NURS-6630N-10-Approaches to Treatment
Week 1 Forum
Discussion: Foundational Neuroscience
As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, 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.
Post a response to each of the following:
1. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.
2. Compare and contrast the actions of g couple proteins and ion gated channels.
3. Explain the role of epigenetics in pharmacologic action.
4. Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix–x
Laureate Education (Producer). (2016i). Introduction to psychopharmacology [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2009). Path pharmacology: Disorders of the nervous system: Exploring the human brain [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2012). Introduction to advanced pharmacology [Video file]. Baltimore, MD: Author. Foundational Neuroscience Essay
Discussion: Foundational Neuroscience
Agonist-To-Antagonist Spectrum of Action of Psychopharmacologic Agents
An agonist is the transmitters that bind to a receptor and when the binding occurs, the receptor is then activated leading to the generation of biological response (Stahl, 2013). Antagonists on the other hand hinder the action of agonists and therefore obstructs the activation of the receptor. The agonist spectrum is classified as an antagonist, agonist, partial agonist, and an inverse agonist. The main role of the agonist is to open the ion channel and also to control the rate of binding at the binging location. The agonist is found in the middle of the spectrum and it also maintains the resting state by obstructing the regular opening of the ion channel. The role of the inverse agonist is to ensure that the ion channel is closed and thus inactive. Antagonists return the ions into their resting state and they can block everything occurring in the agonist spectrum.
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Similarly, some pharmacological agents stimulate receptors in the same way as neurotransmitters and thus such medications can be referred to as agonists. On the other hand, the drugs that block the neurotransmitter’s action at its receptor are antagonists while drugs acting contrary to the agonists are inverse agonists (Stahl, 2013). Different health problems require different therapeutic actions that depend on the balancing between the agonist’s action and the action of the antagonists (Zimmer, 2016).
Comparison of the Actions of G Couple Proteins and Ion Gated Channels
G Coupled Proteins are the neurotransmitters involved in the transmission of signals from various stimuli. Even though the G-protein-coupled receptors lack ion channels, their activation affects the channels. They contain an extracellular sphere where neurotransmitters are able to bind and an intracellular domain where the binding of the G-proteins occurs (Pirri et al., 2015). G-protein coupled receptors normally elicit the activation of the intracellular signaling cascade which produces numerous messengers.
Since the G couple proteins contain receptors with trans-membrane areas having binding sites for transmitters, it enables the exact targeting of the psychotropic medications. When drugs bind to these sites, the receptor actions are modified and this hinders the neurotransmitter function that occurs at the receptor. Actions of the drugs can elicit molecular events (Johnson & Lovinger, 2016). Moreover, such drugs can also change the expression of genes and thus the synthesis of proteins.
In contrast, the ion gated channels are connected to the ionotropic receptors which are the sites that neurotransmitters bind into. This thus indicates that the ion gated channels can be target sites for drugs (Stahl, 2013). Foundational Neuroscience Essay
The Role of Epigenetics in Pharmacologic Action
Epigenetics includes systems involved in the regulation of the expression and the suppression of genes. The body contains various genes that can be expressed or suppressed. Neurotransmission or pharmacological agents can impact the expression or suppression of certain genes. Foundational Neuroscience Essay
Epigenetic control can thus express or suppress genes by changing the chromatin structure by utilizing agents such as the drugs and through chemical processes such as phosphorylation or methylation. Drugs can be used to disrupt processes like phosphorylation or methylation and either causes the epigenetic suppression or expression of the genes (Stefanska & David, 2015). For example, pharmacological agents that alter chromatin have been shown to cause antidepressant responses which trigger genetic changes.
The Impact of the Information on Prescription of Medications to Clients
Some drug classes normally target the control of the epigenetic action and the pharmacologic action of such medications is normally broad. When treating some health conditions, some medications need to epigenetically function on various genes in order to ensure their efficacy (Stefanska & David, 2015). For instance, the epigenetic approach can be used in treating various cancer types because the cancers can be caused by epigenetic variations. Therefore, this indicates the rationale of targeting a variety of genes or proteins of the different involved pathways (Magnus et al., 2015). Similarly, pharmacological agents with epigenetic function have been shown to be effective in the treatment of conditions such as diabetes. Nonetheless, the epigenetic approach is not effective in the treatment of psychiatric disorders such as addictions, depression, schizophrenia, and bipolar disorder. Accordingly, such information can significantly influence the prescription of drugs to clients where some health conditions may need medications having an epigenetic function, whereas in other health conditions the medications with an epigenetic function may not be effective (Magnus et al., 2015).
Johnson K & Lovinger D. (2016). Presynaptic G Protein-Coupled Receptors: Gatekeepers of Addiction? Front Cell Neurosci, 10(264).
Magnus I, Zhong X, Oliver H, Sudheer B Yu A, Lai P & Osawa Y. (2014). Potential Role of Epigenetic Mechanisms in the Regulation of Drug Metabolism and Transport. Drug Metab Dispos, 41(10), 1725–1731.
Pirri K, Rayes D & Alkema M. (2015). A Change in the Ion Selectivity of Ligand-Gated Ion Channels Provides a Mechanism to Switch Behavior. PLoS Biol, 13(9), e1002238.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY, US: Cambridge University.
Stefanska B & David M. (2015). Epigenetics and pharmacology. British Journal of Pharmacology, 172(11), 2701–2704.
Zimmer L. (2016). Pharmacological agonists for more-targeted CNS radio-pharmaceuticals. Oncotarget, 7(49), 80111–80112.