Feb 23, 2024 SELF ASSESSMENT: NEUROBIOLOGY AND MEDICATION ADHERENCE CONCEPTS NURS 6630
SELF ASSESSMENT: NEUROBIOLOGY AND MEDICATION ADHERENCE CONCEPTS NURS 6630
A Sample Answer For the Assignment: SELF ASSESSMENT: NEUROBIOLOGY AND MEDICATION ADHERENCE CONCEPTS NURS 6630
Neurons are information messengers whose role is to transmit information between the areas of the brain and the rest of the nervous system. They have three main parts namely the cell body, axon, and the dendrites (Kringelbach et al., 2020). The cell body is made up of a nucleus and cytoplasm and produces protein required to construct other parts of the neuron.
The axon, on the other hand, extends from the cell body and carries signals away from the cell body while the dendrites carry signals toward the cell body and have numerous synapses to receive the signal from nearby neurons.
Upon stimulation, neurons transmit an electrical impulse that passes through the dendrite, to the cell body, axon, axon terminal, and finally, the stimulus is passed (Kringelbach et al., 2020). At the axonal terminal, the axon releases neurotransmitters that depolarize neighboring cells through synapses and by binding to the membrane of the dendrite.
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Other structures within the brain are subcortical structures that act as information hubs for the nervous system. Their main role is to relay and modulate information circulating in different areas of the brain. They include the basal ganglia, limbic structures, pituitary gland, and the diencephalon (Malinowski, 2019). The limbic systems play a great role in learning and memory addiction. The systems provide the anatomical substrate for emotions and motivated behaviors, including the circulatory for reward-related events and stress responses.
SELF ASSESSMENT NEUROBIOLOGY AND MEDICATION ADHERENCE CONCEPTS NURS 6630
Specifically, the hippocampus is used to mediate a cognitive/spatial form of memory. It controls learning and declarative memory which covers the memory of facts and events (Malinowski, 2019). The dorsal striatum also helps in memory by mediating the stimulus-response habit memory.
Addiction on the other hand is linked to the limbic system through the orbitofrontal cortex and anterior cingulate gyrus (Malinowski, 2019). In line with motor control, the nigra striatal region offers two anatomically and functionally distinct portions knowns as the substantia nigra pars compacta and the substantia nigra pars reticulata.
Other essential components in the central nervous system are the glial cells. They include the astrocytes whose role is to maintain the environment for neuronal signaling by controlling the level of neurotransmitters surrounding the synapses (Hirbec et al., 2020). Equally, oligodendrocytes wrap around the axons forming a protective layer called myelin sheath which enhances neuron signaling.
The cells also include microglia, ependymal cells, and radial glial whose roles are clearing dead cells or removing harmful toxins, maintaining homeostasis, and regenerating neurons and other glial cells like astrocytes and oligodendrocytes respectively.
Neurons communicate with each other through synaptic transmission. A chemical synapse is registered at the axon terminal of the presynaptic neuron and the dendrite of the postsynaptic neuron (Malinowski, 2019).
The dendrite picks up signals and passes the signals down to the axon, into the axon terminals, and into the synapses. The role of the chemical synapse is to transform the electrical signal in the presynaptic cell’s axon into a chemical signal and back into an electrical signal in the postsynaptic cell.
Brain plasticity denotes the ability of the brain to reorganize itself and form new neural connections in response to extrinsic or intrinsic stimuli. Through axonal sprouting, the undamaged axons develop new nerve endings and reconnect neurons with severed or injured links (Mateos-Aparicio & Rodríguez-Moreno, 2019).
For instance, undamaged brain sites of stroke patients rewire themselves to take over functions of the damaged brain sites. Similarly, the undamaged axons sprout nerve endings that connect with other undamaged nerve cells to form new neural pathways (Mateos-Aparicio & Rodríguez-Moreno, 2019). For example, exposing the brain to specific grammatical rules helps it process and develop language.
References
Hirbec, H., Déglon, N., Foo, L. C., Goshen, I., Grutzendler, J., Hangen, E., … & Escartin, C. (2020). Emerging technologies to study glial cells. Glia, 68(9), 1692-1728. https://doi.org/10.1002/glia.23780
Kringelbach, M. L., Cruzat, J., Cabral, J., Knudsen, G. M., Carhart-Harris, R., Whybrow, P. C., … & Deco, G. (2020). Dynamic coupling of whole-brain neuronal and neurotransmitter systems. Proceedings of the National Academy of Sciences, 117(17), 9566-9576. https://doi.org/10.1073/pnas.1921475117
Malinowski, M. N. (2019). Anatomy of the brain and brain stem. In Deer’s Treatment of Pain (pp. 49-59). Springer, Cham.
Psychopharmacological Action
Agonist drugs help to boost or increase the targeted action by performing very similarly to the natural ligand’s action (Mental Health TV, 2022). The antagonist acts to block the receptor sites on the cells from receiving the chemical signals from the presynaptic neurons. Agonist drugs increase action and antagonist drugs decrease action.
Partial agonist function relates to situations where there are parts of the brain that have hyperactive neurotransmission and other parts that have hypoactive neurotransmission. The partial agonist drugs act by blocking, antagonistically, the areas that are hyperactive, and activating, agonistically, the areas that are hypoactive (Mental Health TV, 2022). Inverse agonist both blocks receptor sites and reduces agonist activity (Stahl, 2021). The agonist-to-antagonist spectrum refers to the varied action potentials of these drugs types.
