Talk:Melarsoprol
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Wiki Education Foundation-supported course assignment
[edit]This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Felicewu595, Adnisley, Chiange. Peer reviewers: Leeraymo, Victor arias, Lypimentel21, Sophia.lai.
Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 03:50, 17 January 2022 (UTC)
Melamine
[edit]This drug also contains melamine in its structure. Is there any data about kidney toxicity? 62.143.171.2 (talk) —Preceding undated comment added 20:11, 7 September 2011 (UTC).
Structure
[edit]Is there an image around with a line drawing structure for this drug? It would be helpful.OcciMoron 18:59, 9 July 2007 (UTC)
Fact or Fiction
[edit]The phrasing "it is fatal in and of itself 10 percent of the time" and "arsenic in antifreeze" appear on "House," word for word. Is there any verifiable proof this is the case, or was this simply taken from the TV show? Jimzim66 04:10, 8 February 2007 (UTC)
- I don't know much about the arsenic and antifreeze statement, but as for the death rate I'll change it back "a significant fraction" (see below) until we can get a better percentage. Scaper8 14:15, 26 March 2007 (UTC)
- I watched the episode again, and the phrase "It is fatal in and of itself..." is copied in the article, word for word. Just wanted to bring this up so TV show quotes arent being cited as canon. Jimzim66 05:42, 18 April 2007 (UTC)
- There seems to be a lot of "information" in this article that was lifted from House MD. I removed the comment regarding "glass syringes only"--this was taken verbatim from House as well, and is not true. Auto antifreeze is sold in plastic bottles--clear evidence to the contrary. Furthermore, the source cited with this comment made no mention of the "facts" proported. For more information, see http://content.nejm.org/cgi/content/full/346/26/2069; the drug is clearly described as being suppled in ampoules, not "glass syringes".
- Ampules are made of glass. I have no source to cite on this except for a decade of medical practice. Not saying this confirms or disproves any of the previous issues on the "glass syringe only" issue, but your logic in dismissing it is flawed. As the container that it comes in is glass as well. — Preceding unsigned comment added by 24.104.67.214 (talk) 22:10, 17 August 2012 (UTC)
Here's a source for both the glass syringes bit and the antifreeze (propylene glycol): http://archives.who.int/eml/expcom/expcom15/applications/sections/Antitrypanosomal.pdf
You can read this article for evidence of the antifreeze quote and a 5% death rate. http://www.newscientist.com/article/mg18524821.800-curing-diseases-modern-medicine-has-left-behind.html
Jfdwolff, while I agree that U.S. government information is generally public domain, I think you're hasty in judging this to be pd. If you would look at the link from which the information derives, you'd notice that the bottom of the page ascribes a coypright to the drug information. I think if the U.S. government web site marks the info as copyrighted, we can't reasonably consider it public domain. If you have other information to the contrary, I'd gladly hear it. :-) Jwrosenzweig 17:44, 24 Nov 2004 (UTC)
- Thanks JW, I was under the impression that MedlinePLUS was PD. Now this page can be written up properly. Well spotted, and a very good autumn to you :-) (see User_talk:Jfdwolff). JFW | T@lk 10:57, 25 Nov 2004 (UTC)
I am a researcher on Human African Trypanosomiasis and I can confirm the accuracy of the House statements. Melarsoprol is very toxic and causes fatality in about 5% of cases and can cause serious problems. The drug contains Arsenic in its structure, hence the term "arsenic in antifreeze." It is highly corrosive. It eats through plastics and flesh, and must be stored and administered through glass. The drug is so painful to receive that often times patients must be physically restrained during treatment to keep them from ripping the IV's out. — Preceding unsigned comment added by 205.170.12.195 (talk) 23:15, 20 June 2014 (UTC)
Death rate
[edit]The 12% death rate given in the article appears to be on the high side.
This [1] suggests that the death rate from melarsoprol is rather lower than the 12% figure given in the article. According to this, the death rate was 6 deaths out of 250 in each of two experimental groups with N=250, a rate of 2.4%, with all deaths due to encephalopathy, with a rate of 14 out of 250 in each of the groups, a rate of 5.6%. That is to say, out of the 5.6% with encephalopathy, 43% died.
This report [2] gives the following figures:
- The rates of encephalopathic syndromes ranged from 3.3 - 29.6% (average 8.7%) compared to the retrospective rates of 0 – 13% (average 8.3%). The case fatality rate of encephalopathic syndromes was 45% which is comparable to reported rates (range 30 – 80%). 67% of the fatalities were attributable to encephalopathic syndromes.
This suggests that roughly 45% * 9% = 4%-ish of patients died due to encephalopathic syndromes, and that the overall fatality rate was 4% / 67% = 6%-ish.
Changing to "a significant fraction".
