Systematic review

Published: 2019-08-16 08:00:00
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A systematic type of review is a type of literature review that helps in the collection and the analysis of multiple research papers or studies and helps in the evaluation of the effects that the research studies have on the development of the knowledge in the modern society. The type of review is much cheaper and easier as compared to the other methods of review as it deals with the analysis of existing literature other than embarking on a new study (Bachelerie et al., 2013, p62). It is advisable for the researchers to engage in the review of the existing methods carrying out the research processes before the formulation of the research questions. This would help in ensuring that the questions that are developed conform to the goals and obligations of the research. In this manner, there would be the ease of ensuring that the research processes are carried out and quickly and that it serves to meet the designed goals.

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The systematic reviews are randomized controlled trials that are key in the practice of the evidence-based medicine. The understanding and the use of the systematic reviews greatly help the medical professionals in the delivery of proper healthcare. In addition to the use of the systematic reviews of the health interventions, the process finds great use in the examination of clinical tests, social interventions, public interventions, economic evaluations and the adverse effects in the modern society (Tripathi, 2013, p76). In this manner, systematic reviews are not confined to the field of medicine as they find great use in all another field of common sciences where there is a collection of data, publishing of data and the analysis of the methodological quality that find great help in the society. This type of review is exhaustive in nature, and it leads to the holistic analysis and exhaustive summary of the current literature that is relevant to a research question.

Meta-analysis

Meta-analysis, on the other hand, is a statistical technique that combines findings from different independent studies in the society and helps in the assessment of the effectiveness of the healthcare interventions. The analysis does this by combining the data from two or more randomized control trials. The importance of meta-analysis in the field of medicine is that it helps in the provision of a precise estimate of the effect of treatment which helps to give due weight to the size of the different studies that are included in the study (Bachelerie et al., 2014, p69). Moreover, the other advantage of the meta-analysis is that it helps in the provision of the required quality during the process of taking part in the systematic review on which it is based. The major goal of a meta-analysis is that it helps in the complete coverage of all the relevant studies involves the analysis (Harvey et al., 2012, p543). Additionally, this type of analysis helps in the proving the presence of heterogeneity and helps in exploring the robustness of the aims and the goals of the main findings with the use of sensitivity analysis.

The main benefit of meta-analysis is that it leads to the segregation of information, and this leads to a higher statistical power that results in a more robust point estimate which is not possible from the measure derived from any measure from an individual study. Before the performance of a meta-analysis, the investigator needs to make a choice that affects the choices made in the analysis of the data (Alexander et al., 2013, p1463). The choices that the investigator makes, therefore, affects the results of the study because it helps in deciding how to search for the studies, selecting studies basing on a set of criteria objection and the process of dealing with data which is incomplete. Some of the choices that affect the process of carrying out meta-analysis are such as the analysis of data, accounting for and choosing not be accountable for publication bias. Meta-analyses are, in most cases, components of systematic review procedure, and this makes the two to be closely related leading to the effects of credibility of the investigations carried out.

Use of tricyclic antidepressant

The tricyclic antidepressants (TCAs) are the types of antidepressant drugs that have similar chemical structure and biological effects on the human body. They fine great use in the patients that suffer from depression and that might have an imbalance in neurotransmitters and the chemicals that nerves use to communicate with other nerves in the human body. The work by increasing the level of norepinephrine and serotonin, two neurotransmitters and block the action of acetylcholine that is another transmitter in the human body (Hilal-Dandan and Brunton, 2013, p204). By helping in the restoration of imbalance in the neurotransmitters in the brain of an individual, TCAs helps in the alleviating depression, and they have additional functions by causing sedation and blocking the action of enzyme histamine. The use of TCAs in the human body is approved for some use in the human body and core of it is the treatment of the several types of depression, obsessive compulsive disorder and bedwetting (Stoelting and Hillier, 2012, p74). Additional uses of the drug in the society are such in the treatment of conditions such as panic disorder, bulimia, chronic pain, chronic itching, phantom limb pain, and neuropathy.

The TCAs prove to be effective in the human body because they affect the naturally occurring chemical messengers, otherwise called neurotransmitters, that help in the communication of the brain cells in the human body (Shamma, 2012, p355). The action of the cyclic antidepressants to block the absorption or the reuptake of the neurotransmitters serotonin and the norepinephrine helps in making the cells more available in the brain cells that that increases the efficiency of sending and receiving messages thereby boosting the moods of a person (Turner, 2013, p61). Moreover, more antidepressants work by changing the levels of one or more neurotransmitters thereby relieving depression in the human body. However, the action of the cyclic antidepressants affects other chemical messengers that then lead to some side effects in a person. Some of the side effects of TCAs are such as blurred vision, dry mouth, constipation, urinary tension, drowsiness, increase appetite that leads to weight gain and drop in the blood pressure.

