Saturday, April 20, 2013

EB2013, ASPET Blogging: Pharmacology after Trauma

This week, wow. I think everyone would agree that the world was a scary and depressing place this week. Bombings, fertilizer plant explosions, ricin in the mail, earthquakes, and a manhunt. The attendees of Experimental Biology have been glued to social media and traditional media worrying about their friends in Boston and anxiously wondering if the conference would go on. If it didn’t, some of us were unsure of reimbursement protocols for plane tickets and hotels already charged to our credit cards for a conference we weren't able to attend. Thankfully, the show will go on. But all of the events happening this week had me reflecting on how the science at EB is related. And because I’m blogging for ASPET, I was especially thinking about the involvement of pharmacology and therapeutics.

After the bombing at the Boston marathon I was overwhelmed thinking of the pain, surgery, and long recovery for those who would have to have limbs amputated. I can't even imagine what it would be like to return to my home and not be able to climb the stairs to my bedroom. Pharmacology research has fueled the development of anesthetics and muscle relaxants which provide safety for surgeries. Anesthetics keep the patient unconscious while muscle relaxants keep the muscles from moving so the surgeons can perform their precise work. Imagine having a limb amputated while awake. Imagine waking up to excruciating pain without adequate relief via pain relievers.

Once the patient awakens, recovery begins and pharmacology is available for both the physical and psychological recovery. Depression is common after major surgery following trauma. Thanks to advances in psychiatric medications approximately 50% of patients find relief from antidepressants. Therapy is very important in recovery as well but for a subset of patients, therapy is not enough.

Many people who experience traumatic events like the ones that occurred this week develop post-traumatic stress disorder (PTSD). People with PTSD syndrome have three categories of symptoms: intrusion, hyperarousal, and avoidance. Intrusion is when patients have recurring thoughts of the trauma experience. Hyperarousal is an increased “jumpiness” or startling easily. Avoidance is when patients attempt to avoid situations or places that would cause intrusions to occur; in other words, avoiding things that would trigger anxiety of the event. Patients with PTSD also have difficulty sleeping and concentrating. Treatment includes cognitive behavioral therapy and antidepressant medications.

While this week has been frightening and, at times, horrifying I find hope in pharmacological research. I'm so thankful for biomedical scientists who are working every day to create new and improve existing treatments. I'm excited to learn about pharmacological research being performed all over the world. I’m looking forward to attending this year's Experimental Biology meeting in a city that responded to tragedy with strength and calm. Thank you for hosting us, Boston!