Feb 23, 2024 NURS 6630 Neurobiology and Medication Adherence Concepts
NURS 6630 Neurobiology and Medication Adherence Concepts
A Sample Answer For the Assignment: NURS 6630 Neurobiology and Medication Adherence Concepts
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.
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.
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NURS 6630 Neurobiology and Medication Adherence Concepts
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.
Quiz: Neurobiology and Medication Adherence Concepts
Photo Credit: Getty Images
By Day 7
Complete the 20-question Quiz to gauge your understanding of this module’s content.
Submission Information
Submit Your Quiz by Day 7
To submit your Quiz:
Week 3 Quiz
What’s Coming Up in Module 2?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In the next module, you will begin to apply your assessment and therapy skills in treating patients for disorders with affective components.
Next Module
To go to the next module:
Module 2
Week 3: Concepts in Assessing Medication Adherence and Strategies to Mitigate Non-Adherence
Poor adherence to psychiatric treatments is a widespread clinical problem that negatively impacts rates of treatment response and remission. While empirically-supported treatments are available for many psychiatric disorders, these treatments are not universally effective. Patients commonly face difficulties in taking prescribed psychotropic medications or attending psychotherapy sessions as recommended, and therefore may not achieve optimal outcomes.
—Traeger, L., Brennan, M. M., & Herman, J. B. (2016, p. 20)
This week, you will explore how medication adherence can impact a patient’s success with treatment. You will examine the epidemiology of adherence, the impact of non-adherence from a clinical and economic viewpoint, risk factors for non-adherence, assessing adherence, and integrating adherence into a treatment plan. You will also complete a Quiz to test your understanding of this module’s content.
Reference:
Traeger, L., Brennan, M. M., & Herman, J. B. (2016). Treatment adherence. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 20–26). Elsevier.
Learning Objective
Students will:
Identify concepts related to neuroanatomy, receptor theory, and medication adherence in psychopharmacology
Learning Resources
Required Readings (click to expand/reduce)
Traeger, L., Brennan, M. M., & Herman, J. B. (2016). Treatment adherence. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 20–26). Elsevier.
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Fialko, L., Garety, P. A., Kuipers, E., Dunn, G., Bebbington, P. E., Fowler, D., & Freeman, D. (2008). A large-scale validation study of the medication adherence rating scale (MARS). Schizophrenia Research, 100(1–3), 53–59. https://doi.org/10.1016/j.schres.2007.10.029
LaMorte, W. W. (2019). The transtheoretical model (stages of change). Boston University School of Public Health. https://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories6.html
The transtheoretical model of health behavior change by Prochaska, J. O., & Velicer, W. F., in American Journal of Health Promotion, Vol. 12/ Issue 1.
Copyright 1997 by Sage Publications, Inc.Reprinted by permission of Sage Publications, Inc. via the Copyright Clearance Center.
Required Media (click to expand/reduce)
Centers for Disease Control and Prevention. (2017). Overcoming barriers to medication adherence for chronic diseases [Video]. https://www.cdc.gov/grand-rounds/pp/2017/20170221-medication-adherence.html
Quiz: Neurobiology and Medication Adherence Concepts
Photo Credit: Getty Images
By Day 7
Complete the 20-question Quiz to gauge your understanding of this module’s content.
Submission Information
Submit Your Quiz by Day 7
To submit your Quiz:
Week 3 Quiz
What’s Coming Up in Module 2?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In the next module, you will begin to apply your assessment and therapy skills in treating patients for disorders with affective components.
Next Module
To go to the next module:
Module 2
QUESTION 1
Of the components of patient-focused interventions to enhance adherence, which component includes the following strategies: adaptive thinking, use of cues, and support?
A.MotivationB.SkillsC.LogisticsD.Education
0 points
QUESTION 2
Motivation is a component of patient-focused interventions to enhance adherence. Based on the transtheoretical model, readiness to change can fluctuate across five stages. Which stage is represented by the patient who is aware that a problem exists and, while seriously thinking about overcoming it, has not yet committed to a plan of action?
A.PreparationB.ActionC.ContemplationD.Maintenance
0 points
QUESTION 3
Glia cells play a supportive role to the neuron. A few of the functions of the glial cells include providing nutrition, maintaining homeostasis, stabilizing synapses, and myelinating axons. The glial cells are categorized as microglia and macroglia. Of these two cell types, which one plays an active and critical role in glutamatergic neurotransmission by providing a co-agonist required for glutamate receptor function?
A.microglialB.macroglial
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QUESTION 4
Introducing adherence in facilitating treatment goals is something that would be necessary in a patient who has previously displayed nonadherence patterns.
A.TrueB.False
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QUESTION 5
Which neurotransmitter is considered the major excitatory neurotransmitter?
A.GlycineB.GABAC.GlutamateD.Serotonin
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QUESTION 6
Receptors trigger one of two effector pathways resulting in changes in neuronal activity. These changes will, ultimately, effect gene expression. Which effector pathway is characterized by ion flux through transmitter-activated channels resulting in an altered membrane potential and neuronal activity?
A.Slow effector pathwaysB.Modulated effector pathwaysC.Rapid effector pathwaysD.NMDA glutamate receptor pathways
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QUESTION 7
If a patient admits to taking his medication every other day (instead of daily, as prescribed), a potential concern would be:
A.Sufficient understanding or acceptance of the illnessB.Abuse of the medicationC.ExpenseD.Is the desired effect recognized at a lower daily dose?
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QUESTION 8
1Neurons are classified in several different ways. From the following statements, select which ones are true.The two structural classifications are projection neurons and local inter-neurons.Function classifications are made up of two subcategories: excitatory and inhibitory.Histological classification includes bipolar, unipolar, and multipolar.Classifications using a combination of structural, functional, and neurotransmitter type provide the most robust and useful description.
