Learning Concept Discussion:
Wanted to take a moment to share with you all the idea of applied physiology. It relates in a very broad and general sense to the way your mind approaches, learns, and applies information.
Some of this I learned from Dr Francis in pass program many years ago the other is from experience and teaching.
Students, residents, and many learners often feel bogged down with information. Because the desire to learn is earnest, and physicians tend to be a pre selected group of very detailed oriented individuals, there is often a desire to try to “know it all”. This is, regrettably, a fools errand unless you happened to be blessed with superior IQ and eidetic memory.
Let’s take three of my favorite concepts.
Epilepsy:
A seizure is an uncontrolled depolarization that is localized, localized then spreads, or generalized. For the purposes of this discussion we will agree to simplify a bit to get certain points across.
There are many AED’s (anti epileptic drugs) and it is very difficult to remember them all.
So when you are asked: What is the mechanism of action of gabapentin/valproic/carbamezapine/clobazam etc etc it is unlikely you can memorize all those things.
But go back and ask yourself - well what is a seizure? An uncontrolled depolarization. Is there any way to block that process or inhibit the brains response to cortical irritability or seizure foci?
So I will propose a conceptual approach:
I suggest you ask yourself a couple of things:
1: What is the electrolyte responsible for the action potential and depolarization in the brain?
2: What is the dominant inhibitory neurotransmitter in the brain?
3: What is one of the main excitatory neurotransmitters in the brain?
Take a moment to answer the above three questions.
Now I would ask you to look up how all the AED drugs work. Surprise surprise it’s a 50/50 split between items 1 and 2 above.
The take home message: never forget the physiology. The basis of pharmacological therapeutics is receptor based. Receptors work on a few primary pathways in the body. Understanding physiology is understanding medicine.