Talk:Epinephrine

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Contents

[edit] Archive

This talk page was getting quite unruly and lacked structure, so I archived it. --BJ 22:53, 23 October 2006 (UTC)

[edit] The name issue

Epinephrine or adrenaline: what do people think about a poll? --David Iberri (talk) 02:52, 8 November 2006 (UTC)

I'm not sure what the problem is, in the U.S. Epinephrine is the medical name and adrenaline is the common name, I would think the medical name would be the articles names as well. BJTalk 04:41, 8 November 2006 (UTC)
The issue was brought up here some time ago (see archives). You're right that epinephrine is favored in US medical literature. But abroad, adrenaline predominates in scientific literature as well as among laypeople. --David Iberri (talk) 04:58, 8 November 2006 (UTC)
Is there a more scientific name for epinephrine/adrenaline? If so we move the page to that name and redirect all other names to it, else I would support a poll. BJTalk 05:11, 8 November 2006 (UTC)
Also I thought we prefer INN naming if possible. BJTalk 05:20, 8 November 2006 (UTC)
There's no more scientific name that I'm aware of. IMO, if there's a term that's universally understood and accepted by a large majority of scientists and medical practitioners, then it should be preferred. In this case, I believe the MoS's use common names for things policy should take precedence over its recommendation to use the INN name. --David Iberri (talk) 05:30, 8 November 2006 (UTC)
Yeah, I agree with your stance now, so I think a poll would be a good idea. BJTalk 05:37, 8 November 2006 (UTC)

Just an extra perspective: I teach science in an Australian high school, and am also the son of a surgeon, so I have a pretty good handle on scientific language. The use of the word "epinephrine" is very uncommon here. It is generally only KNOWN by the medical/scientific community, and even there it is often regarded as a rather quaint Americanism. The name for the hormone is generally considered adrenaline. In fact, when the staff at my school were trained to use an epipen, only I knew where its name came from. . .Johno 14:12, 26 November 2006 (UTC)

As a UK medical student, I can also confirm that Epinephrine is indeed an americanism. Here the accepted clinical term is also adrenaline, and all British medical texts will ONLY call it adrenaline, including the gods of pharmacology; Rang, Dale, Ritter, and Moore. Afterall, the correct term for an adrenaline receptor is an adrenoceptor/adrenergic receptor and the gland it is produced from is the adrenal gland. It then seems a little confusing to call the neurotransmitter 'epinephrine' or 'norepinephrine'.Swarvellous dude 18:10, 6 December 2006 (UTC)

The BMJ in 2000 had an interesting article rooting for "adrenaline" [1]. --David Iberri (talk) 03:17, 11 December 2006 (UTC)
Not an Americanism: I'm a medical student at the Faculty of Medicine of Lisbon and I can say that the term "epinefrina" in portuguese is preferred to "adrenalina" the common everyday name. In European scientific articles, the word epinephrin is becoming more and more common as time passes and sometimes it is preferred as a more scientific term.
Yes, there are some medical communities outside the US that prefer "epinephrine" over "adrenaline". Regardless, "adrenaline" is no less "scientific" than "epinephrine" and is therefore no less acceptable in theory. Keep in mind that we aren't writing an encyclopedia for scientists, and even if we were, those in favor of "epinephrine" are clearly in the minority as far as I can tell. Perhaps the strongest case for using "adrenaline" on WP is that it's almost universally understood by laypeople and scientists alike. --David Iberri (talk) 03:26, 13 December 2006 (UTC)

Also, if you check the most important Biochemistry books (Harper's and Devlin, for instance), you'll see they write epinephrin and not adrenalin. —The preceding unsigned comment was added by 62.169.114.249 (talk) 16:24, 12 December 2006 (UTC).

