The two articles I have considered for summarization include ‘Pharmacology of Drugs Used as Stimulants’ by James R. Docherty and ‘Pharmacokinetics of drugs in pregnancy’ by Maisa Feghali MD. The first article demonstrates the pharmacology of different drugs used as stimulants. Stimulants, especially those intended for recreational use, work on the central and peripheral nerve systems, causing various psychostimulant effects such as enhanced alertness, hyperactivity, and altered mood and affecting the cardiovascular, ocular, and temperature control systems.
They can cause acute psychosis, especially in high doses and long-term use. Many stimulants cause their effects by activating mono-aminergic pathways involving the neurotransmitters norepinephrine, dopamine, and serotonin. This article examines amphetamine-like motivations that work through central mono-aminergic courses and frequently target the sympathetic nervous system, resulting in cardiovascular and temperature-related side effects. Because many stimulants have the potential for abuse, they are closely regulated in many jurisdictions. Different stimuli were tested for potency by examining the uptake of monoamine neurotransmitters by NET, DAT, and SERT (Docherty).
Stimulants act on adrenergic, dopaminergic, and serotonergic pathways to produce psychostimulant, cardiovascular, and temperature effects. Stimulants can impede neurotransmitter reuptake or cause reverse transport by working on neuronal membrane transporters. Stimulants may affect monoamine receptors at pre- and postsynaptic membrane levels. Agents with cocaine-like effects that act at the norepinephrine transporters are likely to produce cardiac side effects, while other factors may play a role. As a result, many stimulants function similarly to cocaine, causing potentially catastrophic thermoregulatory and cardiovascular, mainly cardiac, side effects. Furthermore, recreational stimulant users should be aware of the dangers of hyperthermia in a club/rave setting and the importance of controlling ambient temperature. Water intoxication has been related to mortality when treating heat by drinking vast amounts of water (Docherty).
The second article explores the alteration in the pharmacokinetics of several medications during pregnancy. Pregnancy is a complicated situation in which modifications in maternal physiology have evolved to help the placenta and fetus develop and grow. These changes may impact pre-existing diseases or result in pregnancy-related ailments. Physiological changes may also affect the pharmacokinetics and pharmacodynamics that dictate drug dose and effect. As a result, precise pharmacologic information is required to change treatment techniques throughout pregnancy (Feghali et al.). To obtain effective therapy and prevent maternal and fetal risk, it is vital to understand pregnancy physiology and the gestation-specific pharmacology of different medicines. Unfortunately, most medication studies have excluded pregnant women due to misunderstood fetal risk concerns.
Pregnancy causes physiological changes that influence medicine absorption, distribution, metabolism, and excretion. Lower psychotropic medication levels and, in certain situations, therapeutic efficacy may arise from these pharmacokinetic alterations. The pharmacokinetics of psychiatric drugs are affected by pregnancy, giving guidelines for therapeutic drug monitoring. Slower stomach emptying, as well as intestinal and colonic transit time, affect drug absorption. During pregnancy, increased plasma volume, changes in protein binding, and a reduced ratio of lean muscle to fat tissue may result in more drug distribution volume for lipophilic medicines.
The activity of several metabolic enzymes changes during pregnancy, which affects the hepatic metabolism of psychiatric drugs. During pregnancy, sex steroid levels rise, increasing the activity of cytochrome P450 (CYP) family enzymes and Phase 2 metabolic enzymes, including uridine diphosphate glucuronosyltransferase. This stimulation of action could result in clinically essential medication levels being reduced. Increased renal blood flow and the concomitant rise in glomerular filtration rate may improve drug clearance during pregnancy. Physiological changes significantly alter many drugs’ pharmacokinetic characteristics during pregnancy (Feghali et al.).
These changes affect drug distribution, absorption, metabolism, and excretion, which may impact their pharmacodynamic qualities during pregnancy. In many organ systems, pregnant women endure numerous modifications. Some modifications are triggered by hormonal changes during pregnancy, while others are necessary to assist the pregnant woman and her growing fetus. Increased maternal fat and total body water, decreased plasma protein concentrations, mainly albumin, increased maternal blood volume, cardiac output, and blood flow to the kidneys and uteroplacental unit, and decreased blood pressure are some changes in maternal physiology during pregnancy.
Both articles illustrated or demonstrated the pharmacological characteristics of several drugs. The first article explained the usage of certain drugs as stimulants, ranking their potency based on inhibition or elicitation of specific protein transport channels. It also demonstrated the impact of various stimulant-like drugs on human systems. The research in the first article was conducted by measuring the potency of stimulants and then ranking them from the most to the least, thereby aligning them with their effect on several systems. The second article demonstrated the physiological changes in body systems during pregnancy and the complete change in the pharmacokinetics of drugs in response to such physiological alteration.
Docherty, James R., and Hadeel A. Alsufyani. “Pharmacology of drugs used as stimulants.” The Journal of Clinical Pharmacology 61 (2021): S53-S69.
Feghali, Maisa, Raman Venkataramanan, and Steve Caritis. “Pharmacokinetics of drugs in pregnancy.” Seminars in perinatology. Vol. 39. No. 7. WB Saunders, 2015.