March 2011 (UTC)

First of all, a dramatic change such as that should be discussed on the talk page of the wikiproject prior to going through with it. This was not done. Doc James merely posted to the talk page saying, "I have reformatted our main page... blahblahblah" Who the hell appointed him in charge? And the new design absolutely SUCKED! Completely uninspiring, uncatchy, and just an attempt at making this project a clone of WP:MED. Little wonder why the same user brought up merging this group as a taskforce into the medicine project in a subsequent discussion (the merger is also BAD idea as well). I also don't like the fact that it's completely dependent on vertical scrolling, as opposed to the use of columns to try and reduce that. His design also has way too much "white space", making for a rather ridiculously boring and uninspiring page (I think 1995 called. It wants its HTML back). Also, I'm not referring to what Doc James did as the "new version", because I've reverted it. Making those changes was a completely unacceptable thing to do in the first place. WTF? (talk) 16:31, 31 March 2011 (UTC)

Doc James, as a regular participant in this project has exactly as much right to change the page as any other regular participant. Nobody "appointed him in charge" of designing a new page, exactly like nobody appointed you to be in charge of vetoing it. He doesn't need your permission to make an effort at improving the page (as he sees it), just like you don't need his permission to civilly point out its shortcomings (as you see them).

As to your substantive objections, they seem to be:

1. You prefer a column-based design because it requires less vertical scrolling.
2. You object to (excessive) white space because it is boring and uninspiring.
3. You object to having PHARM's project page resemble WPMED's project page.

Did I miss any substantive objections? WhatamIdoing (talk) 21:09, 31 March 2011 (UTC)

The bigger issue here seems to be that, with his recent actions, Doc James appears to be intent on doing away with this wikiproject in favor of completely merging it into WP:MED (see the merger discussion as well). That would not be a good idea. WTF? (talk) 21:36, 31 March 2011 (UTC)

So the changes would probably be okay with you, except that Doc James did it? WhatamIdoing (talk) 21:48, 31 March 2011 (UTC)

I will list the reasons for the change:

1. The columned version is very hard to edit and thus new users will be less likely to contribute.
2. We do not need a list of participants on this page. Would be better as a sub page.
3. A though the changes I made actually decrease white space.
4. Merging is a separate issue and one that if others do not agree with I will not puss

Doc James (talk · contribs · email) 23:14, 31 March 2011 (UTC)

1. With edit links at the top right of each section in the left column, what's so difficult about that? Granted, the edit link for the right column is all the way down at the bottom of the column, but that section shouldn't have to be edited terribly often anyways. As far as new users are concerned, I think most of them are not going to be worried about "messing up" the main page of the wikiproject, and will hopefully ask their questions on the talk page first.

2. I agree on the list of participants. We could put just a link there without redoing the whole damn thing, though.

3. Totally disagree on Doc James' version actually decreasing white space. His version also deletes the image as well, making for a far less attractive page as well.

4. I do agree that merging is a separate issue, but your making bold and major changes to a design which mirror's WP:MED's design, as well as bringing up the merger in close proximity, makes me wonder about a possible "hidden agenda",. . . The truth is, we need more editors around here actually improving articles for a change, rather than worrying about silly little sh!t like rearranging main pages of wikiprojects and other minor process-based stuff. WTF? (talk) 00:38, 1 April 2011 (UTC)

Yes we definitely need more editors. Making things more clear I think would attract them. The current page does not. I am hoping to make the pharma articles more applicable to the general reader. Doc James (talk · contribs · email) 02:09, 1 April 2011 (UTC)

The current page is more attractive to new editors than your proposed mumbo jumbo of whitespace and nothingness,. . . WTF? (talk) 02:54, 1 April 2011 (UTC)

I prefer we keep the majority of the text on the right rather than the left. Another issue I have with this layout is that it does not have a TOC box. A third issue is that the Wikipedia:WikiProject_Pharmacology/Nav template does not line up well in the left column. Doc James (talk · contribs · email) 16:07, 1 April 2011 (UTC)

I have no specific preferences about the project page's design. I want to note, however, that the navbox did line up well before James changed its layout. --ἀνυπόδητος (talk) 11:02, 2 April 2011 (UTC)

I don't have any strong preference. --Tryptofish (talk) 16:56, 2 April 2011 (UTC)

Adding barnstars and will continue working on the page. User who complained does not seem active currently in this project... Doc James (talk · contribs · email) 23:45, 14 April 2011 (UTC)

Ok, fine. Whatever. You want to keep making stupid changes like this to process and procedure, rather than actually editing articles and improving them. Fine. It's no wonder that the total number of editors actively involved in Wikipedia is dropping off like a fracking rock. Too many idiots concerned with petty little process crap instead of what matters. I used to be more interested in this project. But silly debates over petty little processes like article categorization and page design is a waste of fscking time,. . . WTF? (talk) 13:25, 5 May 2011 (UTC)

Um, WTF, if changing the project page is a waste of time, why do you keep doing it? You could be actually editing articles and improving them, instead of editing the project page and complaining about others doing—well, exactly the same thing that you're doing. WhatamIdoing (talk) 16:54, 5 May 2011 (UTC)

RfC: Are the medication articles too technical and if so what should we do about it?