I'm not sure who edited Harper's biochem, but as far as I know, Devlin is an American (I think he's at Drexel), so it's no wonder he prefers "epinephrine". --David Iberri (talk) 03:26, 13 December 2006 (UTC)

My vote's for "epinephrine," following the INN convention. If, according to INN convention, the main entry for acetaminophen is paracetamol (this despite the fact that I bet more people have heard of acetaminophen than paracetamol!), then likewise the same should apply to epinephrine. Andrew73 12:40, 22 December 2006 (UTC)

This is why using the INN should be considered a guideline, not an absolute. There are always exceptions to even very well intentioned rules. I can't argue the point for "adrenaline" any better than the BMJ article. --David Iberri (talk) 19:06, 22 December 2006 (UTC)
The BMJ article is inherently biased towards the British convention (not saying that I'm absolutely free of American biases either). A better exception to the rule would be using "acetaminophen" instead of "paracetamol." Andrew73 12:10, 26 December 2006 (UTC)
I agree that acetaminophen/paracetamol should be another exception to the rule, but that's beside the point, isn't it? Maybe the BMJ article isn't the best way to argue the case for "adrenaline" (after all, some of the article's stronger arguments -- eg, the risk argument -- don't directly apply to Wikipedia). So I'm back to square one: is there a good reason why we can't sidestep the INN convention, acknowledging it as a guideline rather than the sole determining factor of page titles? When a suitable term is nearly universally recognized by the scientific community and general public alike, then it should be favored over a synonym that is considerably less familiar to both pools of people. I don't mean to be beating a dead horse, but I don't feel this point is being adequately addressed by folks who oppose the use of "adrenaline". --David Iberri (talk) 00:30, 27 December 2006 (UTC)
I thought the underlying principle for naming drugs in wikipedia is to use the generic name, even if the lay (or proprietary) name is more commonly known. Otherwise, we'd have articles named after more commonly known names like Viagra or Prilosec as opposed to sildenafil or omeprazole. "Epinephrine" then is most consistent with this logic since it's the accepted medical term (at least in the U.S.) as well as INN term. Andrew73 14:59, 27 December 2006 (UTC)
Our point precisely. In the US it is the accepted medical term. Here the accepted medical term is Adrenaline. It has been demonstrated to my satisfaction that in the majority of the world, Adrenaline is the accepted medical term. Your point? :-) Johno 14:57, 29 December 2006 (UTC)
Well the majority of the world v. the U.S...in these situations, the U.S. generally wins, at least for medical things or spellings of medical things :). Furthermore, the INN guidelines (which aren't always in favor of American spellings (e.g. paracetamol)) favor epinephrine. Andrew73 16:00, 29 December 2006 (UTC)
Like I said above, I agree with your paracetamol vs. acetaminophen argument, but IMO it only underscores the fact that Wikipedia's INN convention should be treated as a guideline rather than a hard-and-fast rule. --David Iberri (talk) 07:07, 30 December 2006 (UTC)
The INN convention is useful as a guideline for selecting non-proprietary names for drugs, but it's not so good for choosing between two equally valid non-proprietary names. So the Viagra vs. sildenafil argument doesn't really relate to the epinephrine vs. adrenaline debate. --David Iberri (talk) 07:07, 30 December 2006 (UTC)
My point with "Viagra" v. "sildenafil" was that the medical terms are preferred over lay terms (it also happens to fall in line with non-propietary being favored over propietary). Furthermore, if you do a Google scholar search, there are more listings for "epinephrine" compared to "adrenaline." Andrew73 15:23, 30 December 2006 (UTC)
I see; my apologies for misreading. Still, I think my point is valid that INN shouldn't be the only thing consulted for choosing between two equally valid non-proprietary names. Google Scholar's results are helpful, but not terribly so. The argument is whether we should use a term that's known almost exclusively by the scientific community or one that's known almost universally by scientists and the general public alike. --David Iberri (talk) 17:00, 30 December 2006 (UTC)
everyone has heard of adrenaline but not epinephrine, but when it comes to acetaminophen/paracetamol most people have heard one but never the other, i'm english and i live in australia and here its always called paracetamol (same with adrenaline) but i have never heard of acetaminophen (or epinephrine) until a month ago

