The Psychiatric Mental Health Nurse Practitioner Assignment

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. The Psychiatric Mental Health Nurse Practitioner Assignment

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Discussion: Foundational Neuroscience

Question 1: Psychopharmacologic agents’ agonist-to-antagonist connection

Agonists initiate a particular action, while an antagonist hinders a specific chemical process or activity. Thus, neurotransmitters that stimulate receptors in the central nervous system (CNS) are considered as agonists. Similarly, some pharmacological agents are classified as agonists since they stimulate receptors (Fasipe, 2018). Additionally, partial agonists are pharmacological agents that act as agonists, although the extent of receptor activation in this reaction is lowered. On the other hand, drugs that are categorized as antagonists block the receptors, preventing them from binding to the agonist.

In the context of opioids, Heroin is considered an agonist, while Naloxone acts as an antagonist. Moreover, Buprenorphine is a partial agonist. Heroin is an agonist that is highly addictive. Naloxone acts as an antagonist in the case of Heroin overdose (France et al., 2021). Consequently, Naloxone reverses the binding receptors and prevents them from binding with accessible Heroin. Furthermore, Buprenorphine, which is a partial agonist, is involved in the pharmacological treatment of cases of Heroin addiction. This medication facilitates partial binding to receptors for opioids, lowering drug craving and preventing severe withdrawal symptoms. These interactions make a pharmacological agent effective in treating heroin overdose without withdrawal symptoms. The Psychiatric Mental Health Nurse Practitioner Assignment

Comparison of the actions of g couple proteins (GPCRs) and ion-gated channels (IGCs)

Postsynaptic receptors are categorized into two significant classes: IGCs and GPCRs. These receptors significantly affect nervous system signaling (Manzini et al., 2022). Moreover, they facilitate direct and rapid change of chemical neurotransmitter messages. Thus, they ensure the chemical message is electrical for easy transfer from one neuron to another. However, the two receptors differ in their functioning mechanism. IGCs bind to a neurotransmitter to open ion channels directly (Manzini et al., 2022). Thus, this neurotransmitter facilitates intercellular communication in the CNS. On the other hand, GPCRs are responsible for the binding of ion channels that occur indirectly following G-protein’s metabolic activation (Manzini et al., 2022). Therefore, GPCRs mediate various physiological responses in the body. As a result, it has significant potential as a therapeutic target for a wide range of illnesses.

Epigenetics’ impact on pharmacologic action

Genetic information described by epigenetics exceeds the data that a gene would code solely. Epigenetics is the mechanism by which the functioning of a gene can be changed without altering the RNA or DNA code (Berdasco & Esteller, 2019). This functional property of the gene can be passed from parents to their offspring. Therefore, epigenetics can influence the development of a particular disease or the working mechanism of specific medication therapy (Berdasco & Esteller, 2019). The efficiency of a pharmacological agent might change if it was initially working on a particular gene with an altered functioning. For example, a person with dopamine formation and receptor binding that has been altered might depict a degree of natural tolerance or drug addiction affinity. This logic also applies to non-addictive substances, explaining why some pharmacological agents might be more effective in one person than another. The Psychiatric Mental Health Nurse Practitioner Assignment

Applying acquired information in medication prescription

A PMHNP must understand the physical aspects and biological mechanisms of medications before prescribing them to persons with various mental health disorders. The prescriber must consider the impact of a specific pharmacological agent on the neurons and the receptors since it would influence the overall mechanism of action. For instance, a PMHNP should consider the working mechanism of Trazodone before prescribing it to an elderly adult patient with difficulty sleeping. Trazodone is a serotonin antagonist because it inhibits serotonin reuptake (Albert et al., 2021). This medication also blocks alpha-receptors, exposing geriatrics to adverse drug-related side effects, especially orthostatic hypotension (Ciccone, 2019). Additionally, Trazodone has anticholinergic effects, increasing the risk of confusion and delirium in geriatrics (Lauretani et al., 2020). Therefore, this pharmacological agent should be used in treating elderly adults with insomnia. The Psychiatric Mental Health Nurse Practitioner Assignment

References

Albert, U., Lamba, P., & Stahl, S. M. (2021). Early response to trazodone once-a-day in major depressive disorder: review of the clinical data and putative mechanism for faster onset of action. CNS spectrums, 26(3), 232-242.

Ciccone, C. D. (2019). Geriatric pharmacology. Guccione’s Geriatric Physical Therapy E-Book, 102.

Fasipe, O. J. (2018). Neuropharmacological classification of antidepressant agents based on their mechanisms of action. Archives of Medicine and Health Sciences, 6(1), 81-94.

Berdasco, M., & Esteller, M. (2019). Clinical epigenetics: seizing opportunities for translation. Nature Reviews Genetics, 20(2), 109-127.

France, C. P., Ahern, G. P., Averick, S., Disney, A., Enright, H. A., Esmaeli‐Azad, B., … & Zapf, J. (2021). Countermeasures for preventing and treating opioid overdose. Clinical Pharmacology & Therapeutics, 109(3), 578-590.

Lauretani, F., Bellelli, G., Pelà, G., Morganti, S., Tagliaferri, S., & Maggio, M. (2020). Treatment of delirium in older persons: what we should not do! International Journal of Molecular Sciences, 21(7), 2397.

Manzini, I., Schild, D., & Di Natale, C. (2022). Principles of odor coding in vertebrates and artificial chemosensory systems. Physiological Reviews, 102(1), 61-154. The Psychiatric Mental Health Nurse Practitioner Assignment