An article was recently published regarding Wikipedia's medication articles. It raised the concern that our content is too technical. Law MR, Mintzes B, Morgan SG (2011). "The sources and popularity of online drug information: an analysis of top search engine results and web page views". Ann Pharmacother. 45 (3): 350–6. doi:10.1345/aph.1P572. PMID 21343404. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

What, if any, changes should be made in response to such criticism? 15:50, 1 April 2011 (UTC)

Looking at some of our pages such as paracetamol I would have to agree. Now I do not think we should in anyway remove technical content from Wikipedia but what I do suggest is that we present the more generally relevant information first. A few suggestions to achieve this: These unsigned suggestions from Jmh649 (talk · contribs)

Comment – Where in the Law, et al. paper does it state that the content of Wikipedia drug articles is too technical? The main purpose of the Law paper was to assess the popularity of various online sources of information about drugs. It does comment that "Wikipedia is potentially both incomplete and subject to serious biases" and "further studies should continue to assess the authorship and quality of the drug information appearing on both Wikipedia and other sites to determine whether patients are obtaining accurate and understandable information". But no where in the paper does it state that Wikipedia drug articles are not accessible. I whole heartily agree that increasing the accessibility of Wikipedia drug articles is a worth while goal, but the citation that you provided does not explicitly support that goal. Boghog (talk) 20:21, 1 April 2011 (UTC)

"Wikipedia page had the lowest completeness and accuracy score and worst readability of the 28 Internet sites studied."Doc James (talk · contribs · email) 22:25, 1 April 2011 (UTC)

(Only half joking: I could say that about Wikipedia as a whole, not just the medical pages.) Are you sure that it is about the issues discussed below, as opposed to the Randy from Boise issues? --Tryptofish (talk) 22:37, 1 April 2011 (UTC)

Not sure to what you refer? Doc James (talk · contribs · email) 23:17, 1 April 2011 (UTC)

I meant people putting misinformation into pages, making the pages inaccurate, as opposed to the pages being too technical. At least on the antipsychotics pages, that's a bottomless pit. --Tryptofish (talk) 16:59, 2 April 2011 (UTC)

You only quoted part of the sentence taken from the introduction of that paper. The entire sentence reads "Similarly, an analysis of sources of information about methotrexate found that the Wikipedia page had the lowest completeness and accuracy score and worst readability of the 28 Internet sites studied" which in turn cites PMID 19004031. So the entire statement is based on the analysis of one Wikipedia article, methotrexate. Boghog (talk) 03:30, 2 April 2011 (UTC)

Plus I have discussed the paper with its author. Doc James (talk · contribs · email) 03:52, 2 April 2011 (UTC)

In my opinion the fact we are an encyclopedia necessitates some higher degree of technical complexity. Wikipedia does not give medical advice, therefore our article is not aimed at the patient who has just been prescribed the drug or the healthcare professional that might prescribe the drug, but covers the entire topic, from its indications, counterindications and other information a source like those above might have, all the way down to the method of action and chemistry, right through on to social/cultural impact and depiction in popular culture. Our mission necessitates less readability than a site that aims only to give advice for consumers. HominidMachinae (talk) 20:25, 5 April 2011 (UTC)

I disagree. Every topic should be explainable at the highest level. More technical complexity should exist in the encyclopedia, but only after a general, higher level description. Niluop (talk) 04:05, 17 April 2011 (UTC)

Consensus is for no split of the infobox

The drugbox Move the current drug box with it chemical and pharmakinetic data lower in the article. Add a simpler clinical drug box to the lead. I have created an example here. This is as opposed to the current warfarin article. This would only be done on topic pages that deal with chemicals that are exclusively drugs. This was discussed here Support #Doc James (talk · contribs · email) 17:41, 1 April 2011 (UTC) Oppose If we make the text "user-friendly" there's no rush to strip the technical data out of the infobox. Readers without any background are likely to read the text first and the summaries later, while readers that are already familiar with the topic in general are looking for things like the half-life or the technical links. If we can serve both audiences, all the better. SDY (talk) 17:52, 1 April 2011 (UTC) If you look down the article the info box with all the technical details is still there just lower down. Doc James (talk · contribs · email) 17:56, 1 April 2011 (UTC) Yeah, I saw it, but I'm not sure I like it. While making the article understandable is a big deal, the infobox has a lot of useful information that we specifically want up front so people don't have to go hunting for it. It might be worthwhile to shuffle the order somewhat so that the "simple" stuff is near the top, but having two infoboxes seems confusing and redundant. SDY (talk) 18:52, 1 April 2011 (UTC) Strong oppose – per SDY and as stated in more detail here and here, we have two audiences: the general public and the more technically oriented. The lead certainly should be written in a way that is understandable to a wide audience. But we also need to capture the attention of the technical audience. If key technical data is included in the infobox, it will immediately draw the attention of the technical community and they will be encouraged to read the rest of the article. Even better, if they stay long enough to read the article, they might be tempted to jump in and expand it. Finally, I think we should not under estimate the ability of patients, particularly if they are suffering from a life threatening illness, to become experts in their particular disease and treatments. They will be more strongly drawn to an article that is both understandable to a wide audience but also contains more in-depth material. Boghog (talk) 19:28, 1 April 2011 (UTC) Mild oppose. I looked at the two warfarin examples, and it seems to me that the proposed new version emphasizes what the pills look like, as opposed to providing information about the chemical structure. As a thought experiment, if we were to substitute a photo of pills of a different medication, what would be the consequences? The page would be about the same, and the only harm to our readers would be of the form "The pills I got at the pharmacy don't look like the ones on Wikipedia." Admittedly, we obviously wouldn't really want to mislead readers that way, but that comes awfully close to WP:NOTGUIDE. I see our readership as coming here for encyclopedic information about a given drug, and not specifically for medical advice, although I readily admit that there's a blurry line between those. --Tryptofish (talk) 19:53, 1 April 2011 (UTC) Oppose. {{Infobox disease}} does the same. If anything, we could add parameters in the drugbox that might be useful for the general reader (e.g. a field that states that linezolid is an antibiotic, or metformin an antidiabetic or a biguanide). JFW | T@lk 10:50, 3 April 2011 (UTC) Strong oppose There are many compounds which are drugs, which are not used for treating specific diseases or whatever. So why create confusion by putting the drugbox on all those drugs on top, while having some where the drugbox is lower on the page. It makes indeed way more sense to add some technical data to the drugbox and keep that on top. That does not prefer people who are more interested in clinical parts, that does not prefer people that are more interested in pharmaceutical data, and it does not prefer the people who are more interested in the chemical data. --Dirk Beetstra T C 09:55, 4 April 2011 (UTC)

Order of content

I propose that we move the "clinical indications" / "therapeutic uses" / "indications" and "side effects" section first. This would than be followed by section on chemical properties. And finished by a section on history. This would place what the general reader is usually looking for first. This was discussed here.

