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Discussion: Foundational Neuroscience | Nursing Term Paper

Discussion: Foundational Neuroscience
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.
 
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. 
By Day 3 of Week 2
Post a response to each of the following:
 

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.

 
Rubric Detail
 
Select Grid View or List View to change the rubric’s layout.
 
Name: NURS_6630_Week2_Discussion_Rubric

 
Excellent Point range: 90–100
Good Point range: 80–89
Fair Point range: 70–79
Poor Point range: 0–69
Main Posting: Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
40 (40%) – 44 (44%)
Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources.
35 (35%) – 39 (39%)
Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references.
31 (31%) – 34 (34%)
Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with fewer than two credible references.
0 (0%) – 30 (30%)
Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references.
Main Posting: Writing
6 (6%) – 6 (6%)
Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style.
5 (5%) – 5 (5%)
Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style.
4 (4%) – 4 (4%)
Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors.
0 (0%) – 3 (3%)
Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Posting: Timely and full participation
9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation. Posts main Discussion by due date.
8 (8%) – 8 (8%)
Posts main Discussion by due date. Meets requirements for full participation.
7 (7%) – 7 (7%)
Posts main Discussion by due date.
0 (0%) – 6 (6%)
Does not meet requirements for full participation. Does not post main Discussion by due date.
First Response: Post to colleague’s main post that is reflective and justified with credible sources.
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
7 (7%) – 7 (7%)
Response is on topic, may have some depth.
0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.
First Response: Writing
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in Standard, Edited English.
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in Standard, Edited English.
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
First Response: Timely and full participation
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date.
4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date.
3 (3%) – 3 (3%)
Posts by due date.
0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date.
Second Response: Post to colleague’s main post that is reflective and justified with credible sources.
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
7 (7%) – 7 (7%)
Response is on topic, may have some depth.
0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.
Second Response: Writing
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in Standard, Edited English.
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in Standard, Edited English.
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
Second Response: Timely and full participation
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date.
4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date.
3 (3%) – 3 (3%)
Posts by due date.
0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date.
 
 
 
