Case-Discussion: Foundational  Neuroscience

Case-Discussion: Foundational  Neuroscience

A Sample Answer For the Assignment: Case-Discussion: Foundational  Neuroscience

The mechanisms used by drugs might be either agonists or antagonists. Drugs that attach to target receptors and change the way the receptors function to cause a response are known as agonists. Drugs that bind to receptors but do not trigger a response are known as antagonists (Salahudeen & Nishtala, 2017). A receptor’s affinity space is decreased when an antagonist attaches to it, which in turn lowers the reactions that the agonist may induce.

Increased agonist concentration results in higher agonist occupancy and a decrease in the antagonist’s inhibitory action. The agonist then receives a full or partial response. Unlike other agonists, which enhance receptor activity, inverse agonists decrease receptor activity and produce strong and weak partial agonists.

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G-protein-coupled receptors (GPCRs) are a large protein family found on the cell membrane that binds to extracellular material (Salahudeen & Nishtala, 2017). The G protein in the intracellular space receives the signals from the receptors and transmits them.

GPCR activity causes physiological responses, including a raised heart rate or dilated pupils. Ion-gated channels, on the other hand, are cell membrane holes that permit the passage or transportation of substances into and out of the cells.

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Epigenetics is the study of genetic information used to understand how the whole genome functions. Pharmacology’s use of epigenetics enables researchers to treat disorders holistically rather than consider how they interact with specific medications (Heerboth et al., 2014).

Scientists and medical professionals may determine the exact and appropriate medications and doses for various individuals by knowing the epigenetics of a certain illness. The notion that “one medicine fits all” may thus be rejected. In practice, before prescribing medicine, they consider dosage parameters including age, body weight, diet, and comorbidities.

Physicians need to understand the information on phamarcoepigenetics and pharmacological antagonists or agonists since it enables them to determine various medications’ short- and long-term effects. The timely and efficient delivery of therapeutic material is one of the biggest factors increasing illness outcomes.

Caution must be used to prevent prescribing the incorrect medications. For example, when prescribing benzodiazepines, the psychiatric profession should consider their side effects, mode of action, half-life, and metabolism. Due to this crucial knowledge, the doctor will be able to prevent withdrawal symptoms by knowing when to taper down or discontinue the medication delivery.

References

Heerboth, S., Lapinska, K., Snyder, N., Leary, M., Rollinson, S., & Sarkar, S. (2014). Use of epigenetic drugs in disease: an overview. Genetics & epigenetics, 6, 9–19. https://doi.org/10.4137/GEG.S12270

Salahudeen, M. S., & Nishtala, P. S. (2017). An overview of pharmacodynamic modelling, ligand-binding approach and its application in clinical practice. Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society, 25(2), 165–175. https://doi.org/10.1016/j.jsps.2016.07.002

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. 

It’s important to understand what agonist and antagonist means when answering these questions. Agonists are drugs that bind to the intended receptors and the receptors produce a response (Berg & Clarke, 2018). Compared to antagonists drugs which bind to the intended receptor but do not produce a response (Berg & Clarke, 2018). Examples of agonist drugs are opioids. They bind to opioid receptors which produce a response and block pain sensation.

An example of an antagonist is naloxone because it binds to opioid receptors but does not produce a response instead blocks the response of opiods. A partial agonist is what it sounds like. Basically it binds to the targerted receptor, but can’t produce the maximal and most efficient response compared to a full agonist. Inverse agonists are drugs that bind to the same receptors as an agonist but produce the opposite response of an agonist (Berg & Clarke, 2018).

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

Both G protein coupled receptors (GPCRs)  and ion gated channels are membrane-bound proteins and react to ions or molecules.  GPCRs are located on the cell’s surface and convert extracellular signals into intracellular responses (Li et al., 2014). GPCRs need to interact with different proteins to produce intracellular response. Ion gated channels are pores in the cell membrane which regulate flow of ions across the plasma membrane (Li et al., 2014). These pores open and close when ions and molecules bind.