Support

1. Doc James (talk · contribs · email) 17:41, 1 April 2011 (UTC)
2. Looking at a bottle of ibuprofen I have at my desk, this is the format the OTC label uses, and by a "principle of least surprise" this is probably what a reader is expecting to see first. SDY (talk) 17:52, 1 April 2011 (UTC)
3. The most important information about a typical drug is certainly its uses. How it was developed and when it was marketed on which continent can make interesting reading, but I wouldn't emphasise it by putting it first. --ἀνυπόδητος (talk) 11:16, 2 April 2011 (UTC)
   1. Qualify my support: This proposal does not mention the "Mechanism" section, which probably belongs to the top in my opinion. See my comment below ("Working with the chemists") --ἀνυπόδητος (talk) 16:44, 3 April 2011 (UTC)
4. Support – Uses followed by chemical properties, mechanism of action, pharmacokinetics, and history as outlined here sounds reasonable (simple → complex per SDY below). Most people coming to read these articles probably are not particularly interested in the history so I agree that the history section should come last. These are only guidelines and there may be special cases where altering the order may make sense but at the same time, it would be desirable to have a consistent ordering of sections for most articles. Boghog (talk) 21:23, 2 April 2011 (UTC)
5. Neither support nor oppose, as a "point of order", so to speak: this is current practice (has been for ages) and is enshrined in MEDMOS. I see no reason to rehash it here. Fvasconcellos (t·c) 16:08, 6 April 2011 (UTC)

Oppose

1. I agree that Paracetamol has got the section ordering wrong and has the scary pharmacology/chemistry too high up. But, MEDMOS has never mandated section ordering and I don't think we should. The sections are a bullet list rather than a numbered list. The given ordering may work for many articles, but not all. A number of our drug articles begin with history and are all the more interesting for it. Any discussion on modifying the proposed sections or listed order of sections should start with an analysis of our best articles. A brief glance at some of them hints there is no consensus. Guidelines should follow best practice. Colin°^Talk 18:50, 1 April 2011 (UTC)

   Standardization has some real value here, especially when addressing two drugs of the same class. If someone is comparing paracetamol and ibuprofen they shouldn't have to do a lot of hunting. Even if it isnt the current practice, standardizing the content makes it easier to use, and ease-of-use is exactly what we're aiming at. SDY (talk) 18:56, 1 April 2011 (UTC)

2. Oppose. Even if MEDMOS doesn't specify section ordering, my impression across Wikipedia as a whole is that History sections often come first. Again, WP:NOTGUIDE means that we are not giving medical advice here. This should be an encyclopedia, not an online site for looking up what medicine you should ask your doctor for. I'd like to assume that our readers are smart enough to skip over the sections that don't interest them. --Tryptofish (talk) 19:59, 1 April 2011 (UTC)
   • MEDMOS gently recommends a typical order for a variety of different medicine-related subjects at WP:MEDMOS#Sections. 'History' sections often come last (or nearly so), as they are often the least important aspects. For example, 'Tuberculosis is a bacterial infection that kills lots of people but can usually be treated with antibiotics' is generally more important to our typical reader than 'The first written description of tuberculosis is in some Greek document that is 25 centuries old'. In many medicine-related articles, especially for newer therapeutics, there's no history section at all. WhatamIdoing (talk) 21:35, 1 April 2011 (UTC)
     • The reader should have most of the vital facts from the lead before we even get to worrying about section order. It is reasonable for MEDMOS to present an order that is likely to be useful but I wouldn't want it to become a block to any editor faced with actually trying to present their facts and tell their story in a reasonable way. I sigh when folk talk about MEDMOS specifying an order when (unlike the proposed PHARMA style guide) it makes no such demands and goes out of its way to give examples where the presented order might not be useful. Unlike the BNF, say, we have little idea why a reader has come to a drug article like midazolam, which makes our task harder. Colin°^Talk 18:46, 2 April 2011 (UTC)
3. Oppose. We cannot discuss the uses/indications for a drug before we have discussed how it works. I have no objection to the "history" section moving to the end, as we do in disease articles. JFW | T@lk 10:50, 3 April 2011 (UTC)

   Do you really mean "how it works"? As in "mechanism of action". I think very few of our readers will be able to understand the "mechanism of action" section, and for a fair number of treatments, we have little idea "how it works". Perhaps you mean "what it does" (like lowering blood pressure), but it is difficult to discuss that without an idea of what was wrong in the first place. I have no objection to "indications" being first (it is on MEDMOS) or early (the lead will cover the primary indications too), what I am uncomfortable with is requiring any section ordering. Colin°^Talk 16:09, 3 April 2011 (UTC)

It's a rule that can be ignored if necessary, but there should be some expectations. Completely opposed to JFW's assertion of "mechanism first." Mechanism is a complex technical subject, and the progression of articles should start with the simple things. SDY (talk) 18:19, 3 April 2011 (UTC)

1. Oppose - per WP:IAR: that competely depends on what we are discussing. Are we discussing a compound which has as single use a drug, or something that has more functions. Sections can have a preferred order for certain articles, but not a defined order that we have to decide here via RfC. --Dirk Beetstra ^{T C} 09:58, 4 April 2011 (UTC)

What should we use for the first heading

Three Four possibilities for the first heading have been put forth "clinical indications", "therapeutic uses", "indications", and "indications for use". Indications IMO implies approval from a licensing board thus I propose we change it to "clinical indications" which would more easily leave room for discussion of off label uses in this section.

