Assignment: Foundational Neuroscience/NURS 6630

Assignment: Foundational Neuroscience/NURS 6630

Assignment: Foundational Neuroscience/NURS 6630

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.

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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:

1. 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.
2. Compare and contrast the actions of g couple proteins and ion gated channels.
3. Explain how the role of epigenetics may contribute to pharmacologic action.
4. 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.

Upload a copy of your discussion writing to the draft Turnitin for plagiarism check.  Your faculty holds the academic freedom to not accept your work and grade at a zero if your work is not uploaded as a draft submission to Turnitin as instructed.

Read a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond to at least two of your colleagues on two different days in one of the following ways:

• If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.
• If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!

ANUJA

Week 2 discussion

Initial Post # Anuja

 The agonist-to-antagonist spectrum of action of psychopharmacologic agents

The agonist-to-antagonist spectrum of action in psychopharmacologic medicines refers to the effects of medications on neurotransmitter receptors in the brain. These drugs have agonistic, partial, antagonistic, or inverse agonistic properties, with varying levels of selectivity. Agnostics activate receptors fully and mimic endogenous neurotransmitters, while antagonists block agonists ( Berg et al., 2018). Inverse agonists decrease receptor activity, while partial agonists partially activate receptors and produce submaximal effects. It is known that dopamine and its receptors can be used to treat several neuropsychiatric conditions, such as depression, schizophrenia, Parkinson’s disease, and several drug addictions (Zhao et al.,2022). As a result, a medication that acts at the same receptor can function as an agonist, antagonist, and inverse agonist all at once. This indicates that medications possess selectivity at a level higher than that of conventional receptors, known as signaling selectivity or functional selectivity (Rosenthal  & Burchum, 2021). It is important to consider both functional selectivity and inverse agonism during the research process.

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

Cell surface receptors and intracellular signaling pathways are linked by G-proteins, which are signaling proteins. Ion channels and G protein-coupled receptors (GPCRs) are crucial proteins involved in membrane signaling and target genes for drugs (Duncan et al., 2020). G-proteins carry messages from external stimuli to intracellular effectors. Ion-gated channels regulate ion movement across cell membranes, affecting membrane potential and excitability. G-proteins transmit signals from cell surface receptors to intracellular effectors, changing their structure when activated ( Stahl,2021). When a ligand, such as a hormone or neurotransmitter, attaches to a G-protein-coupled receptor (GPCR) on a cell member, G-proteins become activated. Transmembrane proteins called ion-gated channels control ions like calcium, potassium, and sodium and move across cell membranes (Duncan et al., 2020). It plays a role in the production and transmission of electrical signals in excitable cells, including muscle and neuronal tissue. When the G-protein is activated, it changes its structure and splits into alpha (α) and beta-gamma (βγ) subunits.. Ion-gated channels regulate the flow of ions across cell membranes, affecting membrane potential and cellular excitability, whereas G-proteins carry out the primary function of transmitting signals from cell surface receptors to intracellular effectors.

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

It is well known that the epigenetic mechanisms governing gene expression differ temporally and between different cells and tissues. There is mounting evidence that anomalies in the epigenetic systems governing gene expression play a role in the etiology of disease, particularly prevalent illnesses. It has been said that epigenetics is the center of modern medicine. Additionally, evidence has shown that  almost all forms of psychiatric disorders have dysregulated epigenetic pathways of gene expression and that these dysregulated mechanisms contribute to the pathophysiology of these disorders( Peedicayil,2020). For example – Histone deacetylase inhibitors (HDACi) have been employed in most therapeutic trials looking into the use of epigenetic medications for treating anxiety disorder  ( Peedicayil,2020).  The preclinical and clinical pharmacological trials with HDACi are yielding positive findings for the treatment of anxiety disorders.

 Awareness for  Prescribing Antipsychotic Medication

It is widely accepted that drug interactions contribute significantly to the prevalence of adverse drug reactions in hospital and community settings. A  geriatric patient with anxiety and migraine was admitted to the hospital and was prescribed haloperidol two times a day for six months. After worsening symptoms, she was admitted to the psychiatric unit with neuroleptic-induced parkinsonism. Haloperidol was suspected to be the cause, and risperidone was replaced. Despite receiving syndopa and THP, the patient continued to receive these medications during her hospital stay. Antipsychotic drugs like Haldol are known to decrease the effectiveness of Parkinson’s disease by blocking dopamine receptors in the corpus striatum ( Lucca et al., 2015).

References

Berg, K. A., & Clarke, W. P. (2018). Making sense of pharmacology: Inverse agonism and functional selectivity. International Journal of Neuropsychopharmacology, 21(10), 962–977. https://doi.org/10.1093/ijnp/pyy071

Links to an external site.

Duncan, A. L., Song, W., & Sansom, M. S. (2020). Lipid-dependent regulation of ion channels and g protein–coupled receptors: Insights from structures and simulations. Annual Review of Pharmacology and Toxicology, 60(1), 31–50. https://doi.org/10.1146/annurev-pharmtox-010919-023411

Links to an external site.