[edit] Responses to RfC

  • Adrenaline - understood also by lay-people.  Andreas  (T) 18:32, 22 December 2006 (UTC)
  • Epinephrine - other than in the intro and the terminology section, epinephrine is used in the entire article. If it is renamed to adrenaline then the article should be rewritten to use adrenaline instead of epinephrine. I don't see much gained in doing this. Cburnett 05:16, 6 January 2007 (UTC)
    • Please refer to the discussion above. The issue is that "adrenaline" is almost universally recognized, while familiarity with "epinephrine" is localized to the US scientific community. --David Iberri (talk) 17:15, 6 January 2007 (UTC)
      • I read it. I say stick with epinephrine, but if I "lose" then I'm warning that this is not a simple page rename as "epinephrine" is used throughout the article. Cburnett 00:32, 7 January 2007 (UTC)
        • Okay; apparently I (mis)read the comment you left as a rationale for your vote. The effort required to change "epinephrine" to "adrenaline" is trivial and isn't valid as an argument to retain "epinephrine" as the page title. --David Iberri (talk) 04:55, 7 January 2007 (UTC)
  • Keep as epinephrine. To paraphrase what I've argued previously, this article is mainly discussing epinephrine in the scientific/medical sense, not the cultural sense. And since it's mainly known as "epinephrine" in the medical community (e.g. a search on Google scholar shows more hits for "epinephrine" than "adrenaline"), the name of the article should stay consistent. Andrew73 16:04, 7 January 2007 (UTC)
  • Adrenaline. As previously stated, it is mainly known as Adrenaline in the SCIENTIFIC and MEDICAL communities in the English speaking countries outside the USA. Which, to all Americans, really do exist! :-)
  • Adrenaline per WP:COMMONNAME, with epinephrine redirecting here. Raymond Arritt 02:02, 9 January 2007 (UTC)
  • In medical circles usage seems to be fairly evenly split, apparently mostly following the American/Commonwealth division (although knowledge of both synonyms is widespread). Among the general audience, adrenaline is substantially more well known. I think in this situation the preferred title for the article, following Wikipedia:Naming conventions (common names), would be Adrenaline. -R. S. Shaw 08:10, 22 December 2006 (UTC)
  • Keep as Epinephrine. The Adrenaline article already is required to list half-a-dozen disambiguation links. So moving this article to Adrenaline really means moving it to Adrenaline_(Biology), which is lame. Heathhunnicutt 22:50, 9 January 2007 (UTC)
    • No, Adrenaline (disambiguation) would be kept where it is, and this article would be titled simply "Adrenaline" (and would have a disambig line to "Adrenaline (disambiguation)" like it has now. -R. S. Shaw 20:49, 12 January 2007 (UTC)
  • Additional comment. If you look at Wikipedia:Manual of Style (medicine-related articles), the scientific or medical name is preferred, not the lay term. Andrew73 02:31, 10 January 2007 (UTC)
    • Both adrenaline and epinephrine are widely accepted medical names, so this Manual of Style guideline does little to help choose between them. -R. S. Shaw 04:31, 10 January 2007 (UTC)
"Adrenaline" is not the standard medical term in the U.S. Maybe in lay discussion, but not in the medical community. Andrew73 12:23, 10 January 2007 (UTC)
I'm not sure why you keep going back to this point. This article is intended for global consumption by medical practitioners and the general public alike. "Adrenaline" being widely known in both circles, it should be our preferred term as well. --David Iberri (talk) 15:59, 10 January 2007 (UTC)
  • But then we also have an article on sugar rather than sucrose. Raymond Arritt 01:50, 11 January 2007 (UTC)
  • Keep as Epinephrine - but note that the official position in Europe is to use "Adrenaline", whilst the British Pharmacopoeia uses BOTH European Pharmacopoeia names and the rINN. As the British National Formulary states:

    "Adrenaline and noradrenaline Adrenaline and noradrenaline are the terms used in the titles of monographs in the European Pharmacopoeia and are thus the official names in the member states. For these substances, BP 2005 shows the European Pharmacopoeia names and the rINNs at the head of the monographs"

    So whilst I might hold a cheerful grudge against the US (re branding of a universal term, so resulting in the INN, ?uniquely?, deciding on an alternative name) I accept that the INN should be the name used for the article. As the INN is "official" from the WHO, this encompasses more than just Europe vs. US debating - wikipedia is afterall worldwide and so "English-speaking" needs to include also Canada, Carribean, South Africa, New Zealand & Australia usage - I guess most of these follow INN ? David Ruben Talk 04:33, 10 January 2007 (UTC)

Australia officially uses the INN, I believe, but that's only relevant to government - some document as such was probably signed by some Canberra flunky who didn't really know what he was signing. In keeping with our grand traditions, scientists and doctors ignore the INN and work with British names. As said before, you'll never hear the word "Epinephrene" here.Johno 13:05, 3 February 2007 (UTC)

  • This may help. --David Iberri (talk) 16:12, 10 January 2007 (UTC)
  • Adrenaline. Axl 11:12, 10 January 2007 (UTC)
  • Adrenaline, as that is what seems to be more common. Strad 01:12, 12 January 2007 (UTC)
  • Adrenaline (despite my being an American) because it's universally recognized, the most common term, and no less scientifically valid than "epinephrine". --David Iberri (talk) 03:07, 12 January 2007 (UTC)
  • Keep as Epinephrine Per David Ruben. (I speak British English). The common-name guideline is surely intended to chose the most sensible name used within one community of speakers. It is not a useful tool when two communities disagree. I disagree that the INN guideline isn't useful here. It is precisely useful here since we have a stalemate. A whole bunch of big brains in Geneva or wherever have already had this discussion and no doubt one side came away feeling bad. The point of the INN guideline is that often there are good arguments for both sides and rather than fall out with each other, we defer to an international authority. Win some, lose some. Colin°Talk 14:26, 17 January 2007 (UTC)
    • Point taken, but I respectfully disagree. I'd like to think that the INN used solid reasoning to avoid "adrenaline", but my best guess is that it was to avoid a conflict with the proprietary name "Adrenalin". And that's just silly, especially considering the pro-"adrenaline" arguments that have been cited here, along with the convincing arguments in the BMJ article. I doubt it, but does the INN publish rationales for their selection of names? That'd be an interesting read. --David Iberri (talk) 05:00, 18 January 2007 (UTC)
I think your guess is reasonable. I did read the BMJ article and it makes a good case. The world of science and medicine is littered with words that were misguided: artery for example. We're not going to change that any time soon. Colin°Talk 09:14, 18 January 2007 (UTC)
Wow, thanks for the link -- I'd never realized the origin of the term. Very interesting history. But the "artery" story is quite a bit different than the "adrenaline"/"epinephrine" debate, IMO. On the one hand, you've got a term that's been deeply ingrained in the whole of the scientific community for centuries. On the other, you've got a comparatively new pair of terms, one of which is universally understood, the other only meagerly so. While I agree that it would be nice to defer to an international authority, I wouldn't recommend doing so without considering whether their decision was sound. And in this case, it seems that their decision-making process was either poorly informed, or I'm missing the piece of the puzzle that rationally explains why "epinephrine" is a more internationally acceptable term than "adrenaline". This brings me to one of my initial suggestions, namely that we use the INN convention as a guideline and not an absolute. When there are reasonable and compelling arguments to use an alternative non-proprietary term (ie, not the INN recommendation), there should be room for discussion and the establishment of community consensus. Cheers, David Iberri (talk) 02:09, 19 January 2007 (UTC)
  • Adrenaline, more common, much more useful in a general encyclopedia Wolfmankurd 18:49, 23 February 2007 (UTC)