Support

1. Doc James (talk · contribs · email) 17:41, 1 April 2011 (UTC)
2. With strong caveat. While I like the basic idea, do not use the term "clinical indications." This is exactly the problem - many of our medical articles look like they are written for a clinician, not your average joe. Some of this isn't a structural problem, this is a problem with overuse of terminology that most readers will struggle with if they understand it at all. SDY (talk) 17:52, 1 April 2011 (UTC)

Oppose

1. The reasons why "therapeutic uses" is a bad idea have already been stated at Wikipedia talk:Manual of Style (medicine-related articles)#Indications vs Therapeutic uses. Adding "clinical" to the front is no help to the average reader (who thinks "clinical" is an adjective meaning "analytical or coolly dispassionate"). Nor does it remove the licensed/off-label concern Doc James has about the term. I can find no dictionary (medical or otherwise) that supports the idea that "indications" implies approval from a licensing authority. When the BNF gives an indication for a drug that is not licensed for that purpose or age group, it tags it with [unlicensed]. It may be relevant to an article to follow this practice and note that an indication is not licensed in the US or UK, etc. There are thousands of drug articles on Wikipedia that use the term "Indications". We would need a very strong reason to change our style guide to something else. Colin°^Talk 18:28, 1 April 2011 (UTC)
2. again per WP:IAR: Oppose. We should not have a defined order of what first for a drug, it depends too much. --Dirk Beetstra ^{T C} 10:01, 4 April 2011 (UTC)

Comment

1. I have low enthusiasm for any of these four. All of them sound legal and/or medical in a jargon-like way. How about, per WP:KISS (sort of), something like "medical uses"? --Tryptofish (talk) 20:03, 1 April 2011 (UTC)

I second that suggestion. The bottle of ibuprofen I'm staring at makes it even simpler as just "uses" but given the nature of the encyclopedia "medical" is a useful qualifier. SDY (talk) 20:12, 1 April 2011 (UTC)

Yes I would support "medical uses" aswell. Doc James (talk · contribs · email) 22:40, 1 April 2011 (UTC)

I agree. "Medical uses" is probably more accessible to general readers than "Indications" or "Clinical indications". Axl ¤ [Talk] 08:47, 2 April 2011 (UTC)

Support "Medical uses". It's understandable, precise, and includes uses under (clinical) investigation as well as approved uses (as opposed to "Indications" which seems to exclude the former). --ἀνυπόδητος (talk) 11:09, 2 April 2011 (UTC)

I'm not convinced that we really want "possible uses that nobody is actually using this for, but someone is currently running an experiment on" to be placed in this section. That sounds like material for a "research" section, not a "how it is being used" section. WhatamIdoing (talk) 19:58, 2 April 2011 (UTC)

If "medical uses" includes investigative research as well as current (best) prescribing practice, then I couldn't be more opposed. This is exactly what is wrong with many of our drug/medicine articles. Colin°^Talk 07:29, 3 April 2011 (UTC)

IMO medical uses does not include investigative research. Like in disease article this should go in a section at the end if included at all. This is how it is currently described [2] Doc James (talk · contribs · email) 07:35, 3 April 2011 (UTC)

James, I thought you wanted not to emphasise the legal issue whether a drug is approved in some country or another? But thinking again, maybe we should actually draw the line between "Uses/Indications" and "Research" when a drug is approved anywhere in the world. --ἀνυπόδητος (talk) 16:48, 3 April 2011 (UTC)

I guess I did not make myself clear. I want to use a combination of reviews articles ( such as AHFS [3] ), guidelines from NICE etc, and approved uses from national / international bodies. Thus not emphasis legal issue but do give them appropriate weight as we do not wish continue with the status quo which seems to be using primary research to conduct our own mini reviews... Doc James (talk · contribs · email) 19:47, 3 April 2011 (UTC)

I don't think that's such a good idea. Particularly for older drugs, the most common and best supported uses may not be "on label" anywhere in the world. The paperwork to have something be a legally "approved indication" is very expensive. WhatamIdoing (talk) 16:51, 3 April 2011 (UTC)

Perhaps it's worth looking at what our best work does? Category:FA-Class pharmacology articles has only eight members, two of which aren't really about drugs, so it doesn't take long. LeadSongDog come howl! 16:30, 13 April 2011 (UTC)

A little background

It might be useful for people to know a bit about the how these publications happen:

They usually compare publicly available sources (like Wikipedia articles) against industry-favored advice for writing patient guides (the sort of brochure that might be handed out to patients, or kept in a literature rack in the lobby of the doctor's office). Such advice typically has a requirement that it can be understood by a patient with the intelligence and reading skills of the average ninth grader (about age 13 or so). When this is mapped to adults, we're talking about someone with an IQ of about 85, who would struggle to read The New York Times.

Also, anything that is deemed inappropriate or irrelevant for a patient should normally be omitted (e.g., chemistry, commercial history), and anything that is necessary for the person's personal medical care must be included (e.g., how many pills to take, when to call your doctor). Pages are evaluated for their reading grade level as a whole, not just on the parts that might interest a patient.

Obviously, Wikipedia is not writing a patient guide. We are writing for chemists, for students, for people who click on Special:Random, for healthcare professionals, for investors, and for people who heard about a drug in the celebrity TV show, as well as for patients (to whom we refuse to give medical advice). We therefore include "inappropriate" material also exclude "necessary information".

The goal here is not how to make Wikipedia stop being an encyclopedia and start being a drug formulary or patient advice page. Those services already exist on the web. The question here is whether and how we could make articles more interesting or informative to people who are not pharmaceutical professionals. WhatamIdoing (talk) 17:43, 1 April 2011 (UTC)

Yes agree. We can link to other sources that provide patient information sources and do not need to structure stuff like that here. Doc James (talk · contribs · email) 17:46, 1 April 2011 (UTC)

Further suggestions

Looking at the paracetamol article, one thing that's definitely obvious is that we need a better lead paragraph. Since we have the infobox, maybe a loose policy of "no numbers in the lead" to focus on the big picture ideas rather than the technical details. SDY (talk) 17:52, 1 April 2011 (UTC)

This is not a bad idea. We make a similar sort of recommendation for mathematics: Focus more on "why anybody cares" and less on precisely and definitively defining the subject. WhatamIdoing (talk) 19:07, 1 April 2011 (UTC)

Agree that this would be a useful measure. Doc James (talk · contribs · email) 09:46, 2 April 2011 (UTC)

Again, this (WhatamIdoing's suggestion) has kind of been standard practice for ages. Paracetamol is a poor example—it has been in bad shape for ages and does not conform to MEDMOS. Fvasconcellos (t·c) 16:19, 6 April 2011 (UTC)

Working with the chemists

Seeing that all pharmaceuticals are chemicals, it might be an idea to discuss these issues also with the chaps over at WP:CHEM. They might have a particular perspective on this matter. Have a look at Wikipedia:Manual of Style (chemistry)/Compound classes, which has a framework for compound articles. Correction: the correct guideline is Wikipedia:Manual of Style (chemistry)/Chemicals.

