Physiology and Pharmacology Synthesis

Physiology and Pharmacology Synthesis

Ms. Jones is the patient of interest. The patient came with complains of pain difficulty falling asleep and anxiety due to upcoming examinations and job hunt. She expresses her interest in managing these distressing symptoms that have been affecting her performance. Anxiety is a psychological condition that can lead to insomnia. Chang and Marwaha (2019) state that anxiety is a future-oriented complex mood state that involving cognitive, affective, physiological, and behavioral responses in anticipation for future events or circumstances perceived as threatening.

Specific phobia, such as the one with Ms. Jones, arises from a specific object or situation (examinations and job hunting). The amygdala receives cues of fear increasing its activity of the amygdala. Fear also causes the release of four most common neurotransmitters that increase the brain’s activity and are responsible for the sympathetic nervous system’s related symptoms.

The physiological symptoms include an increased heart rate, tachypnea, dizziness, hot flashes, chills, nausea, ad weakness. Changes in behavior include agitation, restlessness, pacing, freezing, and difficulty speaking (Chand & Marwaha, 2019). Affective anxiety symptoms are fear, terror, impatience, and frustration. These symptoms interfere with normal function, although anxiety is meant to help prepare for future uncertainties.

A review of these symptoms and a mental status exam can help diagnose the disease using the DSM-IV criteria. Laboratory tests are used to rule out other medical conditions and include thyroid function tests, CT scans, arterial blood gas analysis, electroencephalography, and a full hemogram. Guidelines also support the use of depression-anxiety assessment tools.

Anxiety is managed using either pharmacologic or non-pharmacologic treatment methods. Selective serotonin reuptake inhibitors such as sertraline and fluoxetine are the first line treatments for all types of anxiety (Chand & Marwaha, 2019). Sertraline is the common FDA-approved drug used in anxiety and its side effects, which are rare, include loss of interest in sex and agitation. Serotonin-norepinephrine reuptake inhibitors (such as duloxetine) are also considered first line (Jakubovski et al., 2019).

Other medications are benzodiazepines, Buspirone, beta blockers, and tricyclic antidepressants. Bandelow et al. (2022) state that antidepressants are advised against for their adverse effects such as the bradycardia, drowsiness, blurred vision, and constipation.  Other interventions include psychotherapy, exposure therapy, and patient education (Chand & Marwaha, 2019).

Cognitive behavior therapy helps patients identify disabling patterns and beliefs and work on them (Luong et al., 2020). Advising Ms. Jones on the need for social support and stressing on the need to study for the exams rather than worrying about them could help.

The interventions help patients face of the fears they are avoiding. Counselling her on preparing a sleeping pattern and following it will help the patient fight insomnia. The intervention of choice depends on the severity of the illnesses. Understanding the causes help healthcare providers develop patient-centered and effective interventions.

References

Bandelow, B., Michaelis, S., & Wedekind, D. (2022). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience. https://doi.org/10.31887/DCNS.2017.19.2/bbandelow

Chand, S. P., & Marwaha, R. (2019). Anxiety. Treasure Island (FL).

Jakubovski, E., Johnson, J. A., Nasir, M., Müller‐Vahl, K., & Bloch, M. H. (2019). Systematic review and meta‐analysis: Dose–response curve of SSRIs and SNRIs in anxiety disorders. Depression and Anxiety36(3), 198-212. https://doi.org/10.1002/da.22854

Luong, H. K., Drummond, S. P., & Norton, P. J. (2020). Elements of the therapeutic relationship in CBT for anxiety disorders: A systematic review. Journal of anxiety disorders76, 102322. https://doi.org/10.1016/j.janxdis.2020.102322

Feedback on The Synthesis

For this assignment, I met Ms. Rebecca, an advanced practice registered nurse in primary care. She commented the information was clear but and well-researched but mentioned that it focused entirely on Ms. Jones. She insisted on the importance of including the clinical manifestations because anxiety is a mental health disorder.

She also insisted on mentioning other drugs used in the anxiety treatment besides the selective serotonin reuptake inhibitors. She emphasized the importance of clinical manifestations and the DSM-IV because anxiety is a mental health disorder. The information helped me do more research on anxiety, the various classifications and their diagnosis and helped me improve my synthesis.