NURS 6630 Discussion Reflect On Concepts Of Foundational Neuroscience
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The introduction for the Walden University NURS 6630 Discussion Reflect On Concepts Of Foundational Neuroscience is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NURS 6630 Discussion Reflect On Concepts Of Foundational Neuroscience
After the introduction, move into the main part of the NURS 6630 Discussion Reflect On Concepts Of Foundational Neuroscience assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NURS 6630 Discussion Reflect On Concepts Of Foundational Neuroscience
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NURS 6630 Discussion Reflect On Concepts Of Foundational Neuroscience
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Week 2: Foundational Neuroscience
Psychopharmacologic Agents’ Agonist-to-Antagonist Spectrum of Action
Agonists and antagonists significantly impact pharmacological effects in the body.
The two processes contradict each other. An action produced by an agonist is opposed to an antagonist (Palacios et al., 2019). Therefore, an agonist works with body muscles and works when the muscles are relaxed. When combined with the cell receptor agonists facilitate a specific reaction. On the other hand, an antagonist contradicts the working mechanism of the muscles and works when muscles have contracted (Palacios et al., 2019). Antagonists slow down or oppose action when combined with the cell receptor. In drugs, a response is initiated when agonists get to a receptor site. On the contrary, antagonists block the response by working against the drug.
The efficacy of psychopharmacologic treatments is significantly impacted by partial and inverse agonist functionality. A partial agonist does not generate the maximal response depending on the capability of the tissues, despite binding to an equal number of receptors at the site (Palacios et al., 2019). In some cases, partial agonists bind to receptors without further effect. Thus, psychopharmacologic agents are more effective in treating presented symptoms in the presence of a partial agonist. On the other hand, an inverse agonist generates a pharmacological response that contradicts the action of the corresponding agonist upon binding to a receptor site. An inverse agonist slows down the action of the agonist. Therefore, in drugs, inverse agonist reduces the efficacy of the psychopharmacologic agent in treating presented symptoms.
- Pharmacologic agents are more effective in the presence of partial and inverse agonists compared to full agonists. A partial agonist does not generate the maximal response upon binding to the receptor site (Palacios et al., 2019). Additionally, an inverse agonist slows down the action of the agonist at the receptor site. Thus, the efficacy of pharmacological agents is reduced in partial and inverse agonists. On the other hand, full agonists, bind to a receptor site and initiate appropriate action. Therefore, psychopharmacologic agents are more effective in treating presented symptoms in the presence of a full agonist.
Here are Specific examples to agonists, antagonists, partial agonists, and inverse agonists that we use in Psychotherapy.
Agonist: Alprazolam (Xanax), clonazepam (klonopin), Lisdexamftamine (Vyvanse), and Methlphenidate (Ritalin).
Antagonists: Naloxone (Narcan), acamprosate (campral), Aripiprazole lauroxil (Aristada), Olanzapine (Zyprexa).
Partial Agonist: buprenorphine (suboxone), Cariprazine (vraylar), vilazodone (viibryd), buspirone (buspar).
Inverse agonists: zolpidem (Ambien), ketamine (ketalar), RO15-4513, FG7142.
Comparison of G Couple Proteins and Ion-Gated Channels
G couple proteins and ion gated channels are postsynaptic ion channels that regulate activities of the central nervous system by hyperpolarizing and depolarizing postsynaptic neurons. However, the two differ in terms of their structure and working mechanisms. G protein-coupled receptors are formed by a single polypeptide, which is threaded over the membrane (Joedicke et al., 2018). On the other hand, ion channels consist of pores, which open and shut down upon binding to a ligand (Paoletti et al., 2019). Additionally, receptors that are coupled by the G protein interact with various proteins to initiate an intracellular response. On the contrary, channels are responsible for regulating how ions flow.