Use of SSRIs

The selective serotonin reuptake inhibitors (SSRIs) are antidepressants that work by altering the level of a mood-enhancing chemical serotonin. However, when the pregnant women take them, they increase the risk of autism spectrum disorder (ASD) and various birth defects in the unborn babies. The SSRIs find much use in the pregnant women in the society band they are mostly prescribed for the conditions of depression and anxiety among the pregnant mothers (Pawson et al., 2014, p1103). This prevents the pregnant mothers from hurting themselves and putting the unborn babies at risk. The fact that SSRIs are considered to be third-generation antidepressants, they have limited side effects on the human body than the old antidepressants.

The SSRIs prove to be more effective in the treatment of the severe case of depression, and this leads to the widespread use of the drug in the modern society. However, there are not very effective in the mild cases of depression in the society. They work by increasing the level of the brain chemical, serotonin, which greatly affects the mood of a person (Rang et al., 2014, p486). Under normal conditions, the body works by producing serotonin and keeps the level of the chemical at certain levels, however, SSRI work by increasing the levels of serotonin by inhibiting the reuptake of the chemical in the body. The benefit of the SSRIs over TCAs is that they are more effective in the treatment of severe depression, and this helps in saving human lives when there are acute attacks on the human body.

The NICE guidance

The NICE guidance has various advice that the society needs to take of keen importance and this advice the patients on the various ways that dictate the use of the drugs in the society. One of the guidance is that there is a very high likelihood of a patient leaving the medication because of the various side effects. In this manner, there is a need for the society to be prepared for the side effects and use the drugs for the whole prescription (Riviere et al., 2013, p150). Additionally, the NICE guidance proves that there is a need for the society to help in guiding the patients of the various contraindications and the monitoring requirements for some drugs. Finally, the NICE guidance submits that the non-reversible MAOIs should only be used when prescribed by a qualified and a specialist medical health professionals.

Bibliography

Alexander, S.P., Benson, H.E., Faccenda, E., Pawson, A.J., Sharman, J.L., Spedding, M., Peters, J.A. and Harmar, A.J., 2013. The Concise Guide to PHARMACOLOGY 2013/14: G ProteinCoupled Receptors. British journal of pharmacology, 170(8), pp.1459-1581.

Bachelerie, F., Ben-Baruch, A., Burkhardt, A.M., Combadiere, C., Farber, J.M., Graham, G.J., Horuk, R., Sparre-Ulrich, A.H., Locati, M., Luster, A.D. and Mantovani, A., 2013. International Union of Basic and Clinical Pharmacology.[corrected]. LXXXIX. Update on the extended family of chemokine receptors and introducing a new nomenclature for atypical chemokine receptors. Pharmacological reviews, 66(1), pp.1-79.

Bachelerie, F., Ben-Baruch, A., Burkhardt, A.M., Combadiere, C., Farber, J.M., Graham, G.J., Horuk, R., Sparre-Ulrich, A.H., Locati, M., Luster, A.D. and Mantovani, A., 2014. International Union of Basic and Clinical Pharmacology. LXXXIX. Update on the extended family of chemokine receptors and introducing a new nomenclature for atypical chemokine receptors. Pharmacological Reviews, 66(1), pp.1-79.

Harvey, R.A., Clark, M.A., Finkel, R., Rey, J.A. and Whalen, K., 2012. Lippincotts illustrated reviews: Pharmacology. Philadelphia: Wolters Kluwer.

Hilal-Dandan, R. and Brunton, L., 2013. Goodman and Gilman manual of pharmacology and therapeutics. McGraw Hill Professional.

Pawson, A.J., Sharman, J.L., Benson, H.E., Faccenda, E., Alexander, S.P., Buneman, O.P., Davenport, A.P., McGrath, J.C., Peters, J.A., Southan, C. and Spedding, M., 2014. The IUPHAR/BPS Guide to PHARMACOLOGY: an expert-driven knowledgebase of drug targets and their ligands. Nucleic Acids Research, 42(D1), pp.D1098-D1106.

Rang, Humphrey P., James M. Ritter, Rod J. Flower, and Graeme Henderson. Rang & Dale's Pharmacology: with STUDENT CONSULT Online Access. Elsevier Health Sciences, 2014.

Riviere, J.E. and Papich, M.G. eds., 2013. Veterinary pharmacology and therapeutics. John Wiley & Sons.

Shamma, M., 2012. The Isoquinoline Alkaloids Chemistry and Pharmacology (Vol. 25). Elsevier.

Stoelting, R.K. and Hillier, S.C., 2012. Pharmacology and physiology in anesthetic practice. Lippincott Williams & Wilkins.

Tripathi, K.D., 2013. Essentials of medical pharmacology. JP Medical Ltd.

Turner, R.A., 2013. Screening methods in pharmacology. Elsevier.

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