In my mind, there needs to be a logical flow to articles on chemical compounds, including drugs. One cannot really begin to discuss practical application of a chemical substance (drug or otherwise) without having discussed its properties. My hierarchy for good drug articles would therefore be:

• Lead: summarise all that is relevant
• Chemistry: molecular structure, boiling and melting points, racemic constituents, synthesis, added later: presumed mechanism of action
• Uses:
  • Pharmacology: ADME, toxicity
  • Clinical applications: indications, common off-label uses (including evidence base for use if extant)
  • Common and unusal adverse effects
  • Approval/regulatory framework
  • Abuse/illegal use
• History/Societal impact
• Referencing apparatus

Keen to hear what others think here. JFW | T@lk 10:50, 3 April 2011 (UTC)

I understand which medicines are approved for what uses with out having any idea of the chemistry, boiling point, or if it is a racemic mixture. I usually do not care as the question I have is does it work. The medical use IMO should be discussed before adverse events. As one only gets those if they take the medicine and thus only if they know why it was used.Doc James (talk · contribs · email) 11:27, 3 April 2011 (UTC)

As Jfdwolff has eloquently stated above, "all pharmaceuticals are chemicals". In other words, without chemistry, there would be no drugs. The definition of a drug includes the chemical structure and therefore it is imperative that the structure along with key chemical properties are prominently displayed in the first infobox at the top of the article. It is clear that we have more than one audience. It is also clear that you are not interested in the chemical properties while many others like myself are. You need to accept that some readers are deeply interested in the chemistry. That being said, as long as the chemical structure along with key chemical properties are prominently displayed in the drug infobox, I am less concerned about the order of the sections. The lead will attract attention of a wide audience while the infobox will attract the attention of chemists. Boghog (talk) 12:55, 3 April 2011 (UTC)

Yes I agree now :-) that we should leave the chemical information in the infobox in the lead. It is only the ordering of section I am discussing here.Doc James (talk · contribs · email) 13:54, 3 April 2011 (UTC)

While I wholeheartedly agree that we need the help of the chemists and support the inclusion of the structure right at the top, I don't think that things like synthesis and melting point help much for understanding the drug's action in most cases. The structure often does (eg. beta blockers, nuncleosidic antivirals etc). That being said, I do think that the mechanism of action helps understanding indications, CIs and side effects and should therefore moved further up, probably right after the lead. Any comments? --ἀνυπόδητος (talk) 16:33, 3 April 2011 (UTC)

I have mixed feelings about the order of sections. I would personally like to see the mechanism section right after the lead (I agree that if the mechanism is presented first, it is easer to understand the indications). On the other hand, a wide audience is probably more interested in reading what it is used for first. Hopefully once we have captured their interest, we can encourage them to read on to figure out how it works. Hence I support putting the indications section before the mechanism of action section. Boghog (talk) 17:17, 3 April 2011 (UTC)

I've invited the folks at WT:CHEM to join this discussion. WhatamIdoing (talk) 17:03, 3 April 2011 (UTC)

Good idea. Thanks. Boghog (talk) 17:17, 3 April 2011 (UTC)

While I agree that drugs are chemicals, starting a drug article with the chemistry followed by the pharmacology is deeply nerdy and a very bad idea. The whole issue that sparked Doc James to review our drug articles was the criticism that they aren't accessible or even interesting to the general reader, who vastly outnumbers the pharmacists and chemists. Look at paracetamol before he moved the sections around. The most important information about a drug is why is it used and what does it do (at the macro level, not the molecular level). Paracetamol is used to treat mild to moderate pain and for fever. Why should I have to wade through nine sections before I read that. What percentage of readers look up Viagra with an urgent need to know that it works by "protecting cyclic guanosine monophosphate (cGMP) from degradation by cGMP-specific phosphodiesterase type 5"? And what percentage could even read that sentence--it might as well be French. There are billions of chemicals and the pharmacology of hundreds of thousands of them has been studied and, I dare say, is of interest to various groups. But only a tiny fraction of these become drugs. It is the reasons why those tiny fraction are drugs that are the relevant part of a drug article. Have a look at WP:WEIGHT, which is about balance in an article, not just opinions. What do most reliable sources, when discussing the article topic, spend their time on? Colin°^Talk 18:20, 3 April 2011 (UTC)

If the chemistry sections are unreadable or irrelevant to the general reader they should be rewritten to become readable and relevant. The logical sequence is: this is the drug, this is how it made, this is how it acts, and therefore it is used for the following indications; side-effects arise because of the way it acts.

The intelligent reader will look at the lead, identify what they want to know (side-effects to paracetamol) and skip the chemistry bit to go straight to the adverse events bit.

Compare it to writing an article about a disease where we skip over the clinical characteristics ("signs and symptoms") and go straight to the diagnosis and treatment, because the average reader has already heard about the disease (because they've met a patient, because they've received the diagnosis etc) and wants to know how it is diagnosed and treated. We cannot completely compromise the logical sequence to satisfy people's reading habits. JFW | T@lk 19:45, 3 April 2011 (UTC)

All drugs have know uses or else they are not drugs. All drugs do not have a know mechanism of action. This argument seem similar to saying we should put the pathophysiology of diseases first because unless we know the mechanism of the disease we cannot understand its symptoms. We have a whole specialty of diseases (psychiatry) where the cause / pathophysiology is unknown yet the symptoms are well described. We have whole classes of medications (SSRIs) which we know some about there effectiveness but know little exactly how they work ( as we do not have the pathophysiology of the disease ). Thus I do not support this arrangement. Doc James (talk · contribs · email) 20:01, 3 April 2011 (UTC)

Exceptions proving the rule? JFW | T@lk 20:22, 3 April 2011 (UTC)

A logical presentation is not a "how does it work?", rather a "how does this affect me?" Sure, the intelligent and educated reader will know how to use the article, but the whole point of a general reference work is that the reader is assumed to be uneducated and they are reading the article in an attempt to fix that. If they knew it all already, they wouldn't need Wikipedia. SDY (talk) 20:31, 3 April 2011 (UTC)

I think the first question for a typical reader is "What, if anything, is it good for?" (that is, Why should I spend my precious time reading the rest of this article?), rather than "How do you make it?" or "How does it work?"

