Discussion: Foundational Neuroscience NURS 4430 essay

Discussion: Foundational Neuroscience NURS 4430

Hello. This discussion post actually belongs to the class NURS 6630 and not NURS 4430. Kindly do not be put off by that misrepresentation.

Discussion: Foundational Neuroscience NURS 4430 SAMPLE

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

An agonist action is caused by a drug that purposefully binds to the receptors. The agonist action then produces a detailed response to the targeted chemical and receptors. Alternatively, an antagonistic activity is caused by a drug that binds the receptors causing the receptors to seize from producing a reply. This agent’s agonist to

Discussion Foundational Neuroscience NURS 4430

antagonist spectrum of action is that one simulates reactions while the other stops or slows down responses. Often an agonist will emulate the activities of a neurotransmitter and produce similar reactions to natural receptors of which they bid.

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Furthermore, agonists have affinity and efficacy, which means that they have target receptors they bid to and can change receptor functionality to produce the desired response (Berg & Clarke, 2018). Alternatively, antagonists have an affinity but cannot make a response. Therefore, an antagonist will reduce the receptor ability of an agonist, thus reduction of receptor response. In cases where there is a full agonist, the essential functions of an antagonist can be blocked. This is because a full agonist produces a maximum response, whereas a partial one produces partial responses. In some cases, a full agonist can make maximum response without having to occupy the full receptors.

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

First of all, both are types of proteins integrated with cell membranes. Both types of protein are embedded in cell membranes. G coupled proteins are chains of lipophilic helical segments within the membrane, although sometimes they are short helices in the connecting loops. G coupled proteins are activated by chemical messengers, and these messages arepassed through the interaction of G+proteins. On the other hand, Ion channels are also made from lipophilic helices, but they have various chains ingrained within them. They are built to allow ions through the channel. These channels are more restricted and gated, meaning that only some chemical messengers can lift the restriction or penetrate the gate to switch the channel on (Li, Wong & Liu, 2014). Some chemicals within the proteins are similar. For example, both may contain glutamate or acetylcholine.

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

Epigenetics are systems that have evolved to be able to switch gene activity or tune existing genetic activations. Furthermore, epigenetic regulation of such gene activities is essential in maintaining regular exercise in cells. Distorted epigenetics may lead to cell diseases such as cancer and neurodegenerative disorders like Alzheimer’s. Epigenetic systems can create implications in patients because they alter how patients respond to different drugs (McClarty, Fisher & Dong, 2018).

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.

As a nurse practitioner working in a psychiatric institution, one must know that aging-induced epigenetic alterations exist. Therefore, in a scenario where one is dealing with an elderly patient with a neurogenerative disease, one must consider how epigenetic can interfere with antipsychotic function (McClarty, Fisher & Dong,2018). Epigenetic mechanisms and altered efficacy in agonists can increase side effects in the elderly. In such cases, the nurse can opt for an inverse agonist or partial agonist, which do not produce the same responses as a full agonist (Nutt et al., 2017). These are a new class of lingad that could work in those who find full agonists too reactive.

References FOR Discussion: Foundational Neuroscience NURS 4430

Berg, K. A., & Clarke, W. P. (2018). Making sense of pharmacology: Inverse agonism and functional selectivity. The International Journal of Neuropsychopharmacology, 21(10), 962–977. https://doi.org/10.1093/ijnp/pyy071

McClarty, B. M., Fisher, D. W., & Dong, H. (2018). Epigenetic alterations impact antipsychotic treatment in elderly patients. Current Treatment Options in Psychiatry, 5(1), 17–29. https://doi.org/10.1093/ijnp/pyy071

Li, S., Wong, A. H., & Liu, F. (2014). Ligand-gated ion channel interacting proteins and their role in neuroprotection. Frontiers in Cellular Neuroscience, 8(125), 1-5. https://doi.org/10.3389/fncel.2014.00125

Nutt, D., Stahl, S., Blier, P., Drago, F., Zohar, J., & Wilson, S. (2017). Inverse agonists – What do they mean for psychiatry?European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology, 27(1), 87–90. https://doi.org/10.1016/j.euroneuro.2016.11.013

Discussion: Foundational Neuroscience NURS 4430

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.

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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 of Discussion: Foundational Neuroscience NURS 4430

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 of Discussion: Foundational Neuroscience NURS 4430

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 Discussion: Foundational Neuroscience NURS 4430

What’s Coming Up in Week 3?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will explore medication adherence and strategies to help overcome non-adherence to pharmacotherapeutics. You will also complete a Quiz that addresses the content covered throughout this module.

Next Week

To go to the next week:

Week 3

Week 3: Concepts in Assessing Medication Adherence and Strategies to Mitigate Non-Adherence

Poor adherence to psychiatric treatments is a widespread clinical problem that negatively impacts rates of treatment response and remission. While empirically-supported treatments are available for many psychiatric disorders, these treatments are not universally effective. Patients commonly face difficulties in taking prescribed psychotropic medications or attending psychotherapy sessions as recommended, and therefore may not achