NSC2500 Pathophysiology On Migraine And Use Of Triptans Assessment 1 Answer

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Question :

NSC2500: Assignment 1

Topic: Lay Article & Abstract

Total weighting: 20% of the final mark

Purpose of assignment:

  • Contextualise and improve knowledge of homeostasis and how disruption may lead to a specific disease/disorder
  • Understand and articulate how drug therapies address a particular pathophysiology
  • Identify drug mode of action, indications, contraindications, potential interactions, adverse effects and therapeutic outcomes
  • Learn how to integrate knowledge and present ideas logically and concisely
  • Develop written communication skills, particularly for a lay audience
  • Develop and improve critical thinking skills
  • Specifically address Course objectives 1 - 4

Task overview and topic selection:

For this assessment, you will produce an informative article that describes the pathophysiology of a specific disease or condition, as well as present the pharmacology used to address this. The target lay audience will be chosen by you, and you will specify this within your abstract.

Please note that each topic is also capped, with only 100 students able to select each topic on a first-come first-served basis. So, if there is one particular topic that you are interested in, please ensure that you enter your selection as early as possible so that you don’t miss out!

You will then research your specific disease/disorder and the indicated pharmacology for your chosen audience. From this you will produce an informative article that describes the affected system (the normal physiology), what has gone wrong to cause the disease (the pathophysiology), and then how the related pharmacology is used to address it. Ensure that you use the marking criteria (included below) to ensure that you are addressing all of the required details.

You must also complete and submit a short (250 word) abstract. This abstract will be presented to an educated audience (for example, your peers), and must provide a succinct summary of the article, as well as include a statement about your chosen target audience.

Structure and components of the assignment:

Students will work individually to prepare an original article on their chosen topic, targeted towards a specific lay audience (as identified with the abstract). It must be no longer that 1500 words. The presentation of your article can be as simple, or as advanced and creative as you would like; it may be presented in any number of different ways and may be in any WRITTEN format that you choose, provided that you are addressing all of the assessment criteria.

Some example formats you might consider are:

  • A patient information ‘fact-sheet’
  • A brochure or educational booklet
  • An educational poster
  • … and more…

In short, you have creative freedom in how you present your article so long as all of the assessment criteria and required information are addressed.

Figures and illustrations can be a very important part of conveying complex information to a lay audience. You are welcome – and are encouraged – to utilise these in your article. Just remember that your text must refer to your figures/illustrations, and any figures or illustrations must also be appropriately referenced.

What to include in your article:

Your article should aim to include (but is not limited to):

  • Brief overview of the normal physiology and homeostasis of the system relevant to the topic
  • The pathophysiology and the mechanisms leading to the disease/disorder
  • The pharmacology related to the treatment of the disease/disorder for your specific audience
    • This must also include at least one specific drug example that also addresses:
      • Drug naming (chemical, generic, and proprietary)
      • Mechanism of action (pharmacodynamics)
      • Pharmacokinetics
      • Route of administration
      • Indications, contraindications, precautions and side effects
  • Are there any important drug interactions (other medications, natural products, etc) that patients should be aware of?
  • Are there any lifestyle, exercise, therapy, or physical considerations patients should be aware of?
  • Relevance to clinical practice and the target audience must also be clear
    • This may be in any relevant context, eg. nursing, sports exercise, etc
  • Conclusions and other considerations

Note: A key element of this assessment is the pharmacology. Alternate therapies, or different types of pharmacology, may be relevant for the disease/disorder that you are presenting, but if you do not present the pharmacology that is part of your specific topic you will not be addressing this part of the criteria and will lose marks.

Writing the abstract:

You will also need to write and submit a short (250 word) abstract alongside your article. Your abstract should succinctly summarise the article’s content and is to be targeted to an educated audience (for example, your peers). It should follow the format of: introduction, summary of the main points/discussion, statement of your chosen target audience, and finish with a short conclusion.

