Nurs 6630 Week 2 Discussion
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.
References
Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th Ed.) Cambridge University Press.
Chapter 2, “Transporters, Receptors, and Enzymes as Targets of Psychopharmacological Drug Action” (pp. 29-50)
Chapter 3, “Ion Channels as Targets of Psychopharmacological Drug Action) (pp. 51-76)
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Week 2 Discussion 6630
The neuroscience foundation discussion will evaluate the following areas: psychopharmacologic agents’ spectrum of action through agonist-to-antagonist, ion-gated channels, and g-protein-coupled receptors contrast and comparison, epigenetics in pharmacological action, and ways this information impacts medication prescription.
Psychopharmacologic Agents’ Spectrum of Action Through Agonist-to-Antagonist
For most medications to be effective, they have to reach and bind with a receptor in the target cell. In that case, agonist drugs mimic the signal ligand action by binding and activating a receptor like Heroin (Jacobson et al., 2023). However, antagonists are medications that bind to receptors but do not activate them since they minimize other agonists’ ability to activate the receptors, for example, Naloxone. Consequently, partial agonists refer to medications that help receptors to bind partially, like Buprenorphine, while inverse agonists are those medications that bind actively with receptors and stabilize them, thus minimizing negative intrinsic activity. Hence, if a patient has an issue with Heroin addiction, the healthcare provider can use Naloxone to reverse the Heroin binding (Jacobson et al., 2023). However, the addiction treatment may involve a partial agonist like Buprenorphine to reduce the withdrawal symptoms and drug cravings since it allows partial binding of opioid receptors.
Ion-Gated Channels And G-Protein-Coupled Receptors Contrast And Comparison
Postsynaptic receptors are made up of two classes, which are ion-gated channels and G-protein-coupled receptors. The ion-gated channels (IGCs), also known as ligand-gated ion channels, exist in two domains where one makes the ion channel while the other exists as an extracellular that binds neurotransmitters (Stahl, 2021). The IGCs are crucial within the nervous system since they increase signaling that enables the conversion of chemical neurotransmitters rapidly and directly into electrical currents.
On the other hand, g-protein-coupled receptors (GPCRs) exist as the most diverse and largest membrane group within eukaryotes. The cell surface of GPCRs resembles a message inbox in the form of proteins, sugars, lipids, peptides, and light energy (Stahl, 2021). In such a case, the GPCR’s action mechanism is through signal transduction, where it first becomes activated by changing its conformation that occurs after ligands or agonists bind to the GPCR extracellular region. Once the GPCR becomes activated, it further activates the inactive G protein by dissociating Gα and Gβγ (Stahl, 2021).
Epigenetics in Pharmacological Action
The simplest way to define epigenetics is that it is the study of genes’ transcriptional potential regulation. According to Chmielewska et al. (2019), epigenetics is crucial in pharmacology since it provides more insight into drug effects on individuals regarding abuse potential and clinical utility. That means healthcare providers can easily determine ways medicines work for different individuals and the possible illnesses that they may develop, thus enhancing personalized medication. Hence, the effectiveness of any medication may be determined through epigenetics since it provides insight on why some medications may be effective to some genes but reduce their effectiveness once there is an altered function in such genes (Chmielewska et al., 2019). That explains why some medications may be effective for some and not for other patients.
Ways This Information Impacts Medication Prescription
Psychiatric and mental health nurses need to consider various aspects when prescribing medication to their patients. Some of these aspects include the patient’s family history and genetic implications on the diagnosed disease and its subsequent treatments. For instance, family history may reveal the reoccurrence of the disease and other factors like the age risk factors in their family tree (Chmielewska et al., 2019). For example, a mental issue like dementia is mainly determined by the patient’s age. Hence, nurses need to prescribe antipsychotics sparingly, considering that in old age, patients’ pharmacodynamics and pharmacokinetic aspects of medication change due to age-induced epigenetic alterations. Generally, drug prescription for the older population has different side effects and may become ineffective since most older patients have drug metabolism and clearance issues (Chmielewska et al., 2019). Hence, such consideration, particularly for dementia patients, will help enhance their overall psychological, behavioral, and psychosis symptoms by increasing the medication’s efficacy and reducing side effects.
Conclusion
The neuroscience foundation discussion has evaluated the following areas: psychopharmacologic agents’ spectrum of action through agonist-to-antagonist, ion-gated channels, and g-protein-coupled receptors contrast and comparison, epigenetics in pharmacological action, and ways this information impacts medication prescription.
References
Chmielewska, N., Szyndler, J., Maciejak, P., & Płaźnik, A. (2019). Epigenetic mechanisms of stress and depression. Psychiatria Polska, 53(6), 1413–1428. https://doi.org/10.12740/PP/94375
Jacobson, K. A., R. Rama Suresh, & Oliva, P. (2023). A2A adenosine receptor agonists, antagonists, inverse agonists and partial agonists. International Review of Neurobiology. https://doi.org/10.1016/bs.irn.2023.08.001
Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th Ed.) Cambridge University Press.