Feb 23, 2024 Week 1: Introduction to Neuroscience NURS 6630
Week 1: Introduction to Neuroscience NURS 6630
Pharmacological agents produce both agonist and antagonist actions in different receptors in the human body. The agonist and antagonist actions of pharmacological agents work against one another. The agonists combine with the receptor to produce an action in the body. On the other hand, antagonist action hinders or opposes the action by a receptor, thereby, leading to a failure of an occurrence of an event. The effect of agonists is attributed to the combination it has with compounds or chemical substances to promote the desired action while that of antagonist entails the combination with chemicals or blockage of neurotransmitters to cause interference with action. Partial and inverse agonists have an effect on the efficacy of psychopharmacological agents. Partial agonists bind to a specific receptor to produce partial efficacy at that receptor that is relative to the effect of full agonist. The partial enhancement of the actions of the receptor results in a net decline in the activation of the receptor hence, average activity of the receptor in producing the desired action. Inverse agonists work by binding to a receptor as an antagonist to produce an action that is opposite to that of the agonist (Demler, 2019). Inverse agonists mimic the agonist activity of the receptors, hence, the desired therapeutic activity of psychopharmacological agents.
G-couple proteins and ion-gated channels are the mechanisms in which cells communicate to produce actions. They comprise of the cell-surface receptors that play the roles of signal transfer in multicellular organisms. The two however differ in a number of aspects. Ion-gated channels have receptors that bind to a ligand to cause opening of channels via membranes to allow the passage of specific ions. Ion-gated channels do not allow the passage of fatty acids and amino acids because they are hydrophobic in nature. Ion-gated channels therefore mediate rapid, post-synaptic responses. G-proteins channels on the other hand have receptors that bind and active G-protein on cell membranes. The activation of G-proteins results in cyclic series that cause entry of proteins such as amino acids and fatty acids into the cell to produce action (Hood & Khan, 2020). The G-proteins therefore mediate slow post-synaptic responses.
Epigenetics has a role in pharmacologic actions of drugs. Firstly, changes in the expression of enzymes that metabolize drugs may affect the action as well as metabolism of a drug. For example, changes in enzymes due to aspects such as DNA methylation affects the metabolism of drugs, leading to their altered effectiveness. The addition of methyl group to the cytosine pyrimidine ring causes silencing of transcription, thereby, hindering the binding of co-activators and transcription factors that are needed for metabolism and action of drugs. The second influence of epigenetics is the genetic variations in the transporters of drugs. A genetic change in the transporters of drugs such as ATP binding cassette transporters and solute carrier transporter affect the binding and action of pharmacological agents (Castelo-Branco & Jeronimo, 2020).
The above information will affect my prescribing of medications to patients. For instance, it will translate into my understanding of the disease process and the targets of the medications that I prescribe to the patients. The implication of the information also entails the need for comprehensive patient assessment to identify any relevant patient history that may affect the effectiveness of the prescribed medications. I should also be aware of the contraindications of specific medications to patients with history of allergies or comorbid conditions (Hood & Khan, 2020). Therefore, the information will inform my safe prescribing in my professional role as an advanced practice nurse.
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References
Castelo-Branco, P., & Jeronimo, C. (2020). Histone Modifications in Therapy. Elsevier Science.
Demler, T. L. (2019). Pharmacotherapeutics for Advanced Nursing Practice, Revised Edition. Jones & Bartlett Learning.
Hood, P., & Khan, E. (2020). Understanding Pharmacology in Nursing Practice. Springer Nature.
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Week 1: Introduction to Neuroscience NURS 6630
Modern psychopharmacology is largely the story of chemical neurotransmission. To understand the actions of drugs on the brain, to grasp the impact of diseases on the central nervous system, and to interpret the behavioral consequences of psychiatric medicines, one must be fluent in the language and principles of neurotransmission.
—Dr. Stephen M. Stahl in Stahl’s Essential Psychopharmacology
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.
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:
Analyze the agonist-to-antagonist spectrum of action of psychopharmacologic agentsCompare the actions of g couple proteins to ion gated channelsAnalyze the role of epigenetics in pharmacologic actionAnalyze the impact of foundational neuroscience on the prescription of medicationsLearning 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 this link provided.
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)
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.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!
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.Read a selection of your colleagues’ responses.
By Day 6
Respond to two colleagues 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.Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 1 Discussion
Making Connections
Now that you have:
Explored foundational neuroscienceExamined how medications impact the central nervous systemNext week, you will focus on how neuroscience can be applied to pediatric clients presenting with mood disorders.
To go to the next week:
Week 2
The example you used for treating anxiety was a great way to differentiate between an agonist and a partial agonist. According to Melarango (2021) SSRIs and SSNIs are t first-line treatment options. Buspirone can be used if they are not tolerated well or as an adjunct treatment. This drug is not habit-forming unlike the benzodiazepines Melarango (2021). An agonist such as a benzodiazepine can be used for short-term use in acute conditions. 5 HT can act on the postsynaptic receptor which then causes excitation of the membrane causing anxiety. Buspirone can also act on the pre-synaptic 5 HT 1A receptors binding to it thus decreasing anxiety. Benzodiazepines have a greater affinity of GABA A receptor (Melarango, 2021). GABA increases the frequency of chloride-channel opening and potentiates the inhibitory effect of GABA in the central nervous system. Prescribing Buspirone to a patient would be a better choice in a non-acute situation. As you stated, benzodiazepines have unwanted side effects. This medication is so abused in my line of work. Many patients are taking large amounts when they come into the office. It is unfortunate that some prescribers continue to prescribe Xanax at 2mg BID, along with methadone and buprenorphine, These patients are sent to detox off this medication due to the dangers of abruptly stopping it.
Melarango, A. (2021). Pharmacotherapy for Anxiety disorders-First line options for treatment resistance. Focus, 19(2), 145-160. https://doi.org/10.1176/appi.focus.20200048
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