You abstract must also include a statement to identify your target audience. In particular, you should consider what patients might use and read your article. (ie, who are you writing it for?) For example, are you targeting older oncology patients in a cancer ward? (60+ years old?), or perhaps younger patients requiring exercise as part of their ongoing treatment? (15-25 years old), or a completely different group?

References must also be included in your assignment, but these will be included and listed with your lay article, not the abstract (references and in-text citations are generally not used in an abstract).

Finding information

You may draw your information from a variety of resources, but you should focus on current, up-to-date, research and the current state-of-knowledge. A good guide is to select a minimum of five recent and relevant publications on your topic and cover these in your article (primary research articles published in the past 5 years are what we are looking for).

All of your information sources should be referenced appropriately, and you should aim to avoid resources that may be unreliable or out-of-date (websites, news outlets, and similar, should be strictly avoided).

Your references and in-text citations should be included within your lay article, these do not need to be included with the abstract. All references and in-text citations should be in the required reference format (Harvard AGPS or APA). References and in-text citations do NOT contribute to your word limit.

Textbooks can be a good resource for some established information and concepts, and these can be very useful during your initial investigations. However, you should then source the key information for your article from evidence-based and peer-reviewed sources. Textbooks may be referenced in addition to these, but you should ensure that you are using journal publications as much as possible.

  • You should aim for a minimum of 5 primary journal articles for your article
  • These are the type of publications that are required to address the references criteria (ie, not textbooks!)

Formatting Guidelines:

  • You MUST submit two files to complete your assessment: the lay article AND the abstract
    • Your submission IS NOT COMPLETE if both files are not submitted

Important format details to double-check and remember!

  • The lay article MUST be written for your target lay audience
  • The final article file MUST be in PDF format ONLY
  • The article MUST be no longer than 1500 words in length (+10% leeway)
  • In text-citations and references MUST be in Harvard AGPS or APA format ONLY
  • The lay article MUST include a full reference list
  • The abstract MUST be written for an educated audience (eg. your peers)
  • The abstract file submitted MUST be in PDF format ONLY
  • The abstract MUST be no longer that 250 words in length (+10% leeway)
  • The abstract does NOT need to include in-text citations or references

Selection of topics:

You must have selected your topic before the activity closes. Any student who has not chosen a topic once the activity closes will be randomly assigned to one (students will be notified of their designated topic via an email to their USQ student email address).

Please note that each topic is also capped and only 100 students will be able to select each topic on a first- come first-served basis. So, if there is one particular topic that you are interested in, please ensure that you enter your selection as early as possible so that you don’t miss out!

When you are selecting your topic, make sure that you note the specific details. For example, if you choose “Diabetes mellitus (type 2) and sulfonylureas”, but you then prepare your article and abstract on type 1 diabetes, or base it on insulin therapy, you will lose marks or receive a zero mark for the related criteria!

IMPORTANT: You must complete your assignment on the topic you have chosen, or the one that was assigned to you. If you complete your assignment on a different topic you will receive a zero mark.

Topics (100 students MAX for each):

  1. Gout and corticosteroids
  2. Migraine and triptans
  3. Hashimoto's disease and hormone replacement
  4. Diabetes mellitus (type 2) and sulfonylureas
  5. Cystic fibrosis and bronchodilators
  6. Croup and corticosteroids
  7. Heart failure and ACE inhibitors
  8. Hypercholesterolaemia and statins
  9. Parkinson's disease and dopamine agonists
  10. Schizophrenia and atypical antipsychotics
  11. Hodgkin's lymphoma and chemotherapy
  12. Melanoma and immunotherapy
Show More

Answer :

Migraine and Triptans

Abstract

Migraine is observed as the multifaceted brain disorder. Migraine has been identified in the four phases and it has been described as the premonitory, aura, headache, and postdrome phases. As identified in the linear sequential order it's more like a migraine phase that has shown a significant overlap, and it depicts a linear ordering that can create an attractive and deceptive way to make it a simplicity. To understand the pathophysiology there is a sign of symptomatology that can occur at various stages and can identify it as the symptoms showing the sign of the tiredness and even showing the concentration impairment. The use of Triptan drugs is identified in the brain chemical that can control the serotonin. The use of the drugs helps to control the overactive pain nerves. To control the migraine, the use of the triptan medicines along with the combination drug, for example, the triptan and naproxen which is the non-steroidal anti-inflammatory drug (NSAID) used to prevent it.