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

According to the CDC (2022), epigenetics means the study of how our behaviors and the environment can cause changes that affect the way your genes work. Epigenetic changes are revirsable compared to genetics. Our behaviors and our environment can not change a person’s genetic sequence but these two factors can change how our bodies read the expression of genes.

This contributes to pharmacological actions because everybody will respond to medication differently. Certain factors like our behaviors and environment can affect how receptors respond. Certain diseases are associated with epigenetic alterations and certain drugs can reverse these epigenetic changes and treat the disease.

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.

Understanding if a medication is an agonist or an antagonist is crucial in understanding what kind of response the medication will produce. Knowing the difference between a full agonist and partial agonist allows the prescriber to know how efficient the medication will be for the patient. Buprenorphine is a partial agonist and is used to treat addiction to pain medication but it also can treat pain.

Understanding this drug is a partial agonist is important when perscribing because depending on the dose it will bind  to a different receptor and produce different responses. A high dose of buprenorphine is typically used to address addiction issues and lower doses is used to treat pain. This medication is highly addictive, therefore understanding epigenetic factors is vital when prescribing it.

References 

Berg, K. A., & Clarke, W. P. (2018). Making sense of pharmacology: inverse agonism and functional selectivity. The International Journal of

Neuropsychopharmacology, 21(10), 962–977.

Centers for Disease Control & Prevention (CDC) (2022).What is Epigenetics? Retrieved from https://www.cdc.gov/genomics/disease/epigenetics.htm

Li, S., Wong, A. H., & Liu, F. (2014). Ligand-gated ion channel interacting proteins and their role in neuroprotection. Frontiers in Cellular Neuroscience, 8, 125.

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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.

Learning Objectives

Students will:
Analyze the agonist-to-antagonist spectrum of action of psychopharmacologic agents
Compare the actions of g couple proteins to ion gated channels
Analyze the role of epigenetics in pharmacologic action
Analyze the impact of foundational neuroscience on the prescription of medication

BY DAY 3
Post a response to each of the following:

Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.
Compare and contrast the actions of g couple proteins and ion gated channels.
Explain the role of epigenetics in pharmacologic action.
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.

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

An agonist-to-antagonist spectrum of action of psycho pharmacologic agents, -is explained as when a chemical binds or connect to a receptor, the receptor activates, and a biological response is produced. When agonists activate receptors, like hormones, neurotransmitters, and other endogenous regulators that activate the receptors to which they bind (Golier, J. A., & Yehuda, R. (2018).

Antagonists have no effects on the receptor function, but it can block effectiveness and prevent receptor activation by endogenous molecules and drugs(Golier, J. A., & Yehuda, R. (2018).The antagonist can be a drug with an affinity to bind to a receptor but does not have any intrinsic activity.  The process is considered an example of a full agonist (Golier, J. A., & Yehuda, R. (2018).  A partial agonist means that the molecules do not elicit a full response therefore does not obtain the maximum response from system even when they bind to the same number of receptors as an agonist (Golier, J. A., & Yehuda, R. (2018).

When there is an agonist and a partial agonist working at the same time the partial agonist becomes an antagonist because they are both fighting for space on the same receptors (Frånberg, O et al).. An antagonist refers to molecules that block agonist mediated responses. Inverse agonists are molecules that want to attach to the same receptors as agonists, but they produce an opposite response than the agonist on the target cell (Golier, J. A., & Yehuda, R. (2018).

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

G protein-coupled receptors (GPCRs) are a large family of cell surface receptors on the plasma membrane that transmit signals inside the cell through a type of protein called a G protein (Sunamita de Carvalho et al 2018).  G protein-coupled receptors serve many purposes in the body, and the disorder of GPCR signaling can cause disease. G proteins bind with nucleotide guanosinetriphosphate (GTP) (Sunamita de Carvalho et al 2018).

G protein divides into two portions (one called the α subunit, the other consisting of the β and γ subunits), which are released from the GPCR (Sunamita de Carvalho et al 2018). The subunits can interact with other proteins, triggering other signaling pathways that lead to different responses.

