NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology

Discussion: Foundational Neuroscience
As a psychiatric 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.

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.

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Solution

Foundational neuroscience

Neuroscience is the scientific study of the brain and its effect on human behavior and thinking. The brain controls the voluntary and involuntary actions of the body. It also controls human behavior through their thinking. The brain plays a big role in the function of other organs of the body such as the heart, lungs, liver, skin, and kidneys. The PNP should understand the physiology of the brain so that to understand the mode of action in psychopharmacology. During the treatment of psychiatric disorders, it is important to understand the concepts of neuroscience.

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.

An agonist is a chemical that occupies and binds to the receptors and triggers the receptor to produce a biological response. They also increase the proportion of the activated receptors. Full agonists produce a maximum biologic response (Josephy-Hernandez, et al, 2017). Full agonists are generally efficient and have independent of potency. For example, epinephrine is a full agonist because it produces maximum effects when administered. Partial agonist produces lesser results than expected. They have less than 100% of the expected result despite maximum dose administration. Examples of partial agonists are opioids. An antagonist blocks the action of the agonist at the receptor thus inhibiting a chemical or biological reaction. The antagonist blocks the receptors from producing the desired result (Josephy-Hernandez, et al, 2017). For example, fluphenazine is an antipsychotic medicine that antagonizes the dopaminergic D1 and D2 receptors blocking the production of hypothalamic hormones.

Compare and contrast the actions of g couple proteins and ion gated channels.

G couple proteins GPCRs are integral membrane proteins that are used by cells to convert extracellular responses including response to hormones, neurotransmitters, olfaction, and taste signals (Sriram, K., & Insel, P. A. 2018). The GPCRs work by binding to the hormones, neurotransmitters, and growth factors to initiate a cellular response. Ion gated channels are transmembrane proteins of excitable cells that allow a flux of ions to pass only under defined circumstances. These channels are either voltage-gated by sodium channel neurons or ligand dated by the acetylcholine receptors of the cholinergic synapses (Van Hook, et al, 2019). The ion gated channel pull and bonds to the agonist changing the protein while g coupled proteins are used by the cells to convert intracellular signals into responses.

Explain how the role of epigenetics may contribute to pharmacologic action.

Epigenetics regulate gene activity by switching off the gene activity or activating the gene activity. Epigenetics plays a major role in the phenotypic activity of the cell in diseases such as cancer and neurodegenerative disorders such as Alzheimer’s disease (Delgado-Morales, et al, 2017). Epigenetics modify gene expressions after drug administration to counteract the disease states in humans. Therefore, epigenetics proves to be effective in treating psychiatric and neurodegenerative disorders to its ability to modify gene expressions.

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.

A psychiatric mental health nurse practitioner should have basic knowledge of the concepts of foundational neuroscience. Understanding the basic function of agonists, inverse agonists, partial agonists, and antagonists prevents co-administration of drugs that agonize and antagonize at the same receptors. For example, in treating a patient with a depressive mood disorder, prescribing antipsychotics such as fluphenazine worsens the depressive mood because it antagonizes the dopaminergic D1 and D2 receptors depressing the release of the hypothalamic hormone.

 

References

Delgado-Morales, R., Agís-Balboa, R. C., Esteller, M., & Berdasco, M. (2017). Epigenetic mechanisms during ageing and neurogenesis as novel therapeutic avenues in human brain disorders. Clinical epigenetics9(1), 1-18.

Josephy-Hernandez, S., Jmaeff, S., Pirvulescu, I., Aboulkassim, T., & Saragovi, H. U. (2017). Neurotrophin receptor agonists and antagonists as therapeutic agents: An evolving paradigm. Neurobiology of disease97, 139-155.

Sriram, K., & Insel, P. A. (2018). G protein-coupled receptors as targets for approved drugs: how many targets and how many drugs?. Molecular pharmacology93(4), 251-258.

Van Hook, M. J., Nawy, S., & Thoreson, W. B. (2019). Voltage-and calcium-gated ion channels of neurons in the vertebrate retina. Progress in retinal and eye researc