NURS 4430 Discussion: Concepts of Foundational Neuroscience -

NURS 6630 Discussion: Concepts of Foundational Neuroscience

NURS 6630 Discussion: Concepts of Foundational Neuroscience

1. Agonist-to-antagonist spectrum

Drugs have been classified as either antagonists or agonists in medications. Besides, the way psychopharmacological therapy agents are administered differs depending on the prescribed approach. Due to several alternatives for treatments and therapies for disorders and illness, i.e., biological pathways, ligands, and receptors, would be very hard to know the appropriate option based on the person. The agonists’ drug binds to the target receptor, shifting its activity, which causes a reaction. Also, the moment a partial agonist interacts with a receptor generates a submaximal reaction, thus activating the entire brain receptor. On the flip side, an antagonist links to the receptor without producing a

response, which prevents the agonist from inhibiting the receptor. The agonist-antagonist continuum comprises the partial, full,

NURS 6630 Discussion Concepts of Foundational Neuroscience

inverse agonists and silent antagonists. The main work of a full agonist is to ignite the ion of the receptor channel to open widely. A partial is obtained during the resting state of the receptor. The silent antagonist functions by bringing the receptor back again to its resting state. An inverse agonist is the one that produces the changes in the receptor and the ion channel closure.

2. G-couple proteins and ion gated channels

Ion channels cannot be found in the G-coupled protein neurotransmitter receptors but work as molecules referred to as g-proteins (Allen et al., 2018). The receptors consist of two domains that bind neurotransmitters, i.e., an intracellular and external region. Besides, the G-coupled proteins entail seven distinct protein parts and can traverse the membrane as many times as seven, sending signals to the binding sites of the neurotransmitter. In addition, the process will see the psychiatric drugs to be employed in treating diseases. Once medicines interact with the receptor sites will result in the modification of the actions that occur hence the partial or full inhibition of neurotransmitter activities. Also, the effects of drugs can result in molecular changes, which in turn causes changes in the way phosphoproteins are inactivated or activated and neurotransmission altering of receptors and enzymes.

On the other hand, G-couple proteins pass through the membrane, changing the cells’ behavior, not like ions. In addition, what controls the ion gated channels is the electricity. The availability of charges makes ions not pass the membrane, and this technique plays a major role in governing access to neurons. In comparison, it is evident that what cut across both channels is the agonist spectrum. The main categories of the protein receptors used in binding are located in the cell membrane. Also, medications targeting receptor sites of the G-couple proteins take much time to function, and medicine that modifies the ion flow may result in therapeutic effects.

3. Role of epigenetics

Regarding the way in which required chromatin is arranged inside the nucleus, what decides the classification of genesis the epigenetics (Kaliman, 2019). It decides whether the gene is a protein and a particular gene or it should be switched off. Also, medications, genes, environment, and neurotransmission play a major role when deciding to express or repress genes, resulting in a variety of brain consequences. Researchers are working on drugs able to restore the gene function in illnesses that arise from epigenetic processes. Therefore, this will, in turn, have a solution to some diseases such as fear, chronic pain, and addiction.

4. Medical prescription

Finally, this week’s session has given me a deeper understanding of the psychopharmacological medicine foundation. The takeaway point from this session is that when the time comes to prescribe medications to patients, I will need this concept. It will enable any practitioner to obtain a consensus when writing a prescription and the drugs’ effects background. Besides, the epigenetics concept is another important aspect as it has widened my thinking about drugs and clients. Scientists continue to develop new medications to help control the epigenetic processes helping people live healthier and much longer.

A client diagnosed with major depressive disorder is a good example of these circumstances since practitioners need to be informed about the medicinal actions. The medicine employed in treating MDD is Sertraline which inhibits serotonin uptake (Stahl, 2020). Therefore, the nurse practitioner should know that it is essential to reveal any adverse effects and dose directions to the patient. Another important point that the psychiatric practitioner should stress is the delay in sertraline action, which will affect the functioning time. The efficacy and safety of the clients during the prescription of any drug is always the number one priority. The medical practitioners are tasked with ensuring there are minimal undesired repercussions, thus helping achieve the intended therapeutic impact.

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As a psychiatric nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat patients, 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.

Photo Credit: Getty Images/Cultura RF

For this Discussion, review the Learning Resources and reflect on the concepts of foundational neuroscience as they might apply to your role as the psychiatric mental health nurse practitioner in prescribing medications for patients.

By Day 3 of Week 2

Post a response to each of the following:

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.
Compare and contrast the actions of g couple proteins and ion gated channels.
Explain how the role of epigenetics may contribute to pharmacologic action.
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.