Classification by neurotransmitter type alone provides the most useful description.
A.I onlyB.III onlyC.I, II, and V onlyD.I, II, III, IV, and VE.I, III, and IV
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QUESTION 9
The synaptic cleft is best characterized by which of the following statements?
A.The synaptic cleft is the space between a single neuron’s dendrites and axon terminals in which intracellular communication occurs through the release of neurotransmitters allowing for signal conduction throughout the central nervous system.B.The synaptic cleft is the space between the cell body and axon terminals that allows for release of neurotransmitters from the presynaptic neuron for intercellular communication with an adjacent neuron (post synaptic neuron).C.The synaptic cleft is an area where dendrites and axon terminals are within close proximity, allowing for the release of a neurotransmitter from a presynaptic neuron that can interact with receptors on dendritic cells of a post synaptic neuron, which is the main basis for intercellular communication of neurons.
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QUESTION 10
Which of the following consists of all the known major neurotransmitters that are relevant in psychiatry?
A.glutamate, GABA, dopamine, serotonin, norepinephrine, histamine, steroids, nitric oxideB.glutamate, GABA, dopamine, norepinephrine, serotonin, acetylcholine, histamine, endogenous opioids, steroids, cannabinoids, nitric oxideC.glutamate, GABA, dopamine, serotonin, acetylcholine, endogenous opioids, nitric oxide, cannabinoids, steroidsD.glutamate, GABA, dopamine, serotonin, norepinephrine, endogenous opioids, steroids, histamine, nitric oxide
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QUESTION 11
G-protein coupled receptors are targets for several psychiatric medications. Given what we know about these receptors, what is the ultimate result we will see when one of them is activated in a way that would potentiate an action?
A.Intracellular activation of second messengersB.Protein phosphorylationC.Modification of gene expression
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QUESTION 12
Neurotransmitters are defined by four essential characteristics. These are:
A.Neurotransmitters are synthesized within presynaptic neurons.B.Depolarization of a neuron results in the release of a neurotransmitter, which exerts a multitude of actions on the postsynaptic neuron.C.Their action on postsynaptic neurons can be replicated by administering a drug that mimics the activity of the endogenous neurotransmitter.D.Their action in the synaptic cleft is terminated by a specific action.E.A, C, and D only
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QUESTION 13
Treatment adherence is affected by several different factors. Clinical factors include mood, anxiety, psychosis, and substance misuse. There are also patient factors such as knowledge, attitude, and beliefs; economic and racial/ethnic disparities, and clinical encounters. A patient who presents hopeless, with decreased energy, and poor concentration is affected by which factor?
A.Substance misuseB.Knowledge deficitsC.Attitude ad belief systemD.Mood
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QUESTION 14
Serotonin (5HT) is a neurotransmitter associated with mood, sleep, and psychosis. There are several serotonin receptors all over the human body. A unique aspect of the second generation antipsychotics is their ability to block 5HT2a receptors. What is the effect of this inhibition?
A.Stabilizes dopamine concentrations in the CNSB.Induces anxietyC.Causes hallucinationsD.Reduces platelet function
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QUESTION 15
G-protein coupled receptors are examples of what type of effector pathway?
A.Slow effector pathwaysB.Rapid effector pathwaysC.NMDA glutamate receptor pathwaysD.Modulated effector pathways
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QUESTION 16
The human brain is subcategorized into four major structures. These structures include the cerebral cortex, brainstem, subcortical structures, and the cerebellum. Of these major categories, which one houses the area of the brain that has been found in some neuropathological studies of patients with schizophrenia to be of smaller size?
A.Cerebral cortexB.BrainstemC.Subcortical structuresD.Cerebellum
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QUESTION 17
When dopamine (subtype 2) receptors are blocked in this pathway (system), it is evident by EPS.
A.MesocorticalB.TuberoinfundibularC.NigrostriatalD.Mesolimbic
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QUESTION 18
A patient arrives in the ED via EMS having a grand mal seizure. The ED physician instructs the RN to give 10 milligrams of Diazepam IV X1 dose STAT. The patient’s seizure breaks within 2 minutes of the Diazepam being administered. The mechanism by which this medication causes rapid resolution of seizure activity is via which receptor type (effector pathway/receptor subtype)?
A.Slow effector pathways/G-protein coupled receptorB.Slow effector pathway/ion channelC.Rapid effector pathways/G-protein coupled receptorD.Rapid effector pathway/ion channel
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QUESTION 19
Upon blocking a Serotonin reuptake pump, what happens in the synaptic cleft and on the post synaptic cell membrane?
A.The result will be an increase in available Serotonin in the synaptic cleft causing the post synaptic cell to increase the number of Serotonin receptors.B.The result will be an increase in the available Serotonin in the synaptic cleft causing the post synaptic neuron to reduce the number of Serotonin receptors.C.The result will be an increase in Serotonin in the synaptic cleft resulting in an increase in reuptake pumps on the presynaptic neuron.D.The result will be an increase in Serotonin in the synaptic cleft resulting in a decrease in reuptake pumps on the pre-synaptic neuron.
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QUESTION 20
Neurotransmission is unidirectional insofar as chemical and electrical conduction is concerned within the individual neuron. Of the following descriptions, which best characterizes the order of neurotransmitter/receptor interaction that results in an electrical signal impulse and the release of another neurotransmitter for interaction in the synaptic cleft (signal conduction through a neuron)?
A.Cell body, dendrites, Axon, Axon terminalsB.Dendrites, Axon, Cell body, Axon, Axon terminalsC.Dendrites, Cell body, Axon, Axon terminalsD.Axon terminals, Axon, Cell body, Dendrites
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