The typical patient probably doesn't care how it's made, but the typical reader isn't a patient, and might be interested—but only if he's decided to finish reading the article. WhatamIdoing (talk) 00:16, 4 April 2011 (UTC)

A brief mention of the relevant physical properties and synthesis is important early, even in pharmacology articles. In some cases getting the synthesis might be a bit of a pain, though. As a whole, I think that the order that JFW proposes is reasonable. Shanata (talk) 01:21, 4 April 2011 (UTC)

Why is it "important early". What reason do you give, other then perhaps a personal interest? The comparisons with disease articles, as Doc James points out, quite useful. Let me quote WP:WEIGHT: "Note that undue weight can be given in several ways, including, but not limited to, depth of detail, quantity of text, prominence of placement, and juxtaposition of statements... in determining proper weight, we consider a viewpoint's prevalence in reliable sources, not its prevalence among Wikipedia editors or the general public" (my emphasis). The overwhelming literature on a marketed drug concerns its use for and effects on the person. Virtually nobody needs to know how to synthesise the drug other than pharmacy students. As far as the general public is concerned, the only relevant parts of synthesis are issues like patent protection, cost, purity, volume -- and I've yet to read a drug article that tackles those in that section. I'm all for making these sections as readable and interesting as possible for the general reader, but it is not possible to change the relevance of a section: the relevance is something the reader brings to the article. Most readers will not find these sections particularly relevant and their difficulty will be a major turn off early in the article. Colin°^Talk 07:39, 4 April 2011 (UTC)

Colin, can I suggest you assume good faith when addressing Shanata's points?

As I have tried to explain earlier, the logical flow of an article would be lopsided if we jumped straight to indications. It makes discussions about the mechanism of action and side-effects very difficult to contextualise. If the sections on synthesis and basic pharmacology are too turgid for the general reader, they need editing to make them readable, not moving. JFW | T@lk 09:56, 4 April 2011 (UTC)

There's nothing bad faith about my comments, JFW; I think you misread. Shanata said these aspects were important early, but gave no reason. There are lots of aspects of drugs we might personally find interesting, or even important, but what about our readership. Perhaps Shanata has a good reason. I undestand your point about "logical flow" but disagree, so do many folk here. There are several ways of tackling an article on drugs, each with some merits, but this seems to be the least desirable for anything other than a academic textbook on pharmacy. Is there drug article that follows your suggested order and that would not be improved by changing to move the chemistry and pharmacology towards the end?

Drugs are clinical entites and it is the clinical aspects the matter most about a drug. The occasional serious side-effect of some drugs has been studied to the degree that we discover what aspect of the drug causes it, but I doubt there's a known pharmacological explanation for all the reported side effects like weight gain or sleeplessnes. What aspect of the chemical or pharmaceutical properties of vigabatrin make it a first-line choice for treating infantile spasms (esp with tuberous sclerosis)? And was that drug withdrawn for nearly all other forms of epilepsy because someone discovered its serious side effect (blindness) when they analysed its chemical properties or studied it in a test tube? These properties were discovered clincially and experimentally on people. Colin°^Talk 12:14, 4 April 2011 (UTC)

(←) Consensus seems to be so far that chemistry minutiae (such as physical properties and synthesis) are not that relevant for the general reader and are not required for context, and could perhaps be moved lower down. At the same time I strongly support Boghog in desiring the "mechanism of action" high up in the article. JFW | T@lk 10:18, 4 April 2011 (UTC)

I agree that for many drugs the actual synthesis is not that important, neither are e.g. a boiling point (though it is very important info for some drugs .. and the importance may even end up in the lede - and note that sometimes the melting point decides the form in which a drug has to be administered ...). Generally, the boiling point is just a mention somewhere in the infobox, and indeed, for some the synthesis could be moved down. But it is very dependent on specific cases. For certain drugs some physical properties or parts of the synthesis are a detrimental part of the story of the drug (racemic vs. enantiomerically pure, boiling point/melting point). Sometimes the source of the drug (if it is a natural product) is more of a key point then that it is also used as a high-profile drug - some plants make some alkaloids for a good reason, and that may be more important than the drug use. I am against the thought that we should define a standard order here. If it is for compounds which are very specific drugs, then yes, this is a good order, if it is something that has more functions (some compounds are more than just drugs ..) then the order may very well be that the drug part gets very low in it, way below synthesis and other important facts about the molecule. --Dirk Beetstra ^{T C} 10:54, 4 April 2011 (UTC)

The physical, chemical and pharmacutical properties need to be put into context for the reader. Why is a drug given by IV only, or the buccal route? Why must a drug be taken four times a day after meals rather than just once? Why should the patient avoid alcohol when taking the drug? Why does it need to be kept in the fridge? Merely stating the mollecular weight or half life or enzyme interactions on their own is trivia if we fail to supply a reason for telling the reader. We might include them in the drug box for completeness but we need to find a way to interest the reader in these sections. Colin°^Talk 12:14, 4 April 2011 (UTC)

Yes, the infobox needs to state these in cold numbers, and all that needs explanation needs to have a part in the text as well. It is a 'quick find' place for everything (and some data which is not necessarily needed for the article itself, but may be interesting to a selected few can be there as well - but if the article states that it is not available in a compressed pill, because it is a liquid ... then having a melting point below RT and a boiling point above RT in the infobox both make sense .. (or it needs to be converted into a solid, etc. etc.). --Dirk Beetstra ^{T C} 13:06, 4 April 2011 (UTC)

Comment from two chemists

The synthesis may often be unremarkable but it should still be included for completeness. These drugs do not appear out of thin air, afterall. They are manufactured via (usu.) chemical synthesis. If nothing, a brief mention followed by a reaction scheme is adequate. Especially for high-volume drugs, some production and/or consumption figures are relevant as well. Now from a first principles POV, the preparation of this compound should be at the top, right after properties (blue solid, green liquid). Only after you have the compound can you talk about it (as a drug, etc.), afterall. But if as many here have argued, the general public is really scared (why?) by the chemistry, then it should be a little lower down the article, despite it being an unsatisfactory solution. JFW put it well - all pharmaceuticals are chemicals. They really are. --Rifleman 82 (talk) 17:27, 3 April 2011 (UTC)

The topic of readability is super important. The lead paragraph could contain a few explanatory sentences, followed by "In technical terms, the [techie talk] ..." A similar approach could be taken with a select section or two.