Read a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond to at least two of 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.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 2 Discussion Rubric

Post by Day 3 of Week 2 and Respond by Day 6 of Week 2

To Participate in this Discussion:

Week 2 Discussion

NURS 6630 Discussion: Concepts of Foundational Neuroscience Rubric Detail

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Content
Name: NURS_6630_Week2_Discussion_Rubric

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Excellent

Point range: 90–100 Good

Point range: 80–89 Fair

Point range: 70–79 Poor

Point range: 0–69
Main Posting:

Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

Points Range: 40 (40%) – 44 (44%)

Thoroughly responds to the Discussion question(s).

Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

No less than 75% of post has exceptional depth and breadth.

Supported by at least three current credible sources.

Points Range: 35 (35%) – 39 (39%)

Responds to most of the Discussion question(s).

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least three credible references.

Points Range: 31 (31%) – 34 (34%)

Responds to some of the Discussion question(s).

One to two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with fewer than two credible references.

Points Range: 0 (0%) – 30 (30%)

Does not respond to the Discussion question(s).

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible references.
Main Posting:

Writing

Points Range: 6 (6%) – 6 (6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

Points Range: 5 (5%) – 5 (5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

Points Range: 4 (4%) – 4 (4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

Points Range: 0 (0%) – 3 (3%)

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.
Main Posting:

Timely and full participation

Points Range: 9 (9%) – 10 (10%)

Meets requirements for timely, full, and active participation.

Posts main Discussion by due date.

Points Range: 8 (8%) – 8 (8%)

Posts main Discussion by due date.

Meets requirements for full participation.

Points Range: 7 (7%) – 7 (7%)

Posts main Discussion by due date.

Points Range: 0 (0%) – 6 (6%)

Does not meet requirements for full participation.

Does not post main Discussion by due date.
First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

Points Range: 9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

Points Range: 8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

Points Range: 7 (7%) – 7 (7%)

Response is on topic, may have some depth.

Points Range: 0 (0%) – 6 (6%)

Response may not be on topic, lacks depth.
First Response:
Writing

Points Range: 6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

Points Range: 5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

Points Range: 4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

Points Range: 0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.
First Response:
Timely and full participation

Points Range: 5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

Points Range: 4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

Points Range: 3 (3%) – 3 (3%)

Posts by due date.

Points Range: 0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.
Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.

Points Range: 9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

Points Range: 8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

Points Range: 7 (7%) – 7 (7%)

Response is on topic, may have some depth.

Points Range: 0 (0%) – 6 (6%)

Response may not be on topic, lacks depth.
Second Response:
Writing

Points Range: 6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

Points Range: 5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

Points Range: 4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

Points Range: 0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.
Second Response:
Timely and full participation

Points Range: 5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

Points Range: 4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

Points Range: 3 (3%) – 3 (3%)

Posts by due date.

Points Range: 0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.
Total Points: 100
Name: NURS_6630_Week2_Discussion_Rubric

Week 2 Discussion

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Explain the agonist to antagonist spectrum of action of psychopharmacologic agents including how partial and inverse agonists functionality may impact the efficacy of psychopharmacologic treatments.

First one has to identify the difference between the action of the agonist versus the antagonist. My understanding may be different and I am open to classmates understanding of the difference between the agonist, antagonists, inverse and partial agonists.

An agonist enhances the action, for example, you get in your car and place your foot on the gas pedal to move the car forward, this is an agonist action. You combine your foot with the gas pedal to produce a reaction. If you place your foot on the brake to stop the car this is an antagonist action, the brake is opposing the gas pedal. If you decide to put the car in reverse and drive backwards the reverse button is the inverse agonist. The car is still moving but now is going in the opposite direction. You still have to put your foot on the gas pedal (the agonist) binding to the same site yet you are doing an opposite action using the reverse button (the inverse agonist) to perform the opposite action. A partial agonist would be your child deciding to get into the car and pushing the gas pedal, they are not tall enough to push down the gas pedal far enough to move the car to maximum speed, yet the car still moves.

For example the medication Methadone is an opioid agonist used to treat patients who suffer from drug addition to drugs that affect the opioid receptors like heroin. Methadone binds to the opioid receptors that the drug heroin would, eliminating all withdrawal and drug cravings except it does not produce those euphoric high feeling that heroin would. Buprenorphine is a partial opioid agonist that binds to the same receptors that Methadone does except it doesn’t fully prevent the cravings it slows them down but also does not allow a euphoric feeling. Naltrexone is an opioid antagonist, so it prevents any opioid drug from producing any euphoric feelings, however the patient will experience the withdrawal symptoms (National Institute, 2021).

