FOUNDATIONAL NEUROSCIENCE
As a psychiatric and mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat patients, you must not only understand the pathophysiology of psychiatric disorders but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues.
For this Discussion, review the Learning Resources and reflect on the concepts of foundational neuroscience as they might apply to your role as the psychiatric mental health nurse practitioner in prescribing medications for patients.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 3 OF WEEK 2
Post a response to each of the following:
Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including how partial and inverse agonist functionality may impact the efficacy of psychopharmacologic treatments.
Compare and contrast the actions of g couple proteins and ion gated channels.
Explain how the role of epigenetics may contribute to pharmacologic action.
Explain how this information may impact the way you prescribe medications to patients. Include a specific example of a situation or case with a patient in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.
Read a selection of your colleagues’ responses.
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Foundational Neuroscience
The discussion on the neuroscience foundation aspect will focus on the psychopharmacologic agents’ agonist-to-antagonist spectrum of action, Ion-Gated Channels, and G-Couple Proteins comparison and contrast, epigenetics role in pharmacologic action, and the information impact on medication prescription.
The Psychopharmacologic Agents Agonist-to-Antagonist Spectrum of Action
Agonists refer to the substance that mimics the neurotransmitter’s actions to create a particular response once it binds with a particular brain receptor. Opioid drugs such as methadone and Heroin are agonist examples since they produce responses like respiratory depression and analgesia(Shiriaeva et al., 2022). An antagonist is a chemical substance that binds and prevents certain receptor activation on cells, thus inhibiting biological response. In opioid, one of the receptor antagonists is the Naloxone. Consequently, partial antagonists bind to receptors without activating them, thus having lower efficacy than the full agonist, an example being Buprenorphine. An inverse agonist tends to bind to an agonist binding site but triggers the opposite pharmacological effect (Shiriaeva et al., 2022). Hence, when dealing with a patient addicted to Heroin, mental health, and psychiatric nurses can use Naloxone to block receptors against its binding activity with the free-floating Heroin and reverse the binding. Also, when treating Heroin addiction, these healthcare providers can provide partial agonists such as Buprenorphine to reduce withdrawal symptoms.
Ion-Gated Channels And G-Couple Proteins Comparison And Contrast
G-protein coupled receptors (GPCRs) fundamentally are part of cellular plasma membranes that use G protein to transmit signals to the cell. Hence, the GPCRs may lead to diseases since they have multiple functions. Such different responses provided by the GPCRs are initiated due to G-protein subunits’ interactions with other proteins that the cells hold (Bertrand & Wallace, 2020). These subunits are α β and γ subunits once guanosine triphosphate binding occurs. Hence, these subunits’ interaction with other proteins leads to different signaling pathways in a cell.
For ion-gated channels, they are proteins that allow specific ions to flow within and outside a cell. According to Bertrand and Wallace (2020), ion-gated channels exist in three types: voltage-gated, mechanically-gated, and ligand-gated ion channels. The ligand-gated ions are perceived as ionotropic receptors associated with opening and closing as a binding response. Consequently, voltage-gated ion channels close and open depending on their response to membrane potential changes (Bertrand & Wallace, 2020). Hence, once membrane proteins are activated by the GPCR, ligand-gated ion channels can easily interact, thus prompting their closing and opening.
Epigenetics Role In Pharmacologic Action
Epigenetics studies how environment and behaviors can lead to changes that influence how genes work. Unlike genetic changes, epigenetic changes can be reversed and, at the same time, do not change an individual’s DNA sequence (Wang et al., 2022). However, through epigenetic changes, an individual body can change how it reads the DNA sequence. That is why epigenetic changes result in different disorders like neurodegenerative diseases and cancer, including treatment outcomes. Hence, it is necessary when dealing with patients to consider epigenetics to increase the efficacy of personalized care. In that case, favorable epigenetics influence therapeutic effects on the medications and trigger learning with inimical epigenetic mechanisms triggering behaviors and disorders like addiction, drug abuse, and chronic pain.
The Information Impact on Medication Prescription
When mental health and psychiatric nurses prescribe medications, it is necessary to consider various patient characteristics, more so on the patient’s genetic implications on disease diagnosis, treatment, and family history. As Wang et al. (2022) posits, for dementia patients, age is a great consideration when prescribing antipsychotics to improve the patient’s psychosis symptoms and behavioral and psychological well-being. That is because different treatments have different side effects and may be ineffective due to various aging effects, particularly on drug clearance and metabolism. Hence, for geriatric patients receiving dementia treatment, it is essential to consider the psychotic medication pharmacokinetic and pharmacodynamic changes since they are associated with age-induced epigenetic alterations (Wang et al., 2022). Such consideration, therefore, ensures that the prescription of the antipsychotic leads to increased efficacy of the prescribed medications and minimizes the probable side effects.
Conclusion
The discussion has evaluated the neuroscience foundation aspect, including the psychopharmacologic agents’ agonist-to-antagonist spectrum of action, Ion-Gated Channels, and G-Couple Proteins comparison and contrast, epigenetics role in pharmacologic action, and the information impact on medication prescription.
References
Bertrand, D., & Wallace, T. L. (2020). A Review of the Cholinergic System and Therapeutic Approaches to Treat Brain Disorders. Behavioral Pharmacology of the Cholinergic System, 1–28. https://doi.org/10.1007/7854_2020_141
Shiriaeva, A., Park, D., Kim, G., Lee, Y., Hou, X., Jarhad, D. B., Kim, G., Yu, J., Hyun, Y. E., Kim, W., Gao, Z.-G., Jacobson, K. A., Han, G. W., Stevens, R. C., Jeong, L. S., Choi, S., & Cherezov, V. (2022). GPCR Agonist-to-Antagonist Conversion: Enabling the Design of Nucleoside Functional Switches for the A2A Adenosine Receptor. Journal of Medicinal Chemistry, 65(17), 11648–11657. https://doi.org/10.1021/acs.jmedchem.2c00462
Wang, K., Liu, H., Hu, Q., Wang, L., Liu, J., Zheng, Z., Zhang, W., Ren, J., Zhu, F., & Liu, G.-H. (2022). Epigenetic regulation of aging: implications for interventions of aging and diseases. Signal Transduction and Targeted Therapy, 7(1), 1–22. https://doi.org/10.1038/s41392-022-01211-8