Concepts of foundational neuroscience as they might apply to your role as the psychiatric mental health nurse

      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. 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. 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.  

Sample Solution

     

Agonists and Antagonists

In pharmacology, an agonist is a drug that binds to a receptor and activates it, while an antagonist is a drug that binds to a receptor but does not activate it. Partial agonists bind to a receptor and activate it to a lesser extent than full agonists. Inverse agonists bind to a receptor and inhibit its activity.

The agonist-to-antagonist spectrum of action of psychopharmacologic agents refers to the range of effects that different drugs can have on a receptor. Some drugs are full agonists, meaning that they produce a maximal response when they bind to a receptor. Other drugs are partial agonists, meaning that they produce a smaller response than full agonists. Still other drugs are antagonists, meaning that they block the effects of agonists.

Full Answer Section

      The partial and inverse agonist functionality of psychopharmacologic agents can impact the efficacy of psychopharmacologic treatments in a number of ways. For example, a partial agonist may be less effective than a full agonist in treating a disorder. Additionally, an inverse agonist may actually worsen the symptoms of a disorder.

G Protein-Coupled Receptors and Ion-Gated Channels

G protein-coupled receptors (GPCRs) are a large family of receptors that are activated by a variety of molecules, including neurotransmitters, hormones, and drugs. When a GPCR is activated, it binds to a G protein, which is a molecule that relays the signal from the receptor to other parts of the cell.

Ion-gated channels are proteins that open or close in response to the binding of a molecule. When an ion-gated channel opens, it allows ions to flow into or out of the cell, which can change the cell's electrical activity.

GPCRs and ion-gated channels are two of the main types of receptors that are targeted by psychotropic medications. GPCRs are targeted by a wide variety of drugs, including antidepressants, antipsychotics, and anxiolytics. Ion-gated channels are targeted by a smaller number of drugs, but they include some important medications, such as anticonvulsants and beta-blockers.

The Role of Epigenetics in Pharmacologic Action

Epigenetics is the study of changes in gene expression that are not caused by changes in the DNA sequence. These changes can be caused by environmental factors, such as diet, stress, and exposure to toxins.

Epigenetic changes can affect the way that cells respond to drugs. For example, a study found that people with a certain epigenetic change were more likely to respond to a certain type of antidepressant.

How This Information May Impact the Way I Prescribe Medications to Patients

The information about the agonist-to-antagonist spectrum of action, GPCRs, ion-gated channels, and epigenetics can help me to prescribe medications to patients in a more informed way. For example, I would be more likely to choose a partial agonist for a patient who has experienced side effects with full agonists. I would also be more likely to consider the patient's epigenetic profile when choosing a medication.

Specific Example

One example of a situation in which I would need to be aware of the medication's action is when prescribing an antidepressant to a patient with bipolar disorder. Some antidepressants can trigger mania in people with bipolar disorder, so I would need to choose a medication that is less likely to do this.

Another example is when prescribing an antipsychotic to a patient with tardive dyskinesia. Tardive dyskinesia is a movement disorder that can be caused by long-term use of antipsychotics. I would need to choose an antipsychotic that is less likely to cause tardive dyskinesia.

By being aware of the information about the agonist-to-antagonist spectrum of action, GPCRs, ion-gated channels, and epigenetics, I can prescribe medications to patients in a way that is more likely to be effective and safe.

 

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