Wikipedia:Peer review/Proton pump inhibitor

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[edit] Proton pump inhibitor

I'd like to get this to good or featured article status. Any suggestions would be most welcome. -- Funky Monkey  (talk)  05:05, 14 August 2006 (UTC)

It's rather short for a featured article. Good start, but it could use some expansion.
  • The lead is short, and the juxtaposition "...H2 receptor antagonists. These drugs..." is awkward (I assume "these drugs" refers to PPIs, not H2 receptor antagonists). Statements like "outstanding safety and efficacy" also need inline citations despite being supported by later referenced text.
  • Definitely show the chemical structure of a representative molecule. It would be great if the receptor-inhibitor complex structure has been solved, but that sounds like a difficult crystallographic project. If there's any solved structure of the protein, that should get an image too.
Checked for this. No structure and I coudn't even find a published model. I added a drug structure though. TimVickers 23:12, 28 August 2006 (UTC)
  • Just a list of treatable conditions isn't enough for "clinical use". It would be nice to have contraindications, what type of treatment PPIs are (last resorts or the first thing the doctor gives you when he hears the word "heartburn"?), any well-known or common side effects, etc. Definitely convert from list to prose. (Speaking of heartburn, I thought that was a common use of these drugs, and it's mentioned later but isn't on the list?)
  • The mechanism section is very vague at the moment - might be the effect of targeting the writing to a too-low level. What residue(s) do PPIs modify and what is the result - physically blocking the channel, preventing a conformational change? Should also explain briefly how H2 receptor antagonists work, why PPIs work better, and whether there are any cases where the older drugs are more appropriate.
  • There's mention that the inhibition is irreversible due to covalent modification. More on that would be useful if the research exists. What happens to the inactive proteins (targeted to the proteasome?) and does the body replenish its supply of receptors?
  • The drug is given in an "inactive form", apparently from later discussion a deprotonated form. Chemical structures would be very useful here, and if known, an illustration of the reaction mechanism.
  • The pharmacokinetics section is much more technical than the mechanism section, which isn't a bad thing, but it suddenly mentions individual PPI molecules without having introduced or described them.
  • What's the practical effect of the drug's half-life in the body? How often do patients have to take the drugs?
  • Depending on the amount of information, adverse effects might be best merged with the clinical uses section. As it stands it's a bit awkward to start with clinical information, jump to biochemistry, and then jump back to the clinic.
  • There's no mention of history at all. How were these molecules originally discovered? Synthesized? Which one was the first to market? Over-the-counter, prescription-only, or does it depend on the specific type? AFAIK the ones you listed are all available in the US; are they approved and commonly used in other countries?
  • Might also be worth mentioning their presence in the social sphere - marketing schemes especially. This is a very competitive market, right?
That's a lot of suggested directions and you probably can't go in all of them at once, but it's some things to think about. Opabinia regalis 02:57, 15 August 2006 (UTC)
  • Please see automated peer review suggestions here. Thanks, AZ t 23:43, 16 August 2006 (UTC)
Please add something about the differences between the different PPI's (see also PMID 15580146) --WS 00:27, 22 August 2006 (UTC)
  • No mention of helicobacter. Do these drugs increase the risk of infection with this pathogen? TimVickers 23:12, 28 August 2006 (UTC)
    • Usually use PPI's as part of eradication therapy for Helicobacter. -- Samir धर्म 01:59, 5 September 2006 (UTC)
  • Good start. More information of clinical relevance would be good (i.e. PPI's for treatment of bleeding peptic ulcer disease vs. non-ulcer dyspepsia vs. Helicobacter eradication). A little more on physiology (how high does the pH get with in the stomach with PPI's, and more) I can help with that. More adverse effects (Laheij also had a paper looking at upper respiratory tract infections, there's a Canadian Medical Association Journal paper on Clostridium difficile infections, and a little more about bacterial overgrowth). Prose is always preferred over lists (I'm personally a big fan of lists where appropriate though). Opabinia is right about social relevance and competitiveness of drug companies in this market. Little things (ZES and gastrinoma could be in the same line, add a little about IV preparations and how they've changed management of hemorrhage). More about how esomeprazole was developed would be good. Differences in the PPIs (time of onset, how lansoprazole is available in capsule form, esomeprazole dissolves in water, etc.) Consider putting it up on WP:GI and WP:CLINMED for a broader range of opinions. I'll work on it myself also. -- Samir धर्म 01:59, 5 September 2006 (UTC)
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