The efficacy of treatments would depend on their clinical use. You would not want to give a 10 year heroin addicted patient a prescription for Naltrexone, the withdrawal symptoms would be severe. However, for a patient who is in the hospital suffering from respiratory depression as a result of morphine, naltrexone would be appropriate.

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

G couple proteins consist of an alpha, beta and gamma and they are housed intracellularly attached to the site. The alpha site allows for the receptor site of (Guanosine Diphosphate) GDP to attach and the beta and gamma stick together in its resting state. On the extracellular site a ligand binds to the g couple receptor and this causes GDP to release and Guanosine Triphosphate (GTP) to attach to the alpha site causing the g couple proteins to be active to cause an inhibitory or excitatory function. The g couple proteins require two different pathways to function, the cAMP-dependent pathway and the phosphatidylinositol signal pathway (Med Immersion, 2016).

Ion gated channels are situated inside of the cell membrane, they can open to allow ions inside and outside of the cell membrane based on their concentrations inside or outside of the cell membrane. They cause the movement of ions in and out of the cell to cause a change in the electrical current on the inside and outside of the cell. Some examples ions of include sodium, potassium, chloride, and calcium (Huettner, 2013).

Explain how the role of epigenetics may contribute to pharmacologic action.

When I think about epigenetics I think about the fact we can house the same DNA but we all can express different genes and characteristics based on nurturing, our environment and our diet (Rasool, 2015). Science is starting to understand the reason medications work for someone but not for others. They may both be treated with the same medications yet one fails to respond as a result of their epigenetic alterations. From most of the reading and videos I have reviewed genetic testing would be a way to impact the prescribing of medications, however I am not sure if this is possible with the psychiatric nurse practitioner, I could be wrong.

NURS 6630 Discussion: Concepts of Foundational Neuroscience References

Huettner, J. (2013, April 3). Ion channel. Encyclopedia Britannica. https://www.britannica.com/science/ion-channel

Med Immersion (2016, March 21). G Protein linked 2^nd Messengers, G Protein coupled receptors, GPCRs [Video] https://youtu.be/3qR9B2JCT_s

National Institute on Drug Abuse. (2021, April 13). How do medications to treat opioid use disorder work? National Institute on Drug Abuse. https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-do-medications-to-treat-opioid-addiction-work.

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

Allthough I have been always amazed on how we have used medicines, especially psychotropic meds to induce agonist or antagonist effects to treat multiple psychiatric medications, what really amazes me is how we can use and benefit from epigenetics to treat and control these disoders, and may be prevent this from being passed from a parent to his/her own offsprings (Stahl, 2021). Mountain evidence suggests that epigenetic mechanisms, which induce stable and lasting changes in gene expression in response to environmental events and behavioral experiences, may play a role in the processess that contribute to the pathophysiology of psychiatric disorders (Mahgoub & Monteggia, 2013).

Epigenetics is a process that can change gene expression, without alterations of the DNA sequence and promote stable changes in the Chromatin structure (Stahl, 2021; Maghoub & Monteggia, 2013; Stern, et. al., 2016). A good application of epigenetics in psychiatric disoderders are the following examples:

The modification of brain derived neurotrophic factor (BDNF) as a potential therapeutic target in antidepressant action as well as in mediating antidepressant response (Mahgoub & Monteggia, 2013)
The involvement of BDNF to addiction. Acute administration of cocaine induces release of BDNF in the ventral tegmented area (reward system)
Involvement of histone H4 deacetylases in cocaine addiction. Histone play a crucial role in regulating gene activity by inducing modifications in chromatin structure (Mahgoub & Monteggia, 2013)
The involvement and modification of DNA methylation within GABA in schizophrenia. There was a downward regulation of several genes expressed within the GABA neurons (Chen, et. al, as cited in Mahgoub & Monteggia, 2013)

Much emphasis has been placed right now on histone modifications and DNA methylation for using pharmacologic inhibitors in treating multiple disorders. Both histone acetylation and DNA methylation can induce lasting and stable changes in gene expression, and therefore have been implicated in adaptive behaviors and neuronal changes that accompany many psychiatric disorders.

NURS 6630 Discussion: Concepts of Foundational Neuroscience References:

Mahgoub, M., & Monteggia, L. (2013). Epigenetics and Psychiatry. https://ncbi.nlm.nih.gov/pmc/articles/PMC3805856

Stahl, S. (2021). Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Approach. 5th ed. Cambridge

Stern, T., et. al (2016). Massachusetts General Hospital Psychopharmacology and Neurotherapeutics. 1st ed. Elsevier

NURS 6630 Discussion: Concepts of Foundational Neuroscience Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. *(5 points possible per graded thread)*	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements *per discussion thread*	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement *per discussion thread*	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.