G Couple Proteins and Ion Gated Channels
Both the g coupling proteins channels and the ion gated channels are cell surface receptors that act to receive signals from outside of the cell and transmit that signal to the inside of the cell. As described by their names, the g coupling proteins utilize g proteins for the transmission of signals whereas the ion gated channels use ions of various type to transmit signals. Both cell surface receptors act on an agonist spectrum (Stahl, 2023). Ion flux is passive where g couple protein binding is active and requires energy.
Epigenetics
Epigenetics is defined as an alterations of DNA for the purpose of affecting gene expression (Ben David et al., 2023). Gene silencing or activation may be an advantageous route to improve therapeutic action of psychopharmacological drugs. This is an exciting topic for the effectiveness of pharmacological interventions and is still not well understood.
Prescriptive Rationale
As described by the professor in the Mental Health TV YouTube lecture, Schizophrenia is a classic example to discuss the impact of an antagonist drug. With the hypothesis being that there is too much dopamine, drugs used act to block the action of dopamine neurotransmission may offer symptoms relief, benefit, or improvement (2022).
It is valuable for the prescriber to have an in depth understanding of how to drugs acts on the agonist spectrum when addressing the treatment plan for their patients and the goal for pharmacological interventions.
References:
Ben David, G., Amir, Y., Salalha, R., Sharvit, L., Richter-Levin, G., & Atzmon, G. (2023). Can epigenetics predict drug efficiency in mental disorders? Cells (2073-4409), 12(8), 1173. https://doi.org/10.3390/cells12081173
Links to an external site.
Mental Health TV. (2022, Oct 7). Psychopharmacology-Module four. [Video]. YouTube. https://www.youtube.com/watch?v=46Ioy6SSta4&t=89s
Links to an external site.
Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th Ed.) Cambridge University Press.
Mateos-Aparicio, P., & Rodríguez-Moreno, A. (2019). The impact of studying brain plasticity. Frontiers in cellular neuroscience, 13, 66. https://doi.org/10.3389/fncel.2019.00066 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. Pharmacological agents can act as agonists or antagonists. An agonist binds to the receptor activating an intrinsic response (Berg & Clarke, 2018). Antagonists on the other hand block the agonists mediated responses. Several agonists however exist with an existence of a spectrum measured against the present endogenous agonists in the body, binding to the same receptors. For instance, in the brain, dopamine is the endogenous ligand for dopaminergic receptors, despite the availability of several drugs that also bind to the same dopaminergic receptors. Other examples of agonists include partial and inverse agonists. Partial agonists bind to the receptor, activating it, but display only partial efficacy as compared to full or endogenous agonists. Inverse agonists on the other hand bind to the receptor but inhibit normal activity, excreting an opposing pharmacological action. Compare and contrast the actions of g couple proteins and ion-gated channels. G-protein coupled receptors and ligand-gated ion channels are transmembrane proteins that are components of the postsynaptic ion channels (Egyed et al., 2020). The main difference between ion-gated channels and G-protein coupled receptors is that the former comprises cell membrane pores that allow movement of ions in and out of the cell, once bound to a neurotransmitter, while the latter recognizes several ligands such as small molecules, proteins, and photons to open and close the ion channels via activation of the G-protein, intracellular messenger. Generally, G-coupled proteins are metabotropic while ion-gated channels are ionotropic. Explain how the role of epigenetics may contribute to pharmacologic action. Several classes of new drugs aimed at regulating epigastric mechanisms as a means of counteracting the state of the disease in humans (Rager et al., 2019). The main significance of epigastric mechanisms is to shift the phenotype of the disease towards a healthy phenotype, by maintaining normal cell activity. Epigastric mechanisms have also helped in identifying targeted treatment for neurodegenerative and chronic disorders such as Alzheimer’s and cancer. 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. When prescribing drugs to a patient, it is crucial to understand their mode of action, to ensure that a synergistic effect is achieved (Berg & Clarke, 2018). Consequently, due to drug interactions, dose adjustment may be necessary for drugs that act on the same receptor, or elicit similar effects. For instance, when managing bipolar disorder, patients may be prescribed lithium as the first-line mood stabilizer, together with an SSRI such as sertraline to manage depression. Dose adjustment of the two drugs is necessary given that they both act on 5HT receptors and hence can increase the risks of serotonin syndrome. References Berg, K. A., & Clarke, W. P. (2018). Making sense of pharmacology: Inverse agonism and functional selectivity. International Journal of Neuropsychopharmacology, 21(10), 962–977. https://doi.org/10.1093/ijnp/pyy071 Egyed, A., Domány-Kovács, K., Koványi, B., Horti, F., Kurkó, D., Kiss, D. J., … & Keserű, G. M. (2020). Controlling receptor function from the extracellular vestibule of G-protein coupled receptors. Chemical Communications, 56(91), 14167-14170. https://doi.org/10.1039/D0CC05532H Links to an external site. Rager, J. E., Suh, M., Chappell, G. A., Thompson, C. M., & Proctor, D. M. (2019). Review of transcriptomic responses to hexavalent chromium exposure in lung cells supports the role of epigenetic mediators in carcinogenesis. Toxicology letters, 305, 40-50. https://doi.org/10.1016/j.toxlet.2019.01.011
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