Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

Week 1 Discussion

Discussion: Foundational Neuroscience

1. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.

The spectrum of agonists to antagonists describes how substances, either occurring naturally (ligand) or synthetically such as psychopharmacologic agent, effect receptor sites (Stahl, 2008). The agonists are agents can increase an action on the receptor by mimicking a naturally occurring agent (Strange, 2008). An antagonist acts by blocking the receptor site to decrease the action of agents (Strange, 2008). Substances can also be partial agonists, which is an action that ranges between full agonist and full antagonist. Instead of increasing an action to the maximum level or blocking the action completely, it is an action that is somewhere in between the two levels (Strange, 2008). Many psychopharmacologic agents work by acting on G-protein-linked systems and ion-channel systems because these are triggered by neurotransmitters (Stahl, 2008).

1. Compare and contrast the actions of g couple proteins and ion gated channels.

G protein-coupled and ion-gated channels are both triggered by neurotransmitters (Stahl, 2008). G protein-coupled receptors (GPCRs) have seven transmembrane alpha helices (Strange, 2008). G proteins have three subunits (alpha, beta, and gamma). Ion-gated channels can be activated by electrical signals and neurotransmitters (Stahl, 2008). Ion-gated channels change the flow of ions, causing an almost-immediate effect and GPCRs take longer to work because they may make changes to cellular function over time (Stahl, 2008).

1. Explain the role of epigenetics in pharmacologic action.

Epigenetics is the study of gene expression, or which genes are turn off or on (Stahl, 2008). Pharmacologic actions can turn genes on or off to gain a desired effect. Epigenetic regulation of brain functions is important in the etiology of psychiatric disorders (Boks, et al., 2012). Epigenetic mechanisms, such as DNA methylation and histone acetylation, are affected by many pharmaceuticals, including psychiatric drugs (Boks, et al., 2012).

1. Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

Thorough knowledge of how medications work will allow the nurse practitioner to prescribe the best medication for the client. For example, knowing that many anxiolytics work on inotropic receptors and will work very quickly to calm a client in an acute situation rather than prescribing an antidepressant that works on GPCRs and will take much longer to help with an acute episode.

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.