Foundational Neuroscience Discussion

Foundational Neuroscience Discussion

Some issues concerning antipsychotic drugs have yet to be resolved. The therapeutic potency of these drugs is proportional to their affinity for dopamine D2 receptors, which are possible ultimate targets. Classical neuroleptic drugs work by increasing acetylcholine release while inhibiting striatal cholinergic interneurons. These drugs usually affect a person based on how the muscarinic receptors stimulate the main striatal neurons. Neuroleptic medication has not been beneficial for the majority of patients with psychotic disorders, and their bodies may become resistant to it to some extent, especially if the patient has been subjected to prolonged treatment (Stahl, 2013).

Nonetheless, such patients may benefit significantly from clozapine. These assertions demonstrate why psychiatric mental health nurses should be well-versed in how patients’ central nervous systems may respond to neuroleptic medication. This discussion examines the actions of psychopharmacologic agents in the patient’s body and how foundational neuroscience influences medication prescription.

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Psychopharmacologic Agents’ Agonist-to-Antagonist Action Spectrum

Agonist-to-antagonist drugs act as an agonist in some conditions while acting as antagonists in others. Certainly, it may act as an agonist by fully activating the receptor. In contrast, it may act as an antagonist by binding the activator, which may, unfortunately, fail to activate and prevent the actions of other agonists. Similarly, psychopharmacologic agents act as agonists or antagonists because they are normally the major agonists or antagonists of inhibitors or regulatory enzymes, neurotransmitter receptors, or even stimulators or blockers of neurotransmitter membrane transporters (Stahl, 2013). Classical neuroleptic medications, for example, work by either disinhibiting striatal cholinergic interneurons or increasing acetylcholine release. These drugs affect a person based on how muscarinic receptors affect the principle of striatal neurons. Antipsychotics are another type of psychopharmacologic agent that can be conventional or atypical. With a focus on conventional antipsychotics, it can be further subdivided into either incisive prompts for schizophrenia symptoms or basal antipsychotics that manage schizophrenia symptoms.

G Proteins and Ion Gated Channels: A Comparison

The g protein-coupled receptor (GPCR) is a large protein family of receptors that recognize molecules outside the cell, prompting internal signal transduction pathways and cellular responses. The receptor is activated after attaching to ligands such as hormones, odours, neurotransmitters, and light-sensitive compounds. These ligands bind the GPCR receptors, causing a conformational change in the GPCRs, allowing them to function like a guanine nucleotide exchange factor (GEF) (Laureate Education, 2016). The GPCRs then stimulate the corresponding g protein by substituting the GDP bound to the g protein for the GTP. GPCRs have been regarded as critical medications due to their physiological roles, which include homeostasis regulation, inflammation and immune system activity regulation, and behavioural and mood regulation.

With a focus on ion-gated channels, it can be understood as a collection of transmembrane ion-channel proteins that open to allow ions to pass through the membrane. Some of these ions are chlorine, calcium, potassium, and sodium, which pass through the membrane after being prompted by the binding of a chemical messenger such as a neurotransmitter. In the illustration, an activated presynaptic neuron generates a neurotransmitter from the blisters and channels it to the synaptic left, which attaches to the receptors based on the postsynaptic neuron. This causes the gated ion channels to undergo a conformational change, allowing ions to pass through the cell membrane (Laureate Education, 2016). In the clinical setting, these receptors are usually used as anaesthetics. The actions of GPCRs and ion-gated channels share some similarities. The main similarity is that these receptors undergo a conformational change after being attached to the ligands. The primary difference is that the conformational change causes the GPCR to act as the guanine GEF that later stimulates the associated g protein, whereas, in gated ion channels, the conformational change causes these receptors to open and allow ions to reach the cell membrane.

The Role of Epigenetics in Pharmacological Action

Several studies show that epigenetic factors control the expression of drug-metabolizing enzymes and transporters. Some of these factors include but are not limited to, DNA methylation and histone modification in conjunction with noncoding RNAs. Genetic polymorphism can be defined as the presence of more than one genetically defined phenotype in a population, resulting in long-term diversification (Laureate Education, 2016). Certainly, genetic polymorphism can influence how a drug is absorbed, distributed, metabolized, and eliminated from the body. Its effect on pharmacologic action may be detrimental, leading to death if combined with other drugs. As a result, drug interactions may occur via enzyme inhibition, transport functions, or even interpersonal differences in the expression of genetic polymorphism.

The Importance of Information When Prescribing Medications to Patients

The information discussed in this discussion is important, especially when prescribing medications to clients. It specifically informs clinicians on how the drug may work in the body of the patients, which can be confirmed by looking at the agonist and antagonist aspects of the medication. For example, when treating patients predisposed to psychotic disorders, basal antipsychotic drugs must be used rather than incisive antipsychotic drugs. The reason for this is that basal medications work so that they can contain the symptoms of schizophrenia. In contrast, intelligent drugs cause the symptoms of schizophrenia, lowering the patient’s quality of life. Again, epigenetics is important in pharmacological action, as evidenced by epigenetic polymorphism. Based on epigenetic polymorphism, a patient may take drugs concurrently, which may later interact with each other instead of interacting with the patient’s body (Laureate Education, 2012). As a result, this may harm their health to death. As a result, physicians are encouraged to learn about drug pharmacokinetics to write appropriate prescriptions.

Conclusion

When dealing with patients suffering from central nervous disorders, it is critical to understand the disorders and drug reactions in their bodies. When these drugs are intended to prompt the receptor, they may attach themselves to the activator, causing it to fail to activate and limiting the actions of other agonists (Stahl, 2013). Nonetheless, physicians are always encouraged to recognize agonists and ignore antagonists. A thorough understanding of drugs and their interactions with the human body allows physicians to provide appropriate drug prescriptions to their patients. As a result, they should be educated on the effects of drugs on their patients to write appropriate drug prescriptions.

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References

Laureate Education (Producer). (2016i). Introduction to psychopharmacology [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2012). Introduction to advanced pharmacology [Video file]. Baltimore, MD: Author.

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

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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.
   

   Foundational Neuroscience Discussion

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.

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