Talk:Ribavirin

There
There is no ribavirin article talk page, so I'm starting it here.

My name is Steve Harris. I'm a physician in the U.S.A. I'm new to Wikipedia, and for my maiden project I've decided to flesh out the Wikipedia ribavirin article. When I was a university student in the late 1970's at Brigham Young University, I had the opportunity to work with Dr. Roland Robins, co-discoverer of ribavirin, now deceased. Our project was ribavirin derivatives. A review chapter on activity/structure I wrote with Robins in 1980 will be listed in the references to the Wikipedia ribavirin article. With new and emerging viral epidemics, I think that interest in this newly generic drug and its derivatives, is destined to expand. I have no commercial interest in ribivirin, but it's near to my heart for reasons that are basically sentimental. I welcome direct and indirect comments from experts and insiders who want to contribute. My log-on name is sbharris. I can be emailed at sbharris@[ROMAN9].netcom.com. You have to know how to make a roman numeral nine to fix the address.

I did get a note from a Dutch physician-contributer asking that I try to save up all editing changes into as few sessions as possible, to make tracking easier. I apologize for that. Some of the difficulty is that the Wiki servers have been locking up, and sometimes large editing changes from a long session are "lost." Frequent saving prevents that. I am thinking of editing the entire article offline, then doing a complete replacement each session. Would that be a better solution? Sbharris


 * Sbharris, your work is appreciated. Please join us docs at the Wikiproject "Clinical Medicine". Could you please supply us with classical references? The real use of Wikipedia is not just to document its present use but also the history of the development of ribavirin. This kind of information is sorely lacking from drug articles (sometimes I'm lucky, as with penicillamine). JFW | T@lk  20:30, 13 November 2005 (UTC)

Thanks, JFW. I'll be supplying references shortly. Sbharris


 * Great. There is nothing wrong with editing an article offline and then uploading it. I've written articles on the London Underground on my Psion and uploaded them later. JFW | T@lk  19:18, 14 November 2005 (UTC)

Okay, I've added references and some other stuff. I'm now mostly done, although other references could be added at a few points (readers are invited to point out places where things are said that require additional references). I don't want to multiply references to review article length. I think the most helpful thing to do in this regard would be to add notes to the external links to other reviews, to tell people what they can expect to find there. For some reason I rarely see this done in Wiki articles. Sbharris 06:45, 24 November 2005 (UTC)

Viramidine
By the way, I wonder if I could propose a stub for the antiviral drug Viramidine (discussed in the last external link in ribavirin) which is also discussed in the article, under DERIVATIVES? Viramidine is in phase III trials, and will probably be approved, and important enough to list. It needs a stub showing the structure of ribavirin, but with the -CO-NH2 replaced with -C(NH)-NH2. In it, I'll put enough info in to reference it back to ribavirin, and otherwise fix it up.Sbharris 07:48, 24 November 2005 (UTC)


 * If you think this drug is going to make a major change in the management of retroviral diseases, it may be worthwhile writing up an agent still underdoing trials. I did the same to ximelagatran, because if that ever gets approved it's going to make the AstraZeneca shareholders very, very happy. JFW | T@lk  08:08, 24 November 2005 (UTC)

Indeed. Yes, I think it will make a major change in management of a number of viral diseases, though won't help much against retroviruses per se. It will be great against hepatitis C, yellow fever, hepatitis B, and other liver-targeting viruses. It may also eventually end up replacing ribavirin for the hemorrhagic fevers, since the tox profile's a little better. I've asked Mykhal if he won't draw me the structure as a Viramidine.png, which I can then insert. I can use the ribavirin template for the stub, from there. Do I just start it as a new Wiki page and rely on the internal links to crossreference it? This one won't be long since it will just refer back to ribavirin for much info, but it needs to have a page to itself.Sbharris 05:59, 25 November 2005 (UTC)

Mechanisms of Action
Is the information correct on mechanisms of action? The first sentence states: "Ribavirin's carboxamide group can resemble adenosine or guanosine, depending on its rotation..." and that "when it's incorporated in to RNA it will pair with cytosine or uridine." Should the nucleobases be stated here rather than the nucleosides, since RNA is made up of nucleobases? i.e. ribavirin's carboxamide group resembles adenine or guanine and can pair with cytosine or uracil? I didn't want to change this myself, as I am using this page for reference. If I have got this completely wrong, and the above is all correct, could someone give me a brief answer as to why nucleosides are stated instead of nucleobases? Thanks CG