The impact of Epigenetics on Pharmacologic Action
Epigenetic regulation significantly impacts a drug’s pharmacokinetics. It influences pharmacokinetics by activating or inactivating transmembrane transporters or enzymes (Kringel et al., 2021). Consequently, the drug’s pharmacodynamic effects are influenced indirectly. Drug metabolism, absorption, and excretion are slowed down when epigenetics deactivates transmembrane transporters or enzymes. On the contrary, epigenetics enhances these processes by activating transmembrane transporters or enzymes. Alternatively, epigenetics impact the drug’s pharmacodynamics directly through the target’s modulation of the expression. According to Kringel et al. (2021), modulation of the target significantly influences the drug’s pharmacological plasticity. As a result, the impact of drugs on the body is permanently deformed. Lastly, epigenetics affect the drug’s target by regulating gene expression in the body.
The impact of this Information on the Prescription of Medications to Patients
Medication action significantly impacts the drug prescribed to an individual client. A psychiatric mental health nurse practitioner (PMHNP) must understand medication’s action before prescribing it to a patient diagnosed with a mental health disorder. For instance, a PMHNP must understand a drug’s pharmacokinetics and pharmacodynamics before prescribing it to an elderly patient using other drugs. Specifically, a PMHNP should consider this information when prescribing Selective serotonin reuptake inhibitors (SSRI) to an 83 years old male, with depressive symptoms and a history of diabetes Mellitus, kidney failure, age-related liver disease, and hypertension managed using medication. According to Fugger et al. (2022), SSRIs are recommended as the first-line treatment for depressive symptoms in elderly adults since they are easily metabolized and absorbed in the body. The pharmacokinetics of these drugs enhance their efficacy in managing depressive symptoms and preventing potential toxicity. Therefore, SSRIs should be considered in the client’s managing depressive symptoms since they will be rapidly broken down and absorbed, protecting the patient from potential drug-related side effects. Additionally, the drug will reach the target shortly, reducing the severity of reported depressive symptoms within a short timeframe. Furthermore, the PMHNP should ensure that the selected SSRI does not act as an antagonist upon binding with the receptor to avoid interfering with the efficacy of the client’s current medications. Lastly, the PMHNP should consider how the patient’s characteristics, including aging, sex, and current medications will influence the working mechanism and efficacy of the prescribed drug.
References
Fugger, G., Bartova, L., Fabbri, C., Fanelli, G., Zanardi, R., Dold, M., … & Kasper, S. (2022). The sociodemographic and clinical phenotype of European patients with major depressive disorder undergoing first-line antidepressant treatment with NaSSAs. Journal of affective disorders, 312, 225-234.
Joedicke, L., Mao, J., Kuenze, G., Reinhart, C., Kalavacherla, T., Jonker, H. R., … & Glaubitz, C. (2018). The molecular basis of subtype selectivity of human kinin G-protein-coupled receptors. Nature chemical biology, 14(3), 284-290.
Kringel, D., Malkusch, S., & Lötsch, J. (2021). Drugs and epigenetic molecular functions. A pharmacological data scientometric analysis. International Journal of Molecular Sciences, 22(14), 7250.
Palacios, J. M., Pazos, A., & Hoyer, D. (2019). A short history of the 5-HT 2C receptor: from the choroid plexus to depression, obesity and addiction treatment. Psychopharmacology, 234, 1395-1418.
Paoletti, P., Ellis-Davies, G. C., & Mourot, A. (2019). Optical control of neuronal ion channels and receptors. Nature Reviews Neuroscience, 20(9), 514-532.
NURS 6630 Discussion Reflect On Concepts Of Foundational Neuroscience
NURS 6630 Discussion Reflect On Concepts Of Foundational Neuroscience
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The Agonist-To-Antagonist Spectrum of Action of Psychopharmacologic Agents
Agonists are drugs that stimulate receptors similar to natural neurotransmitters, while antagonists are drugs that block the actions of a natural neurotransmitter at its receptor. True antagonists only apply their actions in the presence of an agonist since they have no intrinsic activity of their own in the absence of an agonist (Stahl & Stahl, 2013). Drugs acting at a receptor occur in a spectrum from full agonist to antagonist to an inverse agonist. Antagonists block the actions of everything in the agonist spectrum.