In my experience, pharmacology articles excessively cite primary journals vs books and reviews. We have this same issue in the WikiChem, but the implications are not as great because our readers are not dosing themselves with our stuff as much as your readers are likely to do with yours.

Like Rifleman 82 above, I also think that an organic chemistry section is key, althought maybe it should be buried somewhat since organic chemistry is unlikely to be sought by your readers. Typically the section would describe molecular structure/stereochemistry and synthesis/production. I guess there could be a chembox there as well. In WikiProject Chemistry, we strive not to repeat chembox information in the text (i.e. melting points, solubility, etc).--Smokefoot (talk) 17:38, 3 April 2011 (UTC)

A brief overview will be in the lead and a lot of data will be provided in the info box.Doc James (talk · contribs · email) 04:35, 4 April 2011 (UTC)

Synthesis is not something that can be captured in an infobox. The infobox can contains some chemical data of the compound. Note that most of the money of a drug is not in its use, it is in its development - the (organic) synthesis. --Dirk Beetstra ^{T C} 10:03, 4 April 2011 (UTC)

Um. Most of the money is in the phase III trials. (That's why 100x500mg hydroxycarbamide cost about 200€, at least in Austria.) --ἀνυπόδητος (talk) 11:06, 4 April 2011 (UTC)

Oops, well, still development. My mistake, knew that. --Dirk Beetstra ^{T C} 13:06, 4 April 2011 (UTC)

Article titles

Have come across the page Lithium pharmacology would this not be better at the title Lithium (medicine) as it is to discuss the medication aspects of lithium? Doc James (talk · contribs · email) 16:31, 1 April 2011 (UTC)

• I agree. I'm neutral about medicine versus medication versus drug, as the word in parentheses. --Tryptofish (talk) 19:45, 1 April 2011 (UTC)
• Agree. Colin°^Talk 21:25, 1 April 2011 (UTC)
• Agree. I was interested to find that lithium salt redirects there also. JFW | T@lk 10:33, 3 April 2011 (UTC)

WT:PHARM Archive

James, I'm not really happy with the new layout of the archive box on top of this page. It provides less information than the old one, i.e. it doesn't give the year, and it isn't clear that the first archives are from WT:DRUGS. Could you say what advantages you see in the new design? Thanks, ἀνυπόδητος (talk) 05:44, 6 April 2011 (UTC)

Thought it was cleaner looking but undid that change.Doc James (talk · contribs · email) 06:43, 6 April 2011 (UTC)

Jmol links from Drugboxes?

Hi, over at WP:CHEM we're looking at the possibility of adding Jmol links (to an NIH server) to allow readers to access manipulable 3D structures. I've also set up an IRC meeting on Tuesday, April 12th at 1500h UTC. Please join us, or leave comments over at Wikipedia_talk:WikiProject_Chemicals#IRC_meeting_to_discuss_possible_addition_of_Jmol_links. Thanks, Walkerma (talk) 17:25, 7 April 2011 (UTC)

New study on the reliability of articles about the top 20 drugs

A study titled "Reliability of Wikipedia as a medication information source for pharmacy students" (abstract) in this month's issue of the journal Currents in Pharmacy Teaching and Learning found the quality of Wikipedia articles on the 20 most frequently prescribed drugs lacking, concluding

“ Wikipedia does not provide consistently accurate, complete, and referenced medication information. Pharmacy faculty should actively recommend against our students' use of Wikipedia for medication information and urge them to consult more credible drug information resources. ”

I haven't read the full article, but from the abstract it seems that like an earlier study, part of the criticism might be based on differing expectations on what information should be included in such articles ("Categories most frequently absent were drug interactions and medication use in breastfeeding"). However, it also concerns factual inaccuracies and the finding that "Referencing was poor across all articles, with seven of the 20 articles not supported by any references."

I will mention this in the Signpost; quotable comments from WikiProject members are welcome.

Regards, HaeB (talk) 18:52, 9 April 2011 (UTC)

Were the authors of the study aware of WP:MEDICAL? That being said, we should take a more careful look at the article however I don't have access to it at the moment. Boghog (talk) 19:13, 9 April 2011 (UTC)

I'd like to have the list of articles they reviewed. (I'd guess that they aren't too different from the Rx-only drugs at Wikipedia:WikiProject Pharmacology/Popular pages, but it would be better to have the actual list.)

I'd have made a different recommendation to the students: to use Wikipedia for learning about the non-clinical aspects of a drug. True: we don't provide the extremely common lack-of-information statements like "It is not known if _____ is found in breast milk." But the authors' preferred sources don't provide information about the discovery, history, sales, or manufacturing, any of which might be just as interesting to a pharmacology student as whether the medication is excreted in breast milk. WhatamIdoing (talk) 19:46, 9 April 2011 (UTC)

The list is atorvastatin, lisinopril, amoxicillin, hydrochlorothiazide, atenolol, levothyroxine, alprazolam, metoprolol, furosemide, azithromycin, metformin, amlodipine, albuterol, escitalopram, esomeprazole, montelukast, ibuprofen, cephalexin, prednisone, and fluoxetine. Doc James (talk · contribs · email) 06:30, 10 April 2011 (UTC)

Thanks. Did they give the date on which they looked at the articles? I find multiple reliable sources in 20 out of 20 articles. WhatamIdoing (talk) 02:09, 11 April 2011 (UTC)

The "Methods" section of the article says "The Wikipedia articles titled with each medication name were accessed on a single day", but doesn't state that day. The only indication I could find is a remark elsewhere in the paper: "At the time this analysis was performed, authors were advised to avoid including 'detailed dosage and titration information' because it could be interpreted as medical advice, could differ across countries, or could be subject to editing by uninformed parties.10" That footnote says: "10. Wikipedia. Manual of Style (medication-related articles). Available at: http://en.wikipedia.org/w/index.php?title?Wikipedia:Manual_of_Style_(medicine-related_articles)&direction=prev&oldid=138106419 Accessed January 4, 2011." The linked version of Wikipedia:Manual of Style (medicine-related articles) is from May 2007.