 * Good catch. The drug resembling adenosine or guanosine is probably the best way to say this, since in its native state it's a nucleoside analog, so nucleosides are the natural thing to compare it to. For example, it interacts with kinases first as the nucleoside analog, and (for example) is kinased probably more by adenosine kinase than any other. But once incorporated into RNA (little evidence it ever gets into DNA) it resembles adenine or guanine and pairs with RNA bases (not nucleosides per se) on the opposite side, and those should have been named as uracil and cytosine (the base names), respectively. You're right, there. I'll fix it. S  B Harris 03:12, 2 June 2007 (UTC)

ribavirin as treatment for rabies?
while the case is still under dispute, a girl who has been "cured of rabies" (http://content.nejm.org/cgi/content/full/352/24/2508) was treated with, among other drugs, ribavirin. should this be mentioned?66.108.40.86 (talk) 03:34, 7 December 2008 (UTC)phil

If you like. But as a single case, I don't know if it's worth it. Many things have been recommended for rabies, including this drug, which is active in vitro, but the numbers are too small to say what, if anything, works. Here would be your cite.

Clin Infect Dis. 2003 Jan 1;36(1):60-3. Epub 2002 Dec 11. Management of rabies in humans. Jackson AC, Warrell MJ, Rupprecht CE, Ertl HC, Dietzschold B, O'Reilly M, Leach RP, Fu ZF, Wunner WH, Bleck TP, Wilde H.

Department of Medicine, Queen's University, Kingston, Ontario, Canada K7L 2V7. jacksona@post.queensu.ca

Rabies is a fatal disease in humans, and, to date, the only survivors of the disease have received rabies vaccine before the onset of illness. The approach to management of the rabies normally should be palliative. In unusual circumstances, a decision may be made to use an aggressive approach to therapy for patients who present at an early stage of clinical disease. No single therapeutic agent is likely to be effective, but a combination of specific therapies could be considered, including rabies vaccine, rabies immunoglobulin, monoclonal antibodies, ribavirin, interferon-alpha, and ketamine. Corticosteroids should not be used. As research advances, new agents may become available in the future for the treatment of human rabies. S B Harris 05:00, 7 December 2008 (UTC)

Not unlicensed
I removed the statement in the opening paragraph that ribavirin is used off-label for RSV - aerosolised ribavirin is licensed: http://www.uptodate.com/contents/respiratory-syncytial-virus-infection-treatment, http://www.medicines.org.uk/emc/medicine/866, etc. 82.19.152.29 (talk) 20:31, 26 June 2015 (UTC)

History content
User:Sro23 please explain why you are removing this. Thanks. Jytdog (talk) 23:13, 18 August 2016 (UTC)
 * The content was added by an IP sock of a blocked user User:Filipz123. I don't trust anything this person says after the disruption they have caused. Sro23 (talk) 23:15, 18 August 2016 (UTC)

Defining concepts in the lead
One of the recommendations for writing in easier to understand language is to define more detailed concepts in the text.

Thus we have defined the World Health Organization's List of Essential Medicines, as the "most effective and safe medicines needed in a health system".

Doc James (talk · contribs · email) 13:13, 30 March 2017 (UTC)

Not knowing
User:Muscleups about this and this -- the lead summarize the body. It is important to say "we don't know" when we don't know. It isn't redundant. Jytdog (talk) 16:00, 10 August 2017 (UTC)


 * If we had no idea about the mechanism at all, then perhaps saying "we don't know" may be necessary, if one wishes to discuss the mechanism at all. However, for this drug, we *do* have an idea of several mechanisms. In biochemistry, all reactions are simply theorized, with either weak, medium, or strong support. Saying "here are some posited mechanisms" is enough. You don't need to insert "We don't know the exact answer, and none of this has been proved" or similar statements because they are redundant. You can add such a statement to *any* scientific theory. It is implied. Muscleups (talk) 16:04, 10 August 2017 (UTC)


 * Okay, so I went ahead and looked up a few papers about mechanisms of action. Several mechanisms are "known", and by this I mean extensively researched in the biomedical literature via experimental evidence. Sure, we don't know which one is for sure responsible, but we have experimental data to support a few likely candidates. So I removed the redundancy and added the reference and mechanisms (though didn't elaborate on them in heavy detail because readers can read the reference if they wish). Muscleups (talk) 16:14, 10 August 2017 (UTC)
 * I am fine with the new edits. thx Jytdog (talk) 17:17, 10 August 2017 (UTC)

Chemistry of furan in it
It is highly important for reactions 2C0F:FC88:9:73BC:A8B9:EB5:2CB6:CB6 (talk) 06:16, 9 May 2022 (UTC)