At one end of the agonist-to-antagonist spectrum, there is the full agonist, which produces the same degree of physiologic receptor-mediated response as the natural neurotransmitter agonist itself (Stahl & Stahl, 2013). At the other end of the spectrum is a full inverse agonist, which in concept does oppose the agonist. In the middle of the spectrum is the antagonist, which blocks the effects of all participants in the spectrum but has no properties of its own in altering the ion channel (Stahl & Stahl, 2013). Thus, the agonist-to-antagonist spectrum goes from full agonist to partial agonist to antagonist to partial inverse agonist to full inverse agonist.
Compare and Contrast the Actions of G Couple Proteins and Ion Gated Channels
Both G couple proteins and ion-gated channels are involved in the opening and closing of postsynaptic ion channels. However, the two accomplish this in different ways. Ion-gated channels are directly linked to ion channels and contain two functional domains. An extracellular site binds neurotransmitters and a membrane-spanning domain that forms an ion channel and thus combines transmitter-binding and channel functions into a single molecular entity (Wulff & Christophersen, 2015). On the other hand, G-protein-coupled receptors do not have ion channels as part of their structure. They thus affect channels by activating intermediate molecules called G-proteins (Johnson & Lovinger, 2016). G-protein-coupled receptors act by dissociating from the receptor and interacting directly with ion channels or bind to other effector proteins, such as enzymes, that form intracellular messengers that open or close ion channels.
I really enjoyed reading your article, it was very informative. However, in addition to your points about the agonist-antagonist spectrum, I will like to share additional insight I found interesting too.
According to Berg and Clarke (2018), Agonists have intrinsic efficacy (the ability to increase the activity of a receptor), and inverse agonists are said to have negative intrinsic efficacy (the ability to decrease the activity of a receptor). Just as agonist intrinsic efficacy for a receptor varies with the structure of the agonist (resulting in strong agonists and weaker [partial] agonists), inverse agonists also have different degrees of negative intrinsic efficacy, resulting in strong and weak (partial) inverse agonists.
Inverse agonists are ligands that selectively bind to the inactive state of the receptor (Kenakin, 2017). If any receptor happens to be in an active state spontaneously, then an inverse agonist will reverse the resultant constitutive activity. However, the main pharmacological effect of inverse agonists is receptor antagonism, that is, inverse agonists will block the effect of agonists and the effect on constitutive activity is only relevant if the system is spontaneously active (Kenakin, 2017). There is a property of inverse agonists that may be therapeutically relevant in nonconstitutively active systems (Kenakin, 2017).
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. https://doi.org/10.1093/ijnp/pyy071
Kenakin, T. P. (2017). Pharmacology in Drug Discovery and Development (Second Edition). ScienceDirect. Retrieved June 10, 2022, from https://doi.org/10.1016/B978-0-12-803752-2.00004-1
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.
Required Readings
Note: All Stahl resources can be accessed through the Library using this link. This link will take you to a log-in page for the Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix–x
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 1, “Chemical Neurotransmission”
Chapter 2, “Transporters, Receptors, and Enzymes as Targets of Psychopharmacologic Drug Action”
Chapter 3, “Ion Channels as Targets of Psychopharmacologic Drug Action”
Document: Midterm Exam Study Guide (PDF)
Document: Final Exam Study Guide (PDF)
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Required Media
Laureate Education (Producer). (2016i). Introduction to psychopharmacology [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 3 minutes.
Accessible player
Optional Resources
Laureate Education (Producer). (2009). Pathopharmacology: Disorders of the nervous system: Exploring the human brain [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 15 minutes.
Dr. Myslinski reviews the structure and function of the human brain. Using human brains, he examines and illustrates the development of the brain and areas impacted by disorders associated with the brain.
Accessible player
Laureate Education (Producer). (2012). Introduction to advanced pharmacology [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 8 minutes.
In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse.
Accessible player
To prepare for this Discussion:
Review this week’s Learning Resources.
Reflect on concepts of foundational neuroscience.
By using a combination of psychotherapy and medication therapy, psychiatric mental health nurse practitioners are positioned to provide a very unique type of care to clients with psychiatric disorders. To be successful in this role, you must have a strong theoretical foundation in pathophysiology, psychopharmacology, and neuroscience. This foundation will help you assess, diagnose, and treat clients as you relate presenting symptoms to theoretical neuronal functioning.