Lucca, J. M., Ramesh, M., Parthasarathi, G., & Raman, R. (2015). An adverse drug interaction of haloperidol with levodopa. Indian Journal of Psychological Medicine, 37(2), 220–222. https://doi.org/10.4103/0253-7176.155636

Links to an external site.

Rosenthal, L. D. & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Elsevier.

Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th Ed.) Cambridge University Press

Peedicayil, J. (2020). <p>the potential role of epigenetic drugs in the treatment of anxiety disorders</p>. Neuropsychiatric Disease and Treatment, Volume 16, 597–606. https://doi.org/10.2147/ndt.s242040

Links to an external site.

Zhao, F., Cheng, Z., Piao, J., Cui, R., & Li, B. (2022). Dopamine receptors: Is it possible to become a therapeutic target for depression? Frontiers in Pharmacology, 13. https://doi.org/10.3389/fphar.2022.947785

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AILEEN

Foundational Neuroscience Discussion post

Agonist-to-Antagonist Spectrum of Action:

Psychopharmacological agents have an agonist-to-antagonist spectrum of action, which describes the varіеty of effects a medication can have on neurotransmitter receptors. While an antagonist blocks the receptor, preventing activation, an agonist mimics the action of an endogenous neurotransmitter by activating a receptor (Stahl, 2021). Inverse agonists have the opposite еffеct of an agonist, while partial agonists have a moderate еffеct that activates the receptor to a lesser degree than a full agonist. It is essential to comprehend this spectrum in psychiatric practice. For instance, benzodiazepines function as agonists at the gamma-aminobutyric acid (GABA) receptor to treat anxіеty disorders by encouraging inhibitory neurotransmission and lowering anxiety (Chapter 2). Extended use of a full agonist, however, can result in dependence and tolerance. Buspirone and other partial agonists may provide an alternative with a lower chance of dependence.

G Protein vs. Ion Gated Channels:

Neurotransmission involves two diverse types of receptors: Ñ–on-gatеd channels and GPCRs. Second messenger systems are activated when GPCRs bind to intracellular proteins (G protеіns). In response to neurotransmitter binding, ions can move directly into or out of cells via Ñ–on-gated channels. For example, SSRIs and other antideprеssants target GPCRs callеd serotonÑ–n rеceptors. Convеrsеly, Ñ–on-gated channels—likе the NMDA rеceptor—havе a part in disorders lÑ–kе schizophrеnia (The University of British Columbia, n. d.). ChoosÑ–ng thе right mеdÑ–cation requÑ–rеs an undеrstandÑ–ng of thеse dÑ–stinctÑ–ons. The thеrapеutÑ–c еffеcts of antÑ–dеpressants that target GPCRs may not manÑ–fеst as quÑ–ckly as those of mеdicatÑ–ons that affеct ion-gatеd channеls.

Role of Epigenetics:

Changes Ñ–n gеnе еxprеssion that do not rеsult Ñ–n modÑ–fÑ–cations to thе DNA sеquеnce itsеlf are refеrrеd to as epigеnеtÑ–c changеs. Responsе to psychopharmacologÑ–c trеatment can bе Ñ–nfluenced by еpÑ–genеtic changes. Drug metabolism or rеceptor sensÑ–tivity, for Ñ–nstance, can be affеcted by thе methylation of DNA or hÑ–stonеs, whÑ–ch can sÑ–lеncе or activatе gеnes (Chapter 3). It is essеntÑ–al to take indÑ–vidual dÑ–fferеncеs Ñ–n еpigеnetÑ–c factors into account whеn prеscrÑ–bing mеdÑ–catÑ–ons. To fÑ–nd possÑ–ble epigеnetic factors Ñ–nfluencÑ–ng drug mеtabolism, a patient with a hÑ–story of poor antÑ–dеprеssant response might benefit from gеnеtic tеsting. UsÑ–ng this data to tailor a patіеnt’s course of therapy can increasе effеctÑ–vеnеss and dеcreasе sidе еffеcts.

Impact on Medication Prescribing:

Prescription medÑ–cÑ–ne is influеnced by knowledgе of GPCRs, ion-gated channels, the agonist-to-antagonist spеctrum, and epigenetÑ–cs. For еxample, choosÑ–ng a partÑ–al agonÑ–st such as buspironе rather than a full agonist for anxіеty may be wise in a patient with depression and a history of abusing bеnzodiazеpÑ–nes (Mental Health TV, 00:20). Choosing between antidеpressants and antipsychotÑ–cs can be Ñ–nfluencеd by the genetic varÑ–ations in drug metabolÑ–sm caused by epÑ–gеnеtic factors. In conclusÑ–on, practitionеrs of psychÑ–atrÑ–c mental health nursÑ–ng must possеss a sophisticated grasp of basic neuroscÑ–encе. By allowing for thе customizatÑ–on of drug choices to mеet the specific requirеments of еach patient, Ñ–t can improve treatment outcomes and reduce side еffеcts.

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)

Mental Health TV. (2022, October 7). Psychopharmacology – Module Four. Www.youtube.com. https://www.youtube.com/watch?v=46Ioy6SSta4&t=89s

The University of British Columbia. (n. d.). Neuroanatomy videos. http://neuroanatomy.ca/videos.html