[edit] Summary of arguments

Partly for my own benefit, I've attempted to summarize the main arguments for "adrenaline" and for "epinephrine" below. Perhaps it'll be useful for others trying to follow the conversation. --David Iberri (talk) 23:40, 10 January 2007 (UTC)

[edit] Pro-"epinephrine"

  • Medical terms are preferred over lay terms
  • "Epinephrine" is more scientifically or medically accepted
  • "Adrenaline" is a lay term
  • The INN term is "epinephrine"
  • There are more Google Scholar results for "epinephrine"
  • The US often wins out over the rest of the world w.r.t. spelling of drug names
  • The "most important" biochemistry texts use "epinephrine"
  • Wikipedia convention is to prefer the scientific over the lay (or proprietary) name

[edit] Pro-"adrenaline"

  • "Adrenaline" and "epinephrine" are equally "scientific", so the most common term should be used per WP:COMMONNAME
  • "Adrenaline" is almost universally recognized among both scientists and the general public worldwide
  • "Epinephrine" familiarity is localized mostly to the US scientific/medical community
  • Wikipedia's INN convention is useful for choosing a non-proprietary name for a drug, but not useful for choosing between two equally valid non-proprietary names; it shouldn't be consulted for choosing between "adrenaline" and "epinephrine"


Thats 7 to 5 should I edit the article? Wolfmankurd 18:50, 23 February 2007 (UTC)

Seriously why was it EVER epinephrine? Is it produced in the medulla of the supraepinephral gland? No! Does 'epinephrine' bind to alpha or beta epinephric receptors? No! Do we learn in medical school how to distinguish the various 'epinephral receptor' differences with epinephrine and norepinephrine? No! Seeing epinephrine as the title for the adrenaline article is like a fat american sitting on your chest each time you view the page. Also i've heard that epinephrine is gay and im homophobic so i say we switch it back to the straight (with a steady girlfriend) adrenaline.

You have a valid point but your method of conveying it is disappointing. Please refrain from such inflammatory remarks in the future. --David Iberri (talk) 19:04, 24 March 2007 (UTC)

Sorry i was being sarcastic... im not actually homophobic. I personally find my 'fat american' comment offensive so if you could please censor that as well. I mean come on! really? you think it's possible for adrenaline to be straight? or epinephrine to be gay? REALLY?! I'm no biochemist but i dont think stereoisomers acount for molecule sexuality. While you're at it why not head over to pages linked to comedy and have a crack at disabling those? No? Any takers? Ok. So will the page be changed to adrenaline?

Okay, fine; I uncommented it. I had supposed you were making an attempt at humor, but Wikipedia isn't the right place for remarks like that. Plus it's difficult to take your comments seriously when they're in the context of such sophomoric humor. Having said that, I agree with you that this page should be at "adrenaline". Whether it will be moved is not up to me, but is a matter of consensus. Unfortunately we're not there yet and comments from those previously interested in this discussion seem to have petered out. --David Iberri (talk) 20:04, 24 March 2007 (UTC)

[edit] How is the release of adrenaline controlled?

Was hoping to find the answer to the above question. SmithBlue 15:06, 9 December 2006 (UTC)

I added a bit on regulation to the article. It's not complete, but it's a start. --David Iberri (talk) 07:03, 10 December 2006 (UTC)

Thanks David. SmithBlue 00:15, 14 December 2006 (UTC)

[edit] Citation

Citation required for some statements. --218.186.9.3 16:04, 9 February 2007 (UTC)

[edit] used with lidocaine

At the dentist's office, I noticed that the lidocaine was labeled as containing epinephrine. I asked the hygeinist what its function was, but she didn't seem to know. Any idea? Does it act as an anaesthetic itself?--207.233.88.250 20:25, 15 February 2007 (UTC)

Someone told me that it might act to keep the lidocaine in the body for longer, because it constricts blood vessels.--207.233.88.250 20:35, 15 February 2007 (UTC)

