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NURS6630 Week 1 Discussion: Foundational Neuroscience

NURS6630 Week 1 Discussion: Foundational Neuroscience

NURS6630 Week 1 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.

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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”

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.

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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. NURS6630 Week 1 Discussion: Foundational Neuroscience

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To prepare for this Discussion:

  1. Review this week’s Learning Resources.
  2. Reflect on concepts of foundational neuroscience.

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.

  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.

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 medication

Foundational Neuroscience Sample Discussion Main Post

To effectively treat and care for our patients with mental health issues, we as mental health nurse practitioners must have a basic understanding of neurobiology. See week 9 assignment here.

The Agonist-to-Antagonist Spectrum of The action of Psychopharmacologic Agents

An antagonist binds to a receptor and prevents a response from occurring, whereas an agonist binds to a receptor and causes a response to occur. A receptor’s activity can be increased by agonists via their intrinsic efficacy, but an antagonist can be decreased by agonists (Berg & Clarke, 2018). Agonist, partial agonist, antagonist, and inverse agonist are all parts of the agonist to antagonist spectrum of medicinal medicines (Berg & Clarke, 2018). When linked to the 5-HT2A and 5-HT2C receptors, the majority of conventional and atypical antipsychotics have an inverse agonist effect. A full agonist binds to receptors and exerts the same effect; an inverse agonist does the reverse (Sullivan et al. 2015).

G-protein Coupled Receptors and Ion Gated Channels

Both proteins involved in membrane transport and intracellular communication are G-protein coupled receptors and ligand-gated ion channels (Duncan et al., 2020). Both ligand-gated ion channel transmembrane receptors and G-protein coupled receptors regulate the opening and closing of ion channels, allowing extracellular ions to move inside cells.

The opening or closing of postsynaptic ion channels is accomplished in different ways by two families of receptor proteins. First is the ionotropic receptors linked directly to ion channels. These receptors contain an extracellular site that binds neurotransmitters and a membrane-spanning domain that forms an ion channel. The second is the G-protein coupled receptors do not have ion channels as part of their structure; instead, they affect channels by the activation of intermediate molecules called G-proteins (Purves et al., 2001).

Epigenetics in Pharmacology

Epigenetics refers to the regulation of gene expression through alterations in DNA or associated factors. These factors control the diverse manifestations of diseases. Understanding the epigenetic modification may lead to new therapies for diseases (Feinberg, 2018). The understanding of the actual function of the entire genome has made pharmacology to be modified further in tackling diseases not in the conventional ‘drug‐receptor’ sense, but in a more ‘global‐response’ sense. Epigenetic regulatory mechanisms may span more than one gene or family of proteins that regulate large groups of genes. Pharmacological agents targeting epigenetic changes have formed the bases of drug treatment of specific disease entities (Stefanska & MacEwan, 2015).

Impact of Foundational Neuroscience on the Prescription of Medication.

According to Seo et al., (2018), Olanzapine as an antipsychotic modifies epigenetic changes in the BDNF gene. Serotonin, histamine, and dopamine as neurotransmitters utilize the ligand-gated ion channels mechanism to allow for ionic influx into the inner cell membrane. This action triggers signaling processes. The knowledge of the effect of agitation and schizophrenia on the central nervous system coupled with the mechanism of action, side effects, or toxicity of the antipsychotic (Olanzapine) will enable the nurse practitioner to prescribe the appropriate medication for patients.

A patient presented with severe agitation, visual and auditory hallucinations, and delusions. Equipped with the knowledge of the mechanism of action of Olanzapine, the Nurse practitioner gathered information about the patient’s past medical history that could affect the metabolism, efficacy, and toxicity of the medication. For example, Olanzapine is metabolized in the liver and excreted by the kidney. The Nurse Practitioner rules out any liver and kidney disease.

In conclusion, understanding the basics of neuroscience, epigenetic changes, and cell communication is important to mental health providers.

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
  • Duncan, A. L., Song, W., & Sansom, M. S. (2020). Lipid-dependent regulation of ion channels and G protein-coupled receptors: Insights from structures and simulations. Annual Review of Pharmacology and Toxicology, 60(1), 31-50. https://doi.org/10.1146/annurev-pharmtox-010919-023411
  • Feinberg, A. (2018). The key role of epigenetics in human disease prevention and mitigation. N Engl J Med. DOI: 10.1056/NEJMra1402513. https://www.nejm.org/doi/full/10.1056/nejmra1402513
  • Purves D, Augustine GJ, & Fitzpatrick D. (2001). Two Families of Postsynaptic Receptors. Neuroscience. 2nd edition. Sunderland (MA): Sinauer Associates; 2001. https://www.ncbi.nlm.nih.gov/books/NBK10855/
  • Seo, M. K., Kim, Y. H., McIntyre, R. S., Mansur, R. B., Lee, Y., Carmona, N. E., Choi, A. J., Kim, G., Lee, J. G., & Park, S. W. (2018). Effects of antipsychotic drugs on the epigenetic modification of brain-derived neurotrophic factor gene expression in the hippocampi of chronic restraint stress rats. Neural Plasticity, 2018, 1-10. https://doi.org/10.1155/2018/2682037
  • Stefanska, B., & MacEwan, D. J. (2015). Epigenetics and pharmacology. British Journal of Pharmacology, 172(11), 2701–2704. https://doi.org.ezp.waldenulibrary.org/10.1111/bph.13136
  • Sullivan, L., Clarke, W., & Berg, K. (2015). Atypical antipsychotics and inverse agonism at 5-HT<sub>2</sub> receptors. Current Pharmaceutical Design,

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