Responding.
Responding to your colleagues on two different days in one of the following ways:
If your colleagues posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.
If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective.
Rita Goode
Initial Post
COLLAPSE
Including how partial and inverse agonist functionality may impact the efficacy of psychopharmacologic treatments. Understanding the difference between agonist and antagonist spectrum of action related to psychopharmacologic agents will help explain how partial and inverse agonist function impacts the efficacy of treatments. Agonist is related to a medication that binds to a receptor, and antagonist inhibit or block by binding to the receptor site. Agonists can be categorized by partial agonist, or inverse agonist that can open the channel to the binding site dependent on the mechanism of action. For example, an inverse agonist would work by placing the binding site in closed or inactive state. Antagonists can inhibit the agonist effects by returning ions to a resting state. Therapeutic treatments within psychopharmacology can be examined with impulsivity related to amphetamine (indirect DA agonist) with increased value has shown delayed rewards(decreased impulsivity) but D1 receptor antagonists decreased the value of delayed rewards(increased impulsivity) (Wade, et. al., 2000). This can stress the importance of finding treatments that hold beneficial outcomes to balance out contraindications between therapeutic treatments. Compare and contrast the actions of g couple proteins and ion gated channels (Howland, 2016).
Compare and contrast the actions of g couple proteins and ion gated channels.
The g couple protein coupled receptors (GPCRs) are the largest and most versatile protein family. The g protein has the most abundant membrane receptors responsible for specific functions in humans. This makes them a great attraction for drug binding and interaction (Johnson & Lovinger, 2018). Ion gated channels bind to the receptor opening a channel that only allows specific ions to pass once the channel is open the membrane may be polarized or depolarized (Bylund, 2020).
Explain how the role of epigenetics may contribute to pharmacologic action.
Epigenetics is the study of changes in gene expression that doesnt involve changing the DNA sequence, thus a change in phenotype, not genotype and this affects how the cells read genes (Rosool et al, 2022) Epigenetic mechanisms in health and disease are uncovered changes in DNA methylation and chromatin structures that may contribute to psychiatric disorders. Recent studies in epigenetics have revealed correlations between DNA and depression, using epigenetics can help personalized patients regimen especially if they are not responding to traditional medications (Rasool, et al., 2015).
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 medications action.
Understanding how the drug will affect the patient and the way the patients body will be affected by the drug is critical when prescribing medications (Laureate Education, n.d.). Knowing that blood work should be obtained periodically for certain drugs like lithium for bipolar to monitor the therapeutic ranges, kidney function and toxicity is vital. Lithium can cause renal insufficiencies. Nurse practitioner must be aware of the medication action in order to safely prescribe medications and to prevent adverse reactions. A nurse practitioner should have an understanding of drug to drug interactions and food drug interactions. It is impossible to know all interactions, so the clinician should have resources readily available such as the drug book or PDA. Understanding the medications actions will require the nurse practitioner to have knowledge of pharmacokinetics and pharmacodynamics in particular age groups. For example, if prescribing a medication to an elderly patient that excretes through the kidneys, the clinician should understand that as a patient ages, the kidney function decreases, which depending on the drug this can cause toxicity. The goal is to effectively treat the patient without causing harm.
Berg, K., A., Clarke, W., P. (2018). Making Sense of Pharmacology: Inverse Agonism and Functional Selectivity, International Journal of Neuropsychopharmacology, Volume 21, Issue 10, October 2018, Pages 962977, https://doi.org/10.1093/ijnp/pyy071
Howland, R. H. (2016). Pimavanserin: An inverse agonist antipsychotic drug. Journal of Psychosocial Nursing & Mental Health Services, 54(6), 21-24. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.3928/02793695-20160523-01
Rasool, M., Malik, A., Naseer, M. I., Manan, A., Ansari, S., Begum, I., Qazi, M. H., Pushparaj,P., Abuzenadah, A. M., Al-Qahtani, M. H., Kamal, M. A., & Gan, S. (2015). The role of epigenetics in personalized medicine: challenges and opportunities. BMC medical genomics, 8 Suppl 1(Suppl 1), S5. https://doi.org/10.1186/1755-8794-8-S1-S5 NURS 6630 week 2 Discussion: Foundational Neuroscience
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