According to this, the epinephrine is used for its vasoconstrictive effect. This helps to maintain a bloodless field. This has two advantages (this is my analysis not source's) 1-lidocaine often used before minor superficial operations (e.g. stitches, etc.) and it helps to have a clean field 2-if lidocaine is injected shallow in a wound, the cleansing action of the bleeding may flush out some of the lidocaine. Rlax 06:54, 23 February 2007 (UTC)

[edit] Adrenaline/Epinephrine move

The Right Honourable (talk • contribs) moved this page from "Epinephrine" to "Adrenaline/Epinephrine" in this edit [2]. The move was in line with WP:BOLD, but doesn't help solve the problem I and others have raised on this talk page, namely that we need to decide between "adrenaline" and "epinephrine". As User:Colin mentioned on my talk page, this may also go against the "Do not use an article name that suggests a hierarchy of articles" policy of WP:NAME. I've moved the page back to Epinephrine for the time being. Input welcome. --David Iberri (talk) 23:21, 6 March 2007 (UTC)

FYI, he also did the same over at what is now called Noradrenaline/Norepinephrine. --Arcadian 00:01, 7 March 2007 (UTC)
Agree with the revertion back to Epinephrine. Whilst the move might be described as WP:Bold, it was not following consensus (the discussion above failed to reach clear consensus to rename). Furthermore, given that discussion was being held, to perform the action outside of consensus was quite frankly disruptive to our group effort. The WHO have carefully considered this and decreed on the INN. It is really not the place of WP to carry out a debate (vs merely reporting on a debate). I really think the article should be as per the INN, but by all means describe in the article the history of the various names, the WHO's INN and how various parts of the world have chosen to follow this or not etc (all with good citations from reliable sources to verify of course) ... David Ruben Talk 00:10, 7 March 2007 (UTC)
PS I've reverted too the renaming of Norepinephrine David Ruben Talk 00:13, 7 March 2007 (UTC)

[edit] Isomers

The isomers section says only "Epinephrine can be found in nature in the R form; however, racemic mixtures of the molecule can be used if its chirality is destroyed." This seems to imply the epinephrine compound is an L form, but that isn't stated (apparently). Also, the R form probably shouldn't be called epinephrine then, since it doesn't have the activity (I presume). Thirdly, what does if its chirality is destroyed mean? Wouldn't one just use the racemic mixture and expect half the level of activity (for a 50-50 mix)? Is some sort of chemical "destruction" or separation step needed? It would be good if someone knowledgeable about this could fix the article. -R. S. Shaw 18:53, 11 March 2007 (UTC)

[edit] Error in Regulation section

Usually when there is a first, second & third, there are three points to be made. Here there is two points & a repeat of the first. I edited it, but the administer reverted it. If you don't believe that tyrosine hydroxylase and dopamine-β-hydroxylase are enzymes for dopa and norepinephrine, please go to http://www.genome.jp/dbget-bin/get_pathway?org_name=hsa&mapno=00350 & click on the enzymes yourself. If there is another way that the first point under regulation is true, in addition to the well documented way mentioned under number three, please add that. I would be most interested & I would expect lots of others would be too. I've already edited it once & the edit just got trashed, so I'll leave it to someone else to fix it again.

Much of Wiki appears as if it is a few sentences taken from one textbook & a few others taken from another. That's fine. I have no problem with that, as long as everything fits together. Having a correct entry is more than making sure each individual sentence is true. It needs to be true when taken as a whole. Stating the same action as two different actions is just as much of an error as any other error.

—The preceding unsigned comment was added by Gregogil (talk • contribs) 00:10, 29 March 2007 (UTC)

It wasn't 'the adminster' that reverted, just another editor. His summary suggests he did it because your edit was unexplained - i.e. you left the Edit Summary blank. -R. S. Shaw 02:31, 29 March 2007 (UTC)
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