Anxiety Disorder: Pharmacology Essay

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Introduction. Pathophysiology of Anxiety Disorder

  • Anxiety causes fear, insomnia, chronic pain, premonition, difficulty concentrating, the effectiveness of selective serotonin reuptake inhibitors (SSRIs), and more.
  • The key point – sympathoadrenal, is associated with hypothalamic-pituitary-adrenal hyperreactivity.
  • An increase in the concentration of ACTH and cortisol (Anxiety disorder).
  • Anxiety decreases the brain-derived neurotrophic factor (BDNF).

Anxiety Disorder Treatment

  • Treatment should not be self-administered
  • The disorder regulatory effect on neurotransmitter systems, mainly serotonin (Anxiety disorder).
  • Together with the norepinephrine and dopamine systems, the concentration of ACTH and cortisol provides an adequate emotional response to the body.
  • Usually, 9-12 months of therapy is required to achieve complete remission
  • The appointment of medicines begins with half the starting dose with a gradual increase in dosage after a week to the standard dose

Definitions of the Two Drug (medication) Classes used for Anxiety Disorder

  • Drugs of selective serotonin reuptake inhibitors (SSRIs) help in anxiety treatment (Anxiety disorder).
  • SSRIs have a pathogenetic therapeutic focus.
  • Tranquilizers: maximum two weeks at the start of therapy.
  • Prescribing tranquilizers is warranted for a maximum of 2 weeks when initiating SSRI treatment to avoid increased anxiety during the first week of SSRIs (Anxiety disorder).
  • Medicines prescribed by a doctor.

Discussion of Medications

  • Examples of SSRIs: citalopram (Celexa), fluoxetine (Prozac).
  • Celexa stimulates synaptogenesis processes, restoring autophagy signals, and improving tissue immunoregulation with inhibition of immunogenic cytotoxicity of macrophages (Citalopram).
  • An analog is Prozac, the mechanism of action in the central nervous system, which block the reverse neuronal uptake of serotonin selectively (Fluoxetine).
  • Examples of tranquilizers: alprazolam (Xanax), clonazepam (Klonopin).
  • Xanax has a sedative, central muscle relaxant, anticonvulsant, hypnotic, anxiolytic, effect. It reduces the impact of motor, vegetative, emotive and helps the body in falling asleep (Alprazolam).
  • The anxiolytic effect of Klonopin is obtained as a result of the impact on the amygdala complex of the limbic system (Clonazepam). It is manifested in decreased fear, emotional stress, weakening and general anxiety.

Pharmacokinetics, Pharmacodynamics & Pregnancy/Lactation of Celexa

  • Celexa dissolves in the liver.
  • The action of the drug occurs because of central inhibition of serotonin reuptake.
  • Celexa has a strong effect on the heart and gastrointestinal tract, thus requires for ECG and/or monitoring of electrolytes.
  • Approved for use during pregnancy and lactation.
  • It has side effects include poor feeding, colic, and unusual drowsiness, irritability, or restlessness in a minimal number of children.

Pharmacokinetics, Pharmacodynamics, & Pregnancy/Lactation of Prozac

  • Absorbed from the gastrointestinal tract.
  • Delays the reverse capture of serotonin.
  • Monitoring is required.
  • Approved for use during pregnancy and lactation.
  • It increases the risk of genetic heart defects in the fetus, premature birth, and weight loss in a baby (Fluoxetine).

Pregnancy/Lactation during treatment for SSRIs

  • Approved for use during pregnancy and lactation.
  • It increases the risk of genetic heart defects in the fetus.
  • Medicines may cause premature birth.
  • In addition, weight loss in a baby is often.
  • Passes into milk, so may affect the baby.

Pregnancy/Lactation during treatment for Tranquilizers

  • Pregnancy and lactation are contraindicated.
  • Easily crosses the placenta.
  • Exceeds the concentration of diazepam in maternal blood.
  • Increases the incidence of birth defects in children.
  • Passes into milk, so may affect the baby.

Safety/Monitoring of Medications

  • Monitoring is required at any stage of the disease.
  • The medicine is prescribed by a doctor.
  • Additional medications are carried out if necessary.
  • Stop taking medications only on doctor’s orders.
  • Completely individual dosage.

Pharmacokinetics, Pharmacodynamics of Xanax

  • Absorbed from the gastrointestinal tract.
  • Binds γ-aminobutyric acid (GABA) type A receptors (GABA AR).
  • Completely individual dosage, therefore, requires monitoring and consultation with a doctor.
  • Alprazolam has a harmful effect on the fetus and raises the possibility of congenital malformations when used in the first three months of pregnancy, thus, prohibited during pregnancy (Alprazolam).
  • May cause drowsiness in newborns.
  • Makes breastfeeding difficult.

Pharmacokinetics, Pharmacodynamic of Klonopin

  • Plasma protein binding.
  • The activity of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in the central nervous system.
  • Completely individual dosage, therefore, requires monitoring and consultation with a doctor.
  • Pregnancy and lactation are contraindicated.

Contraindications of the 4 Medications Discussed Earlier

  • Each drug has its characteristics and contraindications, so one needs to consult a doctor.
  • General contraindications include allergy, heart problems, problems with the gastrointestinal tract.
  • Tranquilizers are prohibited if a person has glaucoma and diseases of the respiratory system.
  • Long-term use is not justified because of the possibility of drug dependence.
  • In addition, after the abolition of drugs in this group, the return of painful symptoms occurs since the main pathophysiological mechanisms associated with impaired serotonin mediation are not resolved.

Conclusions

  • Anxiety disorder has different treatments.
  • It requires individual treatment.
  • Any drug must be prescribed by a doctor.
  • The drugs are taken only under the supervision of the attending physician.
  • One should always be aware of side effects and contraindications.

References

. WebMD. (n.d.).

WebMD. (n.d.).

NHS. (n.d.).

NHS. (n.d.).

NHS. (n.d.).

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