Psychopharmalogical Approaches to Treat Psychopathology
Psychopharmacological Approaches to Treat Psychopathology
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.
Resources for week 2
Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital Psychopharmacology and neurotherapeutics (pp. 1–19). Elsevier.
The University of British Columbia. (n. d.). Neuroanatomy videos. http://neuroanatomy.ca/videos.html
Note: Please review all of the media under the neuroanatomy series.
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Psychopharmacological Approaches to Treat Psychopathology
Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents
Agonists and antagonists are two classes of drugs that play an essential role in human brain cells. An agonist drug is defined as a drug substance that attaches itself to a receptor located within a cell thereby affecting the entire cell. Antagonist drugs are therefore drug substances associated with the activation of cells through their effect on the receptors of the cell. A partial agonist is a term used to describe a drug substance associated with reduced cell receptor activation. The antagonist on the other hand describes a drug substance responsible for reducing or blocking the effect of another drug substance within a cell (Bromberg et al., 2017). Some examples of these classes of drugs include Naloxone, heroin, and buprenorphine. Heroin is an agonistic drug, naloxone is an antagonistic, and buprenorphine is a partial agonist drug. Naloxone drug can be used by an individual who has experienced an overdose of heroin to reduce binding. A partial agonist such as buprenorphine can be used in the treatment of heroin addiction since it would facilitate partial binding of opioid receptors.
Compare and contrast the actions of g couple proteins and ion gated channels
The ion gated channels and the g couple proteins form the two main components of the post-synaptic receptors. Ion gated channels are also subdivided into two main domains where the first one facilitates the binding process of neurotransmitters. The second domain is partially a component of the ion channel. The g couple protein is a component that is so much dependent on more than two processes of metabolism. These processes occur through the help of the lower messenger systems. When the process of binding occurs to the neurotransmitters and to the metabotropic receptors, the g proteins are automatically activated. The process of separation between the receptor and the g proteins happens when there is an occurrence of direct interactions with the ion channels (Atkinson & Abbott, 2018). For the effector proteins to have total control of ion channels, pairing might occur with the aid of the intracellular messengers.
Epigenetics and Pharmacological Action
The process by which the functioning of genetics is altered without necessarily making any changes within the codes of the RNA or DNA is referred to as epigenetics. These changes in the functioning of DNA and RNA may also be hereditary. Epigenetics is, therefore, an essential factor that can be used in testing effectiveness of different medications. Epigenetics can also be used to investigate the diseases that an individual is most likely to develop for a given time period (Bromberg et al., 2017). When a gene with an altered functionality is affected by a medication, the efficacy of the latter might also change. For example, an altered binding of the receptor and formation of dopamine has an effect of making one develop resistance towards drug addiction (Wager et al., 2017).
Medical history is essential data that a healthcare provider should always consider before offering any medication to the patient. Family medical history and genetic testing are two vital issues that a patient must be checked before being prescribed any medication at my current place of work. There are however multiple psychotropics that have been tested but failed to cure genetic disorders. Due to the role of epigenetics, a patient who is in a situation of knowing medications that have successfully cured a close relative patient in the past might also benefit from the same medications.
Atkinson, D. L., & Abbott, J. K. (2018). Cannabinoids and the brain: The effects of endogenous and exogenous cannabinoids on brain systems and function. In The Complex Connection
between Cannabis and Schizophrenia (pp. 37-74). Academic Press.
Bromberg, K. D., Mitchell, T. R., Upadhyay, A. K., Jakob, C. G., Jhala, M. A., Comess, K. M.,
… & Pappano, W. N. (2017). The SUV4-20 inhibitor A-196 verifies a role for epigenetics
in genomic integrity. Nature chemical biology, 13(3), 317-324.
Wager, T. T., Chappie, T., Horton, D., Chandrasekaran, R. Y., Samas, B., Dunn-Sims, E. R., …
& Mead, A. N. (2017). Dopamine D3/D2 receptor antagonist PF-4363467 attenuates
opioid drug-seeking behavior without concomitant D2 side effects. ACS chemical
neuroscience, 8(1), 165-177. https://doi.org/10.1021/acschemneuro.6b00297