Psychopharmacology response: Please respond to Lori post at the bottom 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.

Please respond to Lori post at the bottom 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 and use the resources as references or I dont get credit
NURS 6630: Psychopharmacologic Approaches to Treatment of Psychopathology
Graphic representation of the human brain.
Week 1: Introduction to Neuroscience
Modern psychopharmacology is largely the story of chemical neurotransmission. To understand the actions of drugs on the brain, to grasp the impact of diseases on the central nervous system, and to interpret the behavioral consequences of psychiatric medicines, one must be fluent in the language and principles of neurotransmission.
—Dr. Stephen M. Stahl in Stahl’s Essential Psychopharmacology
By using a combination of psychotherapy and medication therapy, psychiatric mental health nurse practitioners are positioned to provide a very unique type of care to clients with psychiatric disorders. To be successful in this role, you must have a strong theoretical foundation in pathophysiology, psychopharmacology, and neuroscience. This foundation will help you assess, diagnose, and treat clients as you relate presenting symptoms to theoretical neuronal functioning.
This week, as you begin to study psychopharmacology, you explore foundational neuroscience. You examine the agonist-to-antagonist spectrum of action of psychopharmacologic agents, compare the actions of g couple proteins to ion gated channels, and consider the role of epigenetics in pharmacologic action.
Note: In previous courses, the term “patient” was used to describe the person receiving medical care. In traditional medicine and nursing, this term is used to describe the person you do something to, and it often refers to a passive recipient of care and services. As you move into the realm of psychiatric mental health, a transition will occur. You will work with individuals who are active participants in their care, and these individuals are generally referred to as “clients” as opposed to “patients.” It is important to note that the term “client” is also favored in other mental health disciplines, such as psychiatry, psychology, and social work.
Photo Credit: [cgtoolbox]/[Vetta]/Getty Images
Discussion: Foundational Neuroscience
As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, 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.
Learning Objectives
Students will:
Analyze the agonist-to-antagonist spectrum of action of psychopharmacologic agents
Compare the actions of g couple proteins to ion gated channels
Analyze the role of epigenetics in pharmacologic action
Analyze the impact of foundational neuroscience on the prescription of medications
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
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
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 1, “Chemical Neurotransmission”
Chapter 2, “Transporters, Receptors, and Enzymes as Targets of Psychopharmacologic Drug Action”
Chapter 3, “Ion Channels as Targets of Psychopharmacologic Drug Action”
Document: Midterm Exam Study Guide (PDF)
Document: Final Exam Study Guide (PDF)
Required Media
Laureate Education (Producer). (2016i). Introduction to psychopharmacology [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 3 minutes.
Accessible player
Optional Resources
Laureate Education (Producer). (2009). Pathopharmacology: Disorders of the nervous system: Exploring the human brain [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 15 minutes.
Dr. Myslinski reviews the structure and function of the human brain. Using human brains, he examines and illustrates the development of the brain and areas impacted by disorders associated with the brain.
Accessible player
Laureate Education (Producer). (2012). Introduction to advanced pharmacology [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 8 minutes.
In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse
Loris post
6 hours ago Lori Woolley
Week 1 Disc.
COLLAPSE
Main question Post Wk. 1 Psychopharmacology
Agonist-To-Antagonist Spectrum
Agonists are neurotransmitters in the brain that stimulate receptors like some drugs do. There are also drugs that block the actions of the neurotransmitters at the point of the receptors and these are called the antagonists. Antagonists are not the opposite of agonists, inverse agonists are. The full agonist spectrum has agonist, partial agonist, antagonist, partial inverse agonist, and inverse agonist. The natural neurotransmitters in the brain are agonists, but an antagonist can block anything in the spectrum. If th agonist is not as strong as the full agonist it is call a partial agonist. When the inverse agonist is not as strong as the full inverse agonist it is called partial inverse agonist. An action of an agonist would be to reduce anxiety. The action of an inverse agonist would cause anxiety, and a partial agonist may reduce anxiety slightly. A partial inverse agonist would cause anxiety slightly, and an antagonist would block the agonist from reducing anxiety (Stahl, 2013).
G Couple Proteins/Ion Gated Channels
G-protein-coupled receptors (GPCRs) are protein membrane receptors. They mediate responses to hormones and neurotransmitters. They are also involved with taste, olfaction and vision. These proteins bind with guanosine triphosphate (STP) and guanosine diphosphate (GDP). GPCR’s are also known as the seven transmembrane receptors 45% of medicines affects this class. The action of GPCRs mediate physiological responses to hormones, environmental stimulants, and neurotransmitters. (Rosenbaum, Rasmussen & Kobilka, 2009).
Ion channels are also proteins like GPCRs, but their role is to facilitate the diffusion of the ions across the biological membranes and change the electrical excitably of the neurons. (Kurachi & North, 2004). Ion channels establish the flow of ions across the cell membrane and regulate the cell volume. Ion channels are gated and they open and close spontaneously or when they are stimulated (Hille, 1994).
Epigenetics
There are systems in all genes that can be switched off and on. This ability to regulate gene activity can play a role in maintaining normal cell activity. This can also play a role in helping diseases such as cancer and Alzheimer’s (Stefanska & MacEwan. 2015). To administer safe drugs to a patient, it is imperative to understand the absorption, distribution, metabolism and excretion of the drug (Ingelman-Sundberg et al., 2013).
How Information Can Impact Prescribing
A nurse practitioner needs to understand the agonist and the antagonist of the drugs they are prescribing. Special attention needs to be taken to understand how the drug is absorbed, distributed and metabolized in the body and the organ responsible for the excretion of the drug. An example on a psych unit may be the patient coming in with a long history of heroine abuse. Suboxone may be a good choice to use for this patient. It is a combination medication of buprenorphine and naloxone (Narcan). Buprenorphine binds to the opioid receptors and gives an analgesic effect in the CNS. Naloxone (Narcan) is an opioid antagonist and prevents opioid molecules in the CNS from binding to the receptors. Naloxone has a poor bioavailability and is inactivated following oral administration. Because of the difference of the bioavailability between the two medications, buprenorphine/naloxone is a good drug for an abuse deterrent (NAABT, 2018).
References
Hille, B. (1994). Modulation of ion-channel function by G-protein-coupled receptors. Trends In Neurosciences, 17(12), 531-536.
Ingelman-Sundberg, M., Zhong, X., Hankinson, O., Beedanagari, S., Ai-Ming, H. Y., Peng, L., & Osawa, Y. (2013). Potential role of epigenetic mechanisms in the regulation of drug metabolism and transport. Drug Metabolism and Disposition, dmd-113.
Kurachi, Y., & North, A. (2004). Ion channels: Their structure, function and control–an overview. The Journal of Physiology, 554(2), 245-247.
National Alliance of Advocates for Buprenorphine Treatment. (2018). What’s this agonist/antagonist stuff? Retrieved from https://www.naabt.org/index.cfm
Rosenbaum, D. M., Rasmussen, S. G., & Kobilka, B. K. (2009). The structure and function of G-protein-coupled receptors. Nature, 459(7245), 356.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press
Stefanska, B., & MacEwan, D. J. (2015). Epigenetics and pharmacology. British Journal of Pharmacology, 172(11), 2701-270

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