User:OSandoval Future UCSF PharmD/sandbox

Uterotonics

Proposed changes to Prostaglandins subsection:

1. Overview of the mechanism of action of prostaglandins and its role in labor induction.
2. Including more information on each of the prostaglandin types, providing necessary links to their respective articles.
3. Reorganizing the subsection for coherency and avoiding duplicate information.

Utertonic	Administration	Onset	Duration of Action	Common Side Effects	Contraindications
Oxytocin	IV Bolus IV continuous infusion Intramuscularly (IM)	IV: < 1 min IM: 3-5 min	IV: 20 min IM: 30-90 min	IV: Hypotension, tachycardia, arrhythmia IM: Nausea and Vomiting	IV: Hypotension IM: Hemodynamically unstable
Carbetocin	IV bolus IM	IV & IM: 2 min	IV: 60 min IM: 120 min	IV: Hypotension, tachycardia, arrhythmia IM: Nausea and Vomiting	IV: Hypotension IM: Hemodynamically unstable
Misoprostol	Oral (PO) Sublingual (SL) Vaginal (PV) Rectal (PR)	PO: 8 min SL:11 min PV: 20 min PR: 100 min	PO: 120 min SL: 180 min PV: 240 min PR: 240 min	Fever Diarrhea Nausea Vomiting
Carboprost	IM Intramyometrial (IMM)	IM: 3-5 min IMM: No data	IM: 60-120 min IMM: No data	IM: Bronchospasm IMM: Nausea, vomiting, shivering	IM: Asthma IMM: Caution in liver, kidney or heart disease.
Ergometrine	IV IM	IV: < 1 min IM: 2-3 min	IV: 45 min IM: 3 hours	IV: Hypertension IM: Nausea and Vomiting	IV: Hypertension IM: Myocardial Ischemia
Methylergonovine	IV IM	IV: < 1 min IM: 2-3 min	IV: 45 min IM: 3 hours	IV: Hypertension IM: Nausea and Vomiting	IV: Hypertension IM: Myocardial Ischemia

Prostaglandins

Prostaglandins are derived from the cell membrane phospholipids through a series of enzymatic reactions. Phospholipase A2 cleaves arachidonic acid from membrane phospholipids and is eventually converted to prostaglandins by cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). Due to this mechanism, prostaglandins have a presence in many areas of the body and allow for diverse physiological and pathological functions. Primarily known for its role in mediating inflammation, pain, swelling, redness, and warmth, prostaglandin synthesis is a target for many drugs. Inhibition of COX-1 and COX-2 by aspirin and non-steroidal anti-inflammatory drugs prevents the inflammatory response and can also prevent homeostatic functions of the stomach and GI system.

Dinoprost: also known as PGF 2α, is a naturally occurring prostaglandin which causes contraction via PG F receptors. Dinoprost was discontinued in 2015.

Carboprost: an analogue of PGF 2α, this prostaglandin contains oxytocic properties that permit a longer duration of action than the naturally occurring prostaglandins. The injectable prostaglandin is administered via intramuscularly or intramyometrial, and is contraindicated in those with reactive airway diseases. Side effects of this medication include hypertension, hypotension, pulmonary hypertension, vomiting and diarrhea.

Misoprostol: an analogue of PGE1, this injectable PG is a popular choice for PPH prophylaxis and treatment. Misoprostol is easily administered, considered safe, and its low cost. The routes of administration include sublingual, oral, vaginal, and rectal with greatest efficacy from sublingual and vaginal administration. Misoprostol is an agonist of EP1 and EP3 receptors, and can cause a greater stimulation at lower concentrations. At higher concentrations, the medication can suppress contractions.

Peer Review

Do the group’s edits substantially improve the article as described in the Wikipedia peer review “Guiding framework”?

Yes, the group did an excellent job updating the article with pertinent information. They have provided information on pathophysiology, treatment, classifications, complications, and epidemiology. Overall this wikipedia article has vastly been improved by Group 31.

Has the group achieved its overall goals for improvement?

The goals for improvement were not stated, however, looking at the previous version of the article before Group 31 started editing, they have made a great improvement on the article.

Are the edits formatted consistent with Wikipedia’s manual of style?

Overall the edits are formatted consistently with Wikipedia's manual of style, however, there are a few instances where lay language can be used so the article is not written for healthcare professionals in mind.

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