Discussion: Foundational Neuroscience
1. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents. 2. Compare and contrast the actions of g couple proteins and ion gated channels. 3. Explain the role of epigenetics in pharmacologic action. 4. 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 Discussion: Foundational Neuroscience.
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Discussion: Foundational Neuroscience
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: Discussion: Foundational Neuroscience
- 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 medications
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden 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” Discussion: Foundational Neuroscience
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.
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.
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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 Discussion: Foundational Neuroscience.
Foundational Neuroscience
The agonist-antagonist interaction is an important facet of a drug action in pharmacology. According to studies, the agonist-antagonist spectrum works in opposite ways. An antagonist works by activating the receptors of the psychopharmacological agents fully. By binding to these receptors, agonists produce a complete functional response to the psychopharmacological agent. During its mode of action, the agonists can produce full, partial, or inverse functional responses (Stahl, 2013). On the other hand, antagonists work by reversing the impacts of agonist agents. Antagonism occurs in two ways including competitive and non-competitive antagonism. With regard to the competitive antagonist, the effect can be reversed by increasing the agonist dose. Given that both the agonist and the antagonist bind to the same site, the dose-response curve is moved to the right of the curve. However, even as the shift occurs, the maximum response obtained will remain the same. On the other hand, the noncompetitive antagonist’s action cannot be reversed by increasing the dose of the agonist. The phenomenon occurs since the receptor binding sites of the two are disparate, implying that the agonist will not displace the antagonist molecule Discussion: Foundational Neuroscience.
Further, g couple proteins and ion gated channels are important messengers in the system. G couple protein is a GTP-binding protein, which is responsible for relaying signals from a signal receptor found on the plasma membrane. This receptor is called G-protein coupled receptor and it transduces the signal to the other side of the cell proteins. Conversely, the ion gated channel opens and closes thus permitting certain ions to go through the receptor channels (Ehlert, 2015). Thus, the ion gated channels is a protein pore within cell membranes that closes or opens in response to a ligand- a signaling chemical-, which then allows or closes the passage of specific ions. Impor5tantly though, both kinds of receptors have their ligands remaining outside the cells even as the signal transduction occurs. Nevertheless, while the ligand gated ion channel allows transport of ions into the cell across its membrane, the g coupled proteins only change their shapes to facilitate a molecule that initiates the signaling process.
Latest advances in understanding the gene regulation process have revealed that the gene undergoes a substantial regulation that initially considered, via epigenetic regulation. The epigenetic mechanism systems have evolved to either fine-tune or switch off the genetic activation (Jangra et al., 2016). Further, the epigenetic regulation of gene activity has been demonstrated to possess important role in maintaining the phenotypic activity of cells, in addition to playing a role in the advancement of cancers and Alzheimer’s. However, the disease conditions are countered by newer classes of drugs, which regulate epigenetic mechanisms. In other words, epigenetics plays a significant role in the regulation of dug transporters and drug-metabolizing enzymes Discussion: Foundational Neuroscience.
The above information is certainly important in the prescription of drugs in a psychiatric unit. Given that the psychotropic drugs work by altering the way that neurotransmitters send messages across the synapses, the phenomena addressed above are significant. Specifically, in a case wherein the psychiatric condition is accompanied by psychosis, it becomes fundamentally important for the psychiatric nurse to understand the mechanism of action of psychotic drugs (Sheifes et al., 2016). In this case, the mental health nurse practitioner needs to understand the exact target of the psychotic drug. Moreover, the nurse needs to decipher the mechanisms of action of antipsychotics-whether second-generation or atypical- so as to effectively decide the prescription.
References
Ehlert, F. J. (2015). Affinity and efficacy: The components of drug-receptor interactions. Hackensack, NJ : World Scientific.
Jangra, A., Sriram, C. S., Pandey, S., Choubey, P., Rajput, P., Saroha, B., & … Lahkar, M. (2016). Epigenetic Modifications, Alcoholic Brain and Potential Drug Targets. Annals Of Neurosciences, 23(4), 246-260. doi:10.1159/000449486
Scheifes, A., Egberts, T. G., Stolker, J. J., Nijman, H. I., & Heerdink, E. R. (2016). Structured Medication Review to Improve Pharmacotherapy in People with Intellectual Disability and Behavioural Problems. Journal Of Applied Research In Intellectual Disabilities, 29(4), 346-355.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press Discussion: Foundational Neuroscience.