 
EXAMPLE OF PREVIOUS WORK
 
Discussion: Foundational Neuroscience
 
As a mental health provider, it is essential to have a deeper knowledge and understanding
of the human brain. Neuroscience holds the key to understanding the brain and facilitating more
effective treatments for people with mental health conditions. Psychopharmacology is the branch
of neuroscience that studies how drugs affect the brain and behavior. Virtually any drug that
changes the way we think, and feel does this by altering how neurons communicate with each
other. More than 100 billion neurons in your nervous system communicate with each other by
releasing a neurotransmitter across a tiny space between two neurons called the synapse.
Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents,
including how partial and inverse agonist functionality may impact psychopharmacologic
treatments’ efficacy.
Based on traditional receptor theory, drugs can behave as agonists or antagonists.
Psychoactive drugs can either increase activity at the synapse (these are called agonists) or
reduce activity at the synapse (antagonists). Agonists are drugs with both affinities (they bind to
the target receptor) and intrinsic efficacy (they change receptor activity to produce a response).
Antagonists have affinity but zero intrinsic efficacy; hence, they bind to the target receptor but do
not produce a response (Berg & Clarke, 2018). It is also suggested from the traditional receptor
theory that receptors are inactive unless activated by a ligand. Ligands could act as agonists with
various degrees of intrinsic efficacy or as antagonists with zero intrinsic efficacy (Berg & Clarke,
2018).
A new class of ligands called inverse agonist was discovered that produce the opposite
effect of an agonist. Inverse agonists preferentially bind and stabilize receptors in the inactive
state and thus have negative intrinsic activity. This results in a reduction in spontaneous receptor
activity. A full agonist has high efficacy, producing a full response while occupying a low
proportion of receptors. A partial agonist has lower efficacy than a full agonist. A partial agonist
acts as an antagonist in the presence of a full agonist (if they compete for the same receptors). In
contrast, inverse agonists have negative intrinsic efficacy (the ability to decrease a receptor’s
activity).
Compare and contrast the actions of g couple proteins and ion gated channels.
Acetylcholine is a neurotransmitter that activates two types of cholinergic receptors; an ion
channel and a G-protein coupled receptor (GPCR). GPCRs represent the largest class of cell
surface receptors in humans responsible for converting diverse extracellular signals into the
intracellular molecule called a G protein (Stewart & Fisher, 2015). GPCRs regulate every known
physiological process, and its dysregulation plays a causative role in many diseases (Stewart &
Fisher, 2015). GPCRs act like an inbox for messages in the form of light energy, peptides, lipids,
sugars, and proteins.
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Ion channels are proteins responsible for transporting inorganic ions —primarily Na+, K+,
Ca2+, or Cl (Alberts et al., 2002). Ion channels are gated, which allows them to open briefly and
then close again. In most cases, the gate opens in response to a specific stimulus, such as
mechanical stress. The ability to control ion fluxes through these channels is essential for many
cell functions. Ion channels are responsible for the electrical excitability of muscle cells;
however, they are not restricted to electrically excitable cells. For instance, nerve cells (neurons)
use ion channels for receiving, conducting, and transmitting signals (Alberts et al., 2002).
How the role of epigenetics may contribute to pharmacologic action.
Epigenetics is described as genetic information that is ‘beyond’ or ‘above’ that information
coded solely by our genetic code (Stefanska & MacEwan, 2015). Epigenetic regulation of gene
activity is important in maintaining the normal phenotypic activity of cells and impacting the
development and diseases such as cancer and neurodegenerative disorders such as Alzheimer’s
(Stefanska & MacEwan, 2015). As a result, new drug classes target the regulation of epigenetic
mechanisms to treat diseases among humans. It is interesting to note that epigenetics may modify
how we respond to drugs altering our metabolic and pharmacokinetic handling of drugs
themselves. Thus, microRNAs may assist drug behavior by altering its distribution of
metabolism (Stefanska & MacEwan, 2015). Epigenetic drugs may assist not just in
pharmacological therapy but in pain management as well.
How this information may impact the way you prescribe medications to patients.
When prescribing medications, it is important to provide an individualized treatment
approach. We now know that several factors can affect pharmacologic action, including our
unique biology, genetics, pharmacokinetics, and receptor theory. For example, if a partial agonist
drug is used at the same time as a full agonist, and they both act on the same receptors, then the
partial agonist will act as an antagonist (competing with the full agonist for a finite number of
binding sites). Thus, it reduces the total drug effect. By increasing the full agonist dose, the
partial agonist will be displaced from the receptor; therefore, the efficacy of the full agonist is not
affected.
It is also essential to understand the mechanism of action of psychotropic agents to treat
mental disorders. For example, atypical antipsychotic drugs risperidone and olanzapine have 5-
HT2A antagonist effects, which may enhance the action of serotonin, and therefore increase the
therapeutic effect of the selective serotonin reuptake inhibitors (SSRIs) (Daly et al., 2007).
Research has also shown that the combination of SSRIs and atypical antipsychotics has
synergistic effects on dopamine and norepinephrine release (Tarazi et al., 2002).
References
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Alberts, B., Johnson, A., Lewis, J., et al. (2002). Molecular Biology of the Cell. 4th edition. New
York: Garland Science. Ion Channels and the Electrical Properties of Membranes.
https://www.ncbi.nlm.nih.gov/books/NBK26910
Berg, K. A., & Clarke, W. P. (2018). Making Sense of Pharmacology: Inverse Agonism and
Functional Selectivity. The International Journal of Neuropsychopharmacology, 21(10),
962–977. https://doi.org/10.1093/ijnp/pyy071
Daly, E. J., & Trivedi, M. H. (2007). A review of quetiapine in combination with antidepressant
therapy in patients with depression. Neuropsychiatric disease and treatment, 3(6), 855–
867. https://doi.org/10.2147/ndt.s1862
Stefanska, B., & MacEwan, D. J. (2015). Epigenetics and pharmacology. British Journal of
Pharmacology, 172(11), 2701–2704. https://doi.org/10.1111/bph.13136
Stewart, A., & Fisher, R. A. (2015). Introduction: G protein-coupled receptors and RGS proteins.
In Progress in molecular biology and translational science (Vol. 133). Academic Press.
Tarazi, F.I., Zhang, K.H., & Baldessarini, R.J. (2002). Long-term effects of olanzapine,
risperidone, and quetiapine on serotonin 1A, 2A, and 2C receptors in rat forebrain
regions. Psychopharmacology, 161:263–70.
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