The target age group is 30-40 years and as observed the prevalence rate of occurrence is at 15-18% worldwide. Due to the wide phenomenal occurrence, it has caused an episodic and chronic migraine observed in the age group of 30-40 years old. Within the United States, it has cost approximately $19.6 along with the European Union costing the €27 billion annually. To conclude, the growing problem of the migraine and the use of triptan drugs can help to treat the age group of 30-40 years and how to overcome the growing hazard of the problem.

Normal physiology and homeostasis

Migraine physiology shows a sign that begins with the headache to develop leading to the throbs and gradually progress into the intracranial pressure that can cause nausea, vomiting. Gradually the condition worsens to experience the abnormal sensitivity to any ex light, noise, along with the smell. It would show abnormal skin sensitivity (allodynia) along with the muscle tenderness (Haanes, 2019). There can also be other symptoms that can be seen as the migraine during the prodromal stage and it would gradually progress into the headache phase that can show the sign of multiple neuronal systems that would start to act abnormally. Due to the advance stages of the genetic predisposition that can signify the migraine, often one can experience the multiple susceptible gene variants (it shows a sign of the encode proteins which would help to participate in the regulation that can be experienced in the glutamate neurotransmission and there can be a proper identification of the synaptic plasticity) which can show the hypothesis that can be generalized neuronal hyperexcitability and there can be anatomical alterations that can be seen in the migraine brain. It would show a sign of the headache pain and there would be a perpetual sign of the unique qualities that can show an activation of the trigeminovascular pathway that can explain the pain which is often seen only in the head and then it comes to the periorbital area along with the eyes and shows an increased sign of intracranial pressure increases. 

Perpetual sign of the trigeminovascular pathway would show the nociceptive information that would reach the meninges to the brain. Due to the pathway, trigeminal ganglion neurons there can be high peripheral axons that could intensify the pia, dura, along with showing the large cerebral arteries and causing the central axons that can affect the nociceptive dorsal horn laminae of the SpV (Rapoport, 2019).

There would be an increased sign of ascending axonal projections that can note the trigeminovascular SpV neurons which would be obligated to transmit monosynaptic nociceptive and there would be a missing signal that would affect the (1) brainstem nuclei, that can create the ventrolateral periaqueductal gray along with creating the form of the reticular formation that can form the superior salivatory that can result in the parabrachial, cuneiform, that can form the nucleus that can cause the solitary tract and it would help to overcome the hypothalamic nuclei, such as the anterior, lateral, perifornical dorsomedial and it would be observed in the suprachiasmatic along with the supraoptic (Gupta, 2019). It would also cause an impact such as nausea, vomiting, experiencing the yawning, lacrimation along with the high instances of the urination, impacting the loss of appetite and there would be a sign of experiencing fatigue along with the anxiety, irritability that can be observed in the headache itself.  This is observed in different phases. There are growing signs of head pain absence or presence which shows the sign. The use of the Triptans can be used to reverse any brain activity that has triggered the migraine (Goadsby, 2019).

Pathophysiology and the mechanisms

Due to the persistent headache, there is a high instance of the unilateral and there can be pulsating and it would show the more significant of the aggravation of the routine physical activity. It can last a few days to hours. Due to the attack of the migraine, it can cause to impact and trigger the headache progresses, that would experiencing the variety and there is also how there can be an autonomic symptom (causing nausea, experiencing on the vomiting and it would cause the nasal/sinus congestion) (Goadsby, 2019). There would show how there can be rhinorrhea along with the lacrimation along with the ptosis, yawning and can even lead to frequent urination along with diarrhea) and there can be effective symptoms (leading to the depression along with the irritability). It would be cognitive symptoms (it would lead to experience to the attention deficit and how there can be difficult finding words and it would lead to the transient amnesi. There can be a high instance and there would be a reduced ability which would lead to a familiar environment and experiencing sensory symptoms. It can also show the photophobia, phonophobia and there can be an osmophobia and how there would be an extreme the muscle tenderness along with the cutaneous allodynia (Anderson, 2019).

