NURS 6630 Discussion: Foundational Neuroscience

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NURS 6630 Discussion: Foundational Neuroscience

Agonist-to-Antagonist

The agonist stimulates an action, whereas the antagonist blocks an action (Stahl, 2013).  Using medications which have an agonist effect can improve symptoms which may be undesirable (Stahl, 2013).  To that, an antagonist would provide the opposite an agonist, which could be beneficial in a situation of overstimulation (Stahl, 2013).

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G Couple Proteins & Ion Gated Channels

Receptors linked to G proteins consist of seven-transmembrane regions and includes a binding site for a neurotransmitter (Stahl, 2013).  At the binding site, changes to the actions of the receptor can occur similarly to the normal actions of this receptor due to the imitation or blocking of the neurotransmitter (Stahl, 2013).  The action of drugs at these receptors can occur as full or partial agonist and antagonism; although typically, the drugs in which act on G protein linked receptors act as an antagonist (Stahl, 2013).

Ion channels, both a channel and a receptor, are proteins which allow for the transport of sodium, potassium and calcium to move into and out of the cell once it has bound to a chemical messenger known as a ligand, such as a neurotransmitter, hormone or drug (Stahl, 2013).  The ligand can increase or decrease the opening of the ion channel to control the movement of ions (Stahl, 2013). These, unlike G couple protein, are a four-transmembrane region, and when combined with 5 copies, they form a pentameric receptor (Stahl, 2013).

G couple proteins and ion gated channels function differently, despite both being receptors.  However, agonists and antagonist play a role with both proteins.  In ligand gated ion channels, the agonists allow for the ion channel to open fully, whereas the antagonist does the opposite and instead stabilizes the receptor (Stahl, 2013). NURS 6630 Discussion: Foundational Neuroscience

Epigenetics

Epigenetics is specific to the individual person and how their genetic makeup function and regulation (Deans & Maggert, 2015). Having such specific information can allow for improved individualized treatment with medications to better treat the patient, and often avoid unwanted side effects (Deans & Maggert, 2015).  By altering the structure of chromatin, “epigenetic mechanisms” turn genes on or off and can determine whether patients experience psychiatric disorders and how they may react to a medication (Stahl, 2013).

Epigenetic changes which occur in the brain due to abuse of substances can alter the action of a medication and such changes within the brain may warrant the choice of a different medication selection as a result (Knight, 2014).

A previous patient I worked with was suffering from depression and anxiety which was uncontrolled as a result of the patient’s inability to take medications to treat the depression and anxiety.  This patient had side effects with every medication which had been prescribed to treat these symptoms.  After several failed attempts, the psychiatric nurse practitioner of our office decided genetic testing would most likely benefit this patient.  Through this, the drug class which would likely be beneficial to the patient was identified.  A medication was prescribed, the patient experienced no side effects as well as relief of symptoms. NURS 6630 Discussion: Foundational Neuroscience

Example

Psychiatric illness is the result of an imbalance within the brain, therefore being aware of the medications which correct the imbalance while being mindful of whether the medication is also appropriate for the patient in terms of other comorbidities and current medications of the patient being treated (Mental Health America, 2019).  For instance, older adults taking diuretics or other cardiac medications may need to avoid certain medications to treat psychiatric disorders depending on the mechanism of action (Mental Health America, 2019).

Resources:

Deans, C. & Maggert, K. A. (2015). What Do You Mean “Epigenetic”? Genetics Volume 199 (4), pp. 887-896. DOI: https:// doi.org/10.1534/genetics.114.173492 Retrieved from: http://www.genetics.org/content/199/4/887

Knight, M. (2014). Addiction can be measured by epigenetics. Genetic Literacy Project. EIN: 52-1844456 Retrieved from: https://geneticliteracyproje

Week 2: Neurotransmitters and Receptor Theory

Receptors and neurotransmitters are like a lock-and-key system. Just as it takes the right key to open a specific lock, it takes the right neurotransmitter to bind to a specific receptor. Not surprisingly, as it concerns psychopharmacology, the pharmacotherapeutics that are prescribed must trigger the release of certain neurotransmitters that bind to the correct receptors in order to elicit a favorable response for the patient. The mechanism of this binding and the response that follows reflects receptor theory and lies at the foundation of pharmacology.

This week, you will continue your examination of neuroanatomy and neuroscience as you engage with you colleagues in a Discussion. You will also explore the potential impacts of foundational neuroscience on the prescription of pharmacotherapeutics.

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 medications

Learning Resources

Required Readings (click to expand/reduce)

Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 1–19). Elsevier.

Required Media (click to expand/reduce)

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

Note: Please review all of the media under the neuroanatomy series.

Optional Resources (click to expand/reduce)

Pathopharmacology: Disorders of the Nervous System: Exploring the Human Brain

Dr. Norbert 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. (15m)

 

Introduction to Advanced Pharmacology

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. (6m)

 

Discussion: Foundational Neuroscience

As a psychiatric 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.

Photo Credit: Getty Images/Cultura RF

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.

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.

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 “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 2 Discussion Rubric

Post by Day 3 of Week 2 and Respond by Day 6 of Week 2

To Participate in this Discussion:

Week 2 Discussion


What’s Coming Up in Week 3?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will explore medication adherence and strategies to help overcome non-adherence to pharmacotherapeutics. You will also complete a Quiz that addresses the content covered throughout this module.

Next Week

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