Talk:Analeptic

note
*Note to reviewers from BIOL3501: This topic was fairly difficult to find articles for because there are so many different types of analeptics that can be used. Thus, we focused on some of the most popular analeptics and how they have influenced the topic. We did not want to write full fledged histories and use and structure for every single type of analeptic, but we tried to put as much information into the article as we could without overwhelming readers or doing the job of other pages by getting too specific (those specifics we believed would be more relevant in the wikipedia pages for the specifics drugs themselves). Also because of the many different types of analeptics addressed in the article it was hard to find pictures that would encompass all of the analeptics as a whole, so we focused on the two that we most prominent, doxapram and xanthines, for our pictures. Othrowt (talk) 21:32, 4 April 2015 (UTC)

Primary Review 1
Overall you have provided useful information on what analeptics are and how they have been used. However, I think the article could benefit from some cleaning up and a bit of re-organization. You also have a number of scientific terms that need more explanation and/or links. I am going to go by each section because I think that makes the most sense:

Lead paragraph – although you certainly concentrate on the respiratory analeptics, you do mention other uses throughout, so I think that you might was to give mention this in the beginning paragraph. For example: “Analeptics are central nervous system stimulants that include a wide variety of medications used to treat depression, attention deficit hyperactivity disorder (ADHD), and respiratory depression. Respiratory analeptics act on the central nervous system……. Replace tachypnea with the term rapid breathing (tachypnoea). For the withdrawal of Nikethamide from the market find a different source or eliminate this sentence. A dictionary is not an appropriate source as it is tertiary not secondary.

History This section needs quite a bit of editing. The first sentence is particularly problematic. It reads “After its introduction in the early 20th century analeptics were used to study the newly life threatening topological problem of the barbiturate overdose”. My first question is about the term “topological”. I don’t even know what it means in this context. I would at the minimum edit this to “After their introduction in the early 20th century, analeptics were used to study the new life threatening problem of barbiturate overdose”. For the next sentence I might say “Prior to the 1930’s naturally occurring stimulants such as camphor and caffeine were utilized in the treatment of barbiturate overdose” (not antidote). Between 1930 and 1960 synthetic analeptics such as …….. replaced the naturally occurring compounds in treating barbiturate overdose.

Second paragraph on strychnine – not even clear to me why one would use a convulsant. Also, be careful to refer back to the names as in the last sentence: “the other two convulsants, picrotoxin and bicuculline, antagonize………

Last paragraph – editing “decreased blood flow and increases cerebral..” – use the same tense, decreased and increased.

Clinical use You could separate this better into discrete topics


 * 1) to increase the speed of recovery from anesthesia
 * 2) respiratory distress  or apnea in infants
 * 3) to treat respiratory depression associated with drug overdose (I assume that is what it is doing with barbiturate overdoses? Or is there more to it?)
 * 4) Treatment of asthma
 * 5) to treat mental depression?
 * 6) to treat ADHD

The specific information about xanthines and the side effect paragraph on xanthines should be put in the xanthine section. For the side effects I would use the term jitteriness not jittery. Use the words “increase urine production” with diuresis in parentheses and correctly linked (right now it links to the wrong page).

Continue editing the English – read it aloud to make sure it sounds right.

Mechanism of action Again, read your English. The sentence “These are potassium channel blockers,…..” is not correct. It should read “ Analeptics can act as potassium channel …….” Do you see the difference? Potassium channel blocker is not a mechanism. The mechanism is to block the channel.

For paragraph 2 you wrote:

Two common potassium channel blockers are Doxapram and GAL-021. Both act on potassium channels in Carotid Bodies. These cells are responsible for sensing low concentrations of oxygen and transmitting information to the central nervous system. Blocking the potassium channels on the membranes of these cells effectively reduces the membrane potential which in turn leads to voltage gated calcium channels being opened and neurotransmitter release which begins the process of relaying the signal to the central nervous system. Doxapram blocks background potassium channels in the TASK-family of potassium channels while GAL-021 blocks BK channels, or big potassium channels, which are activated by a change in membrane electron potential or by an increase in internal calcium.

I would edit as follows:

Two common potassium channel blockers are Doxapram and GAL-021. Both act on potassium channels in Carotid Bodies. These cells are responsible for sensing low concentrations of oxygen and transmitting information to the central nervous system ultimately leading to an increase in respiration. Blocking the potassium channels on the membranes of these cells effectively depolarizes the membrane potential, which in turn leads to opening of voltage gated calcium channels and neurotransmitter release. This begins the process of relaying the signal to the central nervous system. Doxapram blocks leak potassium channels in the Tandom pore domain family of potassium channels while GAL-021 blocks BK channels, or big potassium channels, which are activated by a change in membrane electron potential or by an increase in internal calcium.

Small edits – say “The endogenous AMPA receptor ligand is glutamate..”

“sodium ions flow into the cell, not through it.

Don’t use the term agonizing the receptor, but rather binding to it.

Related Research

So short, not sure it is informative.

Methylxanthines

How about starting with “The naturally occurring compounds caffeine and theophyilline are structurally classified as methylated xanthines. The synthetic drug caffeine citrate ….

The information in this section overlaps so much with other sections I think maybe it should be incorporated into them. For example, the discussion on use in asthma and infants could be in the clinical use section. The information on its competitive antagonism of the adenosine receptor would be a fourth mechanism under mechanism of action, etc. What do you think? This is where having different people responsible for different parts can lead to problems. The four of you need to make it coherent now and a pulled together article. Don’t worry about not having enough information. It is better to be concise and cover the necessary information without repeating yourself.

References No. 3 is inappropriate.

No. 7 links do not work.

No. 8 fix the citation. It should not direct back to NCBI but rather the F1000Prime Reports.

The remainder looks appropriate.

Keep editing as well as adding appropriate links and it will get even better.--MMBiology (talk) 03:54, 16 April 2015 (UTC)

Primary Review 2
Overall, the article provides a good general understanding of analeptics, with certain specifics here and there.

Lead section - Consider removing "medication" at the end of the first sentence. It is redundant because you already have "in medicine" at the beginning of the sentence. Also, are there other examples of analeptics that you could mention here (whether they are respiratory or not)?

History - My major suggestion is to consider rewording sentences within each section to provide clarity. One example from the history subheading, "In their early use they concentrated on stimulants (camphor and caffeine), between the 1930's and 1960's the production of synthetic analeptics (nikethamide, pentylenetetrazol, bemegride, amphetamine, and methylphenidate) allowed for the treatment of barbiturate antidotes." First, this could be two separate sentences. The wording here is also a little confusing. One example of how you could reword it might be, "Early (clinical or medical) uses of analeptics were primarily with camphor and caffeine. Between the 1930's..." In terms of organization, I would suggest writing it chronologically, with "Recently..." at the end of the history subsection.

Clinical use - For this section, I would recommend having additional subheading (interactions, side effects, etc) that pertain to various types of analeptics. For guidance on how this can be implemented I would suggest looking at other related (or non-related) drug pages to see how those are organized. This might also provide you with some insight on how to organize your article overall.

Mechanisms of action - Some sort of visual would benefit this subtopic very much. Often with biochemical interacts, it can be hard to imagine the molecular pathway being described. Yes, there are many pathways and you address that. Although, a figure (or figures) would be nice, especially in association with your sentence, "there are three main mechanisms which analeptic medications work through in order to stimulate respiration."

Related research - This section needs more content. It can also be organized towards the end of the overall article. The statement you made that was cited to reference 9 is incorrect. First, this source is a primary article and original research. Be sure to use secondary sources. More importantly, this source (and the results of it) does not reflect the sentence it is associated with. Please correct this reference and the content of this subheading.

Overall, it is a good start and I would suggest looking at your sections and whether or not you could clarify the content through restructuring sentences. Also, I would suggest a bit of reorganization of the overall article. There are topics that could be moved ("Methylxanthines caffeine and theophylline" as a subtopic of "Related research"), and others that could be added (such as drug interactions, examples, side effects).

Keep up the work. I look forward to the changes and how the article turns out!

--Mr TA 2015, 19 April 2015 (UTC)

Response to Primary Review #1
Thank your for your review! It has really helped our article overall.

For the lead paragraph, we followed your recommendations, and double checked and corrected hopefully all of the grammar and syntax errors that were made. We mentioned the other uses of analeptics besides just the respiratory use. We also eliminated the dictionary source, which was from the previous author.

For the history section, we put the events in chronological order. We decided to keep the section on strychnine and convuslants, as these were used in medicine in the past, and they are considered analeptics, so we thought they were relevant to the history section.

For the clinical use section, we made subcategories for anesthesia recovery and respiratory management, as you recommended. The reason why we only have two subsections is because those were the most relevant sections. The others only had a short mention. We also moved a piece of the methylxanthine section to the clinical uses section, and vice versa. We created a separate section for Doxapram in general because it had enough information to stand alone, rather than a part of clinical uses.

For the mechanism of action section, we followed your recommendations and reworded and corrected some grammar mistakes. We added the mechanism of action for methylxanthines to this section to provide more clarity.

To the methylaxanthine section, we changed the wording of the first sentence, and the other edits to this section were described above.

For the related research section, we deleted it because it did not warrant its own section.

We fixed all the issues relating to the references section. — Preceding unsigned comment added by Awhiterussian (talk • contribs) 19:21, 24 April 2015 (UTC)

Response to Primary Review #2
Thank you for your review. It was very helpful and informative.

We listed what we changed in the response to Dr. Mynlieff's review. In addition, we followed your review as well.

Specifically, we changed the wording of the first sentence.

For the mechanism of action section, we looked for a figure that was appropriate to one of the mechanisms, or all three, but were unable to find an appropriate one.

We reorganized the article throughout taking into account your recommendations and some other minor edits we encountered.

Thanks a lot for your review once again! — Preceding unsigned comment added by Awhiterussian (talk • contribs) 19:28, 24 April 2015 (UTC)

Response to Ian's Review
Thank you for your review as well! It was a big help to us.

When we first wrote this article, we had a deadline to achieve, and did not do the sourcing correctly. We have since corrected these errors.

We added a LOT more wikilinks after you had suggested we do so. We realized we did not have nearly enough. This really helped improve our article.

We ended up adding more to the Doxapram section and it is now much more complete.

The methylxanthine section was edited thoroughly after your recommendations, as we moved portions throughout our article.

Thanks again for all your help! — Preceding unsigned comment added by Awhiterussian (talk • contribs) 19:38, 24 April 2015 (UTC)