This week, as you begin to study psychopharmacology, you explore foundational neuroscience. You examine the agonist-to-antagonist spectrum of action of psychopharmacologic agents, compare the actions of g couple proteins to ion gated channels, and consider the role of epigenetics in pharmacologic action.
Note: In previous courses, the term “patient” was used to describe the person receiving medical care. In traditional medicine and nursing, this term is used to describe the person you do something to, and it often refers to a passive recipient of care and services. As you move into the realm of psychiatric mental health, a transition will occur. You will work with individuals who are active participants in their care, and these individuals are generally referred to as “clients” as opposed to “patients.” It is important to note that the term “client” is also favored in other mental health disciplines, such as psychiatry, psychology, and social work.
Neuroscience is the scientific study of the human central nervous system to understand the brain’s dysfunction that can lead to disease, mental disorders, and physical impairment (Karmarkar & Plassmann, 2019). The complex design of a neuron is the basic understanding of communication by sending impulses to other body organs. The brain controls human behavior and the functions of body organs. The anatomy and physiology of the brain help understand the part of the brain affected by mental illness. For example, poor concentration and cognitive skills dysfunction is the forebrain pathology. Additionally, one can understand the mode of action of psychopharmacology. For example, antidepressants may function by inhibiting the serotonin or epinephrine receptors.
An Agonist-To-Antagonist Spectrum of Action and How Partial and Inverse Agonists Influence Psychopharmacologic
An antagonist binds at the receptors by blocking any event of an agonist, hence, blocking the biological response. For example, naloxone is a competitive opioid antagonist and has no effects with opioid co-administration (Gicquelais, et al, 2019). An agonist binds to a receptor causing activation of the receptor, hence, the biological response. A partial agonist activates the receptors partially with lesser effect on the brain. For example, buprenorphine is a partial agonist, and therefore, an antagonist may block its opioid function without activating its receptors. An inverse receptor binds with constitutively active receptors and inhibits receptor activity by exerting opposite pharmacological effects that suppress spontaneous receptor signaling.
Comparison between Actions of G Couple Proteins and Ion Gated Channels
G coupled proteins GPCRs are integral membrane proteins that convert extracellular responses to hormones, neurotransmitters, olfaction, and taste signals. The GPCRs work by binding to the hormones, neurotransmitters, and growth factors to initiate a cellular response. The three types of G-couple receptors are alpha, beta, and gamma, in which the ligands bind and activate (Yudin & Rohacs 2019). Ion gated channels are integral membrane proteins of excitable cells that allow a flux of ions to pass only under defined circumstances. These channels are voltage-gated sodium channel neurons and ligand-dated acetylcholine receptors of the cholinergic synapses. 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.
The Role of Epigenetics In the Pharmacologic Action
Epigenetics regulate gene activity by switching off the gene activity or activating the gene activity. Epigenetics plays a role in the phenotypic activity of the cell in diseases such as cancer and neurodegenerative disorders such as Alzheimer’s disease. Epigenetics modify gene expressions after drug administration to counteract the disease states in humans. Epigenetics proves its effectiveness in treating psychiatric and neurodegenerative disorders to its ability to modify gene expressions.
The Significance of the Information to Psychiatric Mental Health Nurse Practitioner
A psychiatric mental health nurse practitioner should have basic knowledge of the concepts of foundational neuroscience. Understanding the function of agonists, inverse and partial agonists, and antagonists prevent co-administration of drugs that agonize and antagonize 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
Gicquelais, R. E., Bohnert, A. S., Thomas, L., & Foxman, B. (2020). Opioid agonist and antagonist use and the gut microbiota: associations among people in addiction treatment. Scientific reports, 10(1), 1-11. https://doi.org/10.1038/s41598-020-76570-9
Karmarkar, U. R., & Plassmann, H. (2019). Consumer neuroscience: Past, present, and future. Organizational Research Methods, 22(1), 174-195.
https://doi.org/10.1177%2F1094428117730598
Yudin, Y., & Rohacs, T. (2019). The G‐protein‐biased agents PZM21 and TRV130 are partial agonists of μ‐opioid receptor‐mediated signalling to ion channels. British journal of pharmacology, 176(17), 3110-3125. https://doi.org/10.1111/bph.14702