When communication is allow to  occur from  one cell to  the next cell through a lipid membrane, charged molecules need assistance in the form of ion channels (Sunamita de Carvalho et al 2018). Ion channels control cellular excitability by using membrane-bound glycol proteins that contain pores filled with water (ion channels) which allows for the charged molecules to move from an extracellular to intracellular (Sunamita de Carvalho et al 2018).

Charged molecules can go into the cell while allowing for uncharged molecules to move out of the cell in an organized, efficient manner. This movement of ions is important in the role of cell excitation, muscle contraction and intracellular signaling (Weir, 2020). G-protein-coupled receptors (GPCRs) are the largest category of receptors allowing for the bodies physiological function (Sunamita de Carvalho et al 2018).

Most medications are made to target GPCRs due to their large distribution throughout the body. They are necessary membrane proteins used by cells to convert extracellular signals into intracellular responses by using hormones (Sunamita de Carvalho et al 2018).

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

Epigenetics is when the expression of a gene can be controlled, promoting or repressing the expression of the gene without changing the code or genome’s sequence (Kumsta, R. 2019).Epigenetics is  gene function is changed by an adaptation in the code. The role of epigenetics may contribute to pharmacologic action by changing a DNA molecule, resulting in amended gene expression.

When a DNA molecule is amended, then pharmacologic action is then modified. Gene articulation can be modified because of the variation of the DNA molecule chromatin. Long-term effects of cognition and behavior can be a result of the alteration of development brought on by abuse or mistreatment in childhood (Kumsta, R. 2019). Heritability is an effect of gene expression changes in the long-term

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.

As a provider, when prescribing medication, it is necessary to treat each patient as individual patient with his or her own familiar history. The assessment should include genetic questing that will be use for the implementation of diagnosing implementation for treatment. Will also access for allergy since most antipsychotics’ medication are commonly cause allergy reaction.

Closely monitor medications prescribed for the treatment of psychosis and behavioral and psychological symptoms of dementia in elderly patients for any adverse reaction (Kumsta, R. 2019)   Monitoring should always continue; it should not only be at the beginning of the therapy because patient can develop tolerance to medication and eventually medication or doses that use to work might not work.

Doses should be monitor and adjusted appropriately.   Also, since aging can affect drug metabolism and clearance, additional pharmacokinetic and pharmacodynamic changes  require additional attention (Kumsta, R. 2019).

References:

Sunamita de Carvalho Lima, Lucas de Carvalho Porta, Álvaro da Costa Lima, Joana D’Arc Campeiro, Ywlliane Meurer, Nathália Bernardes Teixeira, Thiago Duarte, Eduardo Brandt Oliveira, Gisele Picolo, Rosely Oliveira Godinho, Regina Helena Silva, & Mirian Akemi Furuie Hayashi. (2018). Pharmacological characterization of crotamine effects on mice hind limb paralysis employing both ex vivo and in vivo assays: Insights into the involvement of voltage-gated ion channels in the crotamine action on skeletal muscles. PLoS Neglected Tropical Diseases, 12(8), e0006700. https://doi.org/10.1371/journal.pntd.0006700

Frånberg, O., Wiker, C., Marcus, M., Konradsson, Å., Jardemark, K., Schilström, B., Shahid, M., Wong, E., & Svensson, T. (2008). Asenapine, a novel psychopharmacologic agent: preclinical evidence for clinical effects in schizophrenia. Psychopharmacology, 196(3), 417–429. https://doi.org/10.1007/s00213-007-0973-y

Kumsta, R. (2019). The role of epigenetics for understanding mental health difficulties and its implications for psychotherapy research. Psychology and Psychotherapy: Theory, Research and Practice, 92(2), 190–207. https://doi.org/10.1111/papt.12227

Golier, J. A., & Yehuda, R. (2018). Mifepristone as a Psychopharmacologic Agent: Consideration of Efficacy, Plasma Levels, and Mechanism of Action. Biological Psychiatry, 84(1), 5–