Due to the extreme cases of the symptoms of which can trigger the migraine and it would cause a serious headache. It would lead to a more sign of them showing a high instance of the complex neurological disorder which can cause the cortical, subcortical along with impacting the brainstem areas which would regulate the impact of the autonomic, affective and there would be a high impact over the cognitive along with impacting the sensory functions. Due to the high impact of the migraine the brain would also different the functioning of the nonmigraine brain. It would also cause an unravel impact over the pathophysiology of migraine and it must go beyond the simplistic view which can lead to a “migraine generator" area (Chan, 2019). There is also a high sign of the migraine pathophysiology, which can be caused due to the neural networks showing interaction with the migraine which can cause stressors, for example, having insufficient sleep, skipping meals and it can also be due to the stressful or post stressful periods and it would also cause hormonal fluctuations along with expiring alcohol, trigger due to some foods along with experiencing a flickering light. It can even be caused due to the noise, or certain scents, and it can lead to the triggers.

Pharmacology related to the treatment 

In the target age group of 30-40 years, the use of the Aspirin and Naproxen which are used in the oral form as a tablet can lead to serotonin (5-HT) observed as the seminal observations of increased 5-hydroxyindoleacetic acid. in migraine pharmacology related to the treatment can be a result of the Triptans who can control the TCC to modulate and also have control due to the trigeminovascular nociceptive neurons that have the express 5-HT1D and 5-HT1F receptors and it can even cause the TCC neuronal activity and how there can be a centrally active Triptans (Dolati, 2019). Also how there would be CNS sites of action that can be due impact due to the  Triptans and it would further lead to the approaches and it would cause the areas that can cause the electrophysiological approaches. Due to the Microiontophoresis such as the 5-HT1B/1D agonists on trigeminovascular neurons which would cause the TCC results on account of the reversible inhibition and activating the trigeminal activity and there can be a major due to the action (Barra, 2019). There can also be a PAG, PVN, and thalamus impact and it would also be caused due to the diversity on the target sites that would create a modulation of 5-HT1B/1D receptors and it would also lead to the trigeminothalamic projections in creating modulatory structures.

Relevance to practice

The side effects of the Aspirin and the Naproxen overuse can cause fatigue, weakness, dizziness, confusion, difficulty concentrating and tingling of hands and feet, etc.

The medication is taken orally administered and in the certain prescribed doses depending on the levels, intensity, and the reoccurrence. 

Other drug interactions which can be used as the PACAP, sumatriptan (Imitrex, Alsuma along with showing the Imitrex STATdose System and even the Sumavel DosePro, Zecuity, Treximet), rizatriptan (Maxalt, Maxalt-MLT), eletriptan (Relpax), can showing the zolmitriptan (Zomig, Zomig-ZMT) and such as the naratriptan Amerge) (Anderson, 2019).

The patient should be aware of how to reduce stress and avoid any trigger points. The patient should maintain a healthy lifestyle and avoid any sign of the trigger points and even devise a consistent planned approach to overcome the issue (Chan, 2019).

 Conclusions 

To conclude, Migraine can trigger due to the stressor points during the age group of 30-40 and it can be controlled through the Triptans such as the Aspirin, Naproxen and various other drugs to control it.  Migraine can be due to the genetic underpinnings and due to the migraine; one can experience an altered structurally and functionally.  General anatomology is the occurrence of the molecular along with experiencing functional abnormalities that can cause a neuronal substrate leading to extreme sensitivity and experiencing fluctuations in homeostasis (Mullin, 2020). There can also be a sign of decreased resistance to adaptability and there is a growing sign of having the headache leading to the deteriorating condition.