Talk:Warfarin/GA1

GA Review

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Suggestions for GA:

• In the Contraindications section, it should be reworded so that it can't be misread (by those who don't know the term "teratogen") as suggesting that a general side effect is deformation of the patient's face and bones.  Done
• [citation needed] tag in the Hemorrhage section. Also in that section,  Done
• In the Warfarin necrosis section, "occurs in children who are homozygous for protein C mutations" should be revised; surely it doesn't occur in children homozygous for any protein C mutation, only ones that disrupt its function.  Done
• In the Antagonism section: "1 mg of oral vitamin K is effective." Since typical dosage of warfarin is not discussed, neither should this. Likewise, the dosage info in the VKORC1 section should be removed.  Done
• "VKORC1 polymorphisms also explain why African Americans are relatively resistant to warfarin (higher proportion of group B haplotypes), while Asian Americans are more sensitive (higher proportion of group A haplotypes)". This should be rephrased so that it doesn't imply that racial categorizations are genetically anything more than correlations. On average African Americans are more resistant; that doesn't mean any particular person will be.  Done
• "VKORC1 polymorphisms lead to a more rapid achievement of a therapeutic INR, but also a shorter time to reach an INR over 4, which is associated with bleeding." This is confusing. Should it be "Certain VKORC1 polymorphisms..."?  Done
• Similarly in the next section, "but does shorten the time to INR >4" should perhaps be "but does affect the time to INR >4"?  Not done
  • • No, the point seems to be that if warfarin action is very rapid (because higher blood levels are achieved) it is also more likely to overshoot. I think the current phrasing makes sense, but please correct me if needed. JFW | T@lk 00:28, 29 December 2008 (UTC)
• The "Loading regimens" section should be prose, and needs to explain what these named algorithms mean.
  • • Will look into this. JFW | T@lk 00:28, 29 December 2008 (UTC)
• Maybe a number the pharmacology sections (and part of the Interactions section, which seems like a part of pharmacology) could be consolidated to discuss the factors that affect proper dosage and the methods of determining dosage. The small sections are disjointed, and in particular the Adjusting the maintenance dose section seems pretty out of place and lacking context, since the only point of the sentence appears to be to point readers to the footnote (which might be better relegated to an external link at the end).
• The list of herb interactions seems to wander from the topic at hand; the uses and unrelated side effects of these herbs are not particularly relevant, and the list would be better off as normal prose. Done
• In the Interactions section, "potentiating" is a bit jargon-y.

Some suggestions for the next level:

• The history section could use a discussion of the drug's market history. Who marketed it while it was under patent? When did the patent expire? How widely has it been used as a human drug from its introduction to the present? What, if any, have been its competitors? This is discussed in the present in the "Therapeutic uses" section, but might be
• Some discussion of the details of its production (industrially and/or originally by the WARF researchers) would be helpful.
• Citations for all the unreferenced parts
• Be sure to standarize (standardise?) the spelling; I notice some British spelling thrown in with mostly American.
• A picture of warfarin pesticide would be helpful, if possible.
• A graph illustrating the drug's typical pharmacokinetics and the variations caused by the discussed genetic factors might be nice.

It appears to be adequately broad in coverage (for GA, at least), neutral, stable, accurate, and adequately illustrated (for GA, at least). The writing is good when it comes in full paragraphs; the lists and tiny sections are awkward. I'm putting this On Hold for now. Please let me know when it's ready for a final GA evaluation.--ragesoss (talk) 05:20, 7 December 2008 (UTC)

The Warfarin factsheet [chemsoc.org] is a 404 link. --Stone (talk) 23:02, 11 December 2008 (UTC)

Nice work. I'm passing this GA. The loading regimes section still doesn't have enough context/explanation to make sense (I'm not even sure what exactly a loading regime is), but overall the article is in good shape.--ragesoss (talk) 23:27, 21 January 2009 (UTC)