The "seven of the 20 articles not supported by any references" statement might just be sloppy wording though; it appears that only those parts of each article were scrutinized which corresponded to one of the "20 categories of information". From the "Methods" section: "Wikipedia articles were evaluated for the presence of each category, and for each category that was present, the information was designated as accurate (no discrepancies from FDA labeling), complete (contain all subcategories listed above), and referenced (fully, partially, or none)."

Regards, HaeB (talk) 03:50, 11 April 2011 (UTC)

We could complain that Wikipedia articles are not written to given "patient information", and that therefore the study was misguided in comparing our articles "with information found in the manufacturer's package insert". The earlier paper (above) compared the articles with databases for professionals and was criticised for not considering "common questions that a patient or layperson might seek answers to." Since there is only partial overlap between the purpose of an encyclopaedia and the purpose of patient or professional publications, any such comparison should take care to eliminate unreasonable expectations. Many of the sections in a package insert should be covered by a comprehensive article, but some sections would be absent or relatively unimportant. Since we can't give specific medical advice, we avoid covering dosage or what to do if you experience ill effects. Practical details like keeping the packet out of reach of children or watching the expiry date aren't really encyclopaedic. Information specific to the branded formulation (what the tablet or powder looks or tastes like, what additional ingredients it contains) aren't relevant to an article on the actual drug; only a tiny number of brands are notable enough to have their own article.

However, I can't disagree with the conclusion. I wouldn't want my builder consulting Wikipedia for mixing mortar, never mind my pharmacist using a source any fool can edit. Our drug articles are generally poor. The ratio of knowledgeable active editors to the number of drug articles is simply too small. Any random IP can add their personal experience to the list of side effects or extend the trivia list of brand names. There's often little distinction drawn between established prescribing practice and experimental investigations. A bigger project might be expected to target its activities at vital articles, but with the numbers we have, we can only really expect editors to make a decent fist of a topic that personally interests them. We need more editors. Colin°^Talk 08:27, 10 April 2011 (UTC)

Yes couldn't agree more. I guess the real question for us is why don't we have more pharmacists contributing... Doc James (talk · contribs · email) 17:52, 10 April 2011 (UTC)

Well, maybe because they're being warned off the site by their instructors, and being fed false (or at least seriously outdated) information, like a third of the major articles naming zero references. WhatamIdoing (talk) 21:17, 11 April 2011 (UTC)

I am particularly appalled at this: "the information was designated as accurate (no discrepancies from FDA labeling)". Please tell me other sources were used as comparators for appraisal of accuracy. Fvasconcellos (t·c) 21:28, 11 April 2011 (UTC)

From the abstract: "Package inserts, Micromedex Drugdex Evaluations, Clinical Pharmacology, and Lexi-Comp databases were used to verify accuracy, and completeness was evaluated by comparing article contents to package inserts alone."

Relying on package inserts alone for accuracy would be quite scary. WhatamIdoing (talk) 22:22, 11 April 2011 (UTC)

Indeed. Each of those mentioned may be preferable to use in certain cases (such as how-to details), but Wikipedia still offers additional aspects of drugs that other sources don't provide, and often in a more accurate and neutral point of view than others. Mikael Häggström (talk) 07:12, 21 April 2011 (UTC)

The Signpost article, with some additional quotes from the study and the above discussion, is here. Regards, HaeB (talk) 12:57, 14 April 2011 (UTC)

Its entry in article mainspace is currently at the bottom of Reliability of Wikipedia#Science and medicine peer reviewed data. Mikael Häggström (talk) 07:29, 21 April 2011 (UTC)

Drugbox/Chembox merger vs. two infoboxes

Could an uninvolved admin close the discussion at Template talk:Drugbox#Drugbox/Chembox merger vs. two infoboxes? I think the outcome is pretty clear, but I'd prefer it the formal way – this question (or similar ones) has been brought up quite often, and never led to anything. We really should start doing things this time. Thanks, ἀνυπόδητος (talk) 11:53, 10 April 2011 (UTC)

I agree that we should have an admin closing it with a final decision from the pharmacology project. Mikael Häggström (talk) 03:30, 27 April 2011 (UTC)

Changes

This IP is making a bunch of changes to the chemical structures of drug articles Special:Contributions/82.95.217.180 are they improvements? Doc James (talk · contribs · email) 19:26, 11 April 2011 (UTC)

The changes are obviously a lot more erudite than vandalism would be. Evaluating them really requires an organic chemist, so you might do better to ask at WT:CHEM. --Tryptofish (talk) 20:57, 11 April 2011 (UTC)

Yes, they are improvements. Could use some help with the formatting, though. An easy way to check the accuracy of IUPAC name changes is to compare the new version against the verified IUPAC name present in the compound's ChemSpider entry. Fvasconcellos (t·c) 22:41, 11 April 2011 (UTC)

Suggested making separate templates of drugboxes

I suggested in Template talk:Drugbox that drugboxes could be made separate templates in order to make it easier to newcomers to edit, without being overwhelmed by daunting wiki-syntax at the beginning of articles. More comments over there are appreciated. Mikael Häggström (talk) 15:47, 22 April 2011 (UTC)

sounds reasonable.--Doc James (talk · contribs · email) 03:19, 24 April 2011 (UTC)

Drug Box question

(sorry -- thought this was listing new at the top)

Why does the DrugBox return external links to eMolecules & PubChem instead of actually giving us the SMILES string? It seems to me that these links are valuable, but they aren't the SMILES string.

Hansonrstolaf (talk) 11:57, 5 May 2011 (UTC)