Selectivity of eflornithine
[edit]Under Alternatives it is stated that: "Moreover, eflornithine is effective only for West African sleeping sickness (caused by Trypanosoma brucei gambiense); it has no effect on East African sleeping sickness (caused by Trypanosoma brucei rhodesiense)." This is not consistent with the Wikipedia-entry of eflornithine nor the one on African trypanosomiasis. Is there a reference for the statement or is it due to confusion with pentamidine and suramin that has then been misapplied? 81.224.47.12 (talk) 23:12, 20 February 2013 (UTC)
misc. problems
[edit]The structure of melarsen oxide is not "shown below". "Two arsenic-containing stereoisomers exist in a 3:1 molar ratio." should not be under "Dosage". 69.72.92.13 (talk) 08:36, 10 November 2015 (UTC)
Group 15- Suggested Edits To Melarsoprol
[edit]We are going to improve the lead by editing the diction and grammar. Some sections we believed that require expansion are pregnancy/lactation considerations, pharmacology, and pharmacokinetics. It would also be beneficial to mention warnings, black box warnings, and cautionary statements. We are going to add the mechanism of action and explain the current place in therapeutics for African trypanosomiasis. We also might add a brief explanation for the use in special populations such as pediatrics and geriatrics. Elaine will be in charge of pregnancy/lactation. Ashley will work on side effects, black box warnings and cautionary statements. Felice will research the mechanism of action and the drug's place in therapy. Felicewu595 (talk) 17:48, 4 November 2016 (UTC)Felicewu595 (talk) 17:34, 4 November 2016 (UTC)
Does anyone know how to change the link in the drugbox to the correct one? If you click the link for AHFS/Drugs.com it takes you to the wrong drug. Chiange (talk) 17:23, 17 November 2016 (UTC)
Group 16 - Peer Review
[edit]Does this article address a neutral point of view? I think the information provides a very good foundation for readers to get a basic understanding of the drug. Initially, I thought the sentence, "All people diagnosed with trypanosome-caused disease should be treated with an antitrypanosomal," was not neutral enough, but I checked the reference provided and realized that it was indeed a statement made by the CDC. This article consistently provides factual information that is supported by valid resources and does not try to bias the readers. Sophia.lai (talk) 23:02, 14 November 2016 (UTC)
Are the edits formatted consistent with Wikipedia’s manual of style for medicine-related articles? Good use of lay language especially for parts of the page that most visitors would like the side effects and medical uses sections. To make it flow better I feel like you can just combine 2 sentences under "Dosage" section: Change to "The dosing schedule for pediatrics and adults is 2-3.6mg....". Also, under the medical uses section the phrase "based on" in the 2nd sentence is used twice so the 2nd one can likely be omitted. Leeraymo (talk) 00:38, 15 November 2016 (UTC)Raymond
Are the points included verifiable with cited secondary sources that are freely accessible? There were a few sentences that lacked a references. The second sentence of the lead paragraph has no citation. Under medical uses paragraph again the 2nd sentence has no citation. There is also a missing citation for the sentence that starts with "Failure rates of 20-17%..." under the medical uses section. The first sentence of the mechanism of action section also lacks a citation. As for the citations used most of them qualified as secondary opens sources except for [1] --> clinical trial, [3] --> not freely accessible, [4] --> not freely accessible, [9] --> not freely accessible, and [13] --> not freely accessible. Victor arias (talk) 06:03, 15 November 2016 (UTC)
Is there any evidence of plagiarism or copyright violation? If yes, specify. Overall, there is no evidence of plagiarism or copyright violation as the editors did a great job in summarizing and paraphrasing. The only sections I could not validate were those cited with source 4 as I could not gain access to it. Otherwise, the only comment I have is the order of how things are mentioned, and grammar in certain areas. For example: "Other common names for this drug include Mel B and Melarsen Oxide Bal.[2] The active metabolite of Mel B is Mel Ox, which is taken up by the TbAT1 adenosine transporter in T. brucei gambiense or T.b. rhodesiense.[3] Due to side effects similar to arsenic poisoning, other pharmacological agents have become first-line treatments for stage one of the disease and for certain other trypanosomes. In 1949, Freidheim demonstrated the effects of melarsoprol against late stage trypanosomiasis. Melarsoprol is the dimercaptopropanol derivative of melarsen oxide (Mel Ox), whose structure is shown below.[4] It is produced by Sanofi-Aventis and is on the World Health Organization's List of Essential Medicines.[5] The medication is not available in the United States and Canada.[6]" I would rewrite as such: "Melarsoprol is the dimercaptopropanol derivative of melarsen oxide (Mel Ox), whose structure is shown below.[4] The active metabolite of Mel B is Mel Ox, which is taken up by the TbAT1 adenosine transporter in T. brucei gambiense or T.b. rhodesiense.[3] Due to side effects similar to arsenic poisoning, other pharmacological agents have become first-line treatments for stage one of the disease and for certain other trypanosomes. It's effects against late stage trypanosomiasis were first demonstrated by Freidheim in 1949. A few years later in (Insert year here), the French pharmaceutical company, Sanofi-Aventis was able to produce it for medicinal use in humans. As of (year), melarsoprol is considered one of the World Health Organization's List of Essential Medicines.[5]" Other common names for this drug include Mel B and Melarsen Oxide Bal.[2] — Preceding unsigned comment added by Lypimentel21 (talk • contribs) 18:01, 15 November 2016 (UTC)
How many people die from this disease in a year
[edit]How many people die from this disease in a year? 98.115.125.148 (talk) 14:38, 19 November 2021 (UTC)