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3 scholarly citations within the last 5 years
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Share how and why your colleagues’ posts influenced your understanding of these concepts. Include any additional information you learned.
If you believe your colleagues have misunderstood these concepts, offer your alternative viewpoint and be sure to explain why. Include resources to back up your point of view.
1st discussion post response
Psychopharmacologic agents’ agonist-to-antagonist action spectrum.
The agonist spectrum, according to Stahl (2013), progresses from full agonist to partial agonist via antagonist to inverse agonist. Agonist is a naturally occurring neurotransmitter or drug that binds to receptor sites in order to produce the desired effect. Because they function to a lesser extent than the natural chemical, some drugs can be partial agonists or stabilizers. Antagonists are drugs that bind to receptor sites in the presence of an agonist to inhibit the desired effect; thus, they cannot function in the absence of an agonist. An inverse agonist can also reduce activity below the baseline in the absence of an agonist by blocking the desired stimulating effect of the agonist.
Compare the functions of g couple proteins and ion-gated channels.
Ion gated channels are ion channel proteins that allow the passage of ions such as chloride, calcium, potassium, and sodium upon binding with a neurotransmitter, making it ionotropic, whereas G-coupled protein channels activate the messenger G protein to identify a wide range of ligands to open or close ion channels, making it metabotropic. Ligand-gated ion channels interact with ion channels but not with G-protein coupled receptors.
Postsynaptic receptors on postsynaptic neurons include ligand-gated ion channels and G-protein coupled receptors. They collaborate with ion channels to depolarize and hyperpolarize the cell membrane of the post-synaptic neuron (Lakna, 2022).
Explain how epigenetics may play a role in pharmacologic action.
Epigenetics is the study of how genes are expressed and silenced through chromatin remodeling (Stahl 2013). This can be accomplished through a variety of chemical processes that are influenced by drugs, neurotransmitters, and the environment. Methylation is one such process. The methylation of histones and DNA can silence genes, whereas the demethylation of the same can activate them. When drugs affect this process, it determines whether genes are silenced or expressed. For example, an epigenetic change that turns off a tumor-suppressing gene can result in uncontrolled cell multiplication (Rettner, 2013). According to Kanherkar, Bhatia-Day, and Csoka (2014), some drugs used to treat diseases may cause epigenetic changes that manifest as long-term side effects. There are several screening protocols available to identify drugs that have both positive and negative epigenetic effects.
Explain how this knowledge may affect how you prescribe medications to patients. Include a specific example of a patient situation or case in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.
Given my understanding of epigenetics and the fact that it can be inherited, I would want to obtain a thorough history of the patient, including family/genetics, medical, medication, and drug allergies, before prescribing any medication. According to Csoka and Syzyf (2009), drug-induced tardive dyskinesia is thought to be epigenetic. In this case, if a PMHNP is treating a psychotic patient who has a history or a family history of Parkinson’s disease, the use of neuroleptic drugs should be used with caution, as these drugs can induce or worsen the disease.
The second discussion post
According to Berg and Clark (2018), “Agonists are drugs that have both affinity (they bind to the target receptor) and intrinsic efficacy (they change receptor activity to produce a response). Antagonists have affinity but no intrinsic efficacy; thus, they bind to the target receptor but do not produce a response.” Inverse agonists decrease constitutive activity of a receptor and produce the opposite effect of an agonist. According to research, it is critical to consider both inverse agonism and functional selectivity when using drugs as medicines or as research tools.
Shape transformation is used by g couple proteins and ion gated channels to respond to ligand. Both play roles in mediating ion channels that depolarize or hyperpolarize the postsynaptic neuron’s plasma membrane (Lakna, 2022). The primary distinction between the two is in their ion channel activation. Channel receptors open a gate, allowing ions to enter (or exit); G linked proteins, on the other hand, reverse their cytosol part, changing configuration, binding G protein, and activating it using energy from GTP. Finally, postsynaptic ion channels are made up of two types of transmembrane proteins: ligand-gated ion channels and G-protein coupled receptors. Furthermore, Lakna (2022) simply states that “ligand-gated ion channels involve direct opening of ion channels with neurotransmitter binding, whereas G-protein coupled receptors involve indirect binding of ion channels with metabolic activation of G-protein.”
Epigenetics explains how disease develops and is inherited, as well as how it responds to therapeutic intervention. Epigenetics may play a role in pharmacologic actions in a variety of ways, including pain control. According to studies, “man has used drugs to control our physiology since prehistoric use of plants as medicines, such as aspirin-like compounds from the bark of willow trees or other salicylate-rich plants in ancient Egyptian and Greek times” (Stefanska, & MacEwan,2015). Meanwhile, according to the study, “pharmacological intervention with SAM restores the epigenetic control of the -secretase gene by hypermethylation and silencing, followed by a decrease in amyloid plaque formation.” Researchers have recently made significant progress with the use of epigenetics not only in cancer therapy, but also in neurological disorders and autoimmune diseases.
It is well known that several neurological disorders, such as Alzheimer’s disease, have been linked to epigenetic mutations; as mental health nurse practitioners, we must acknowledge and consider this fact when prescribing medication for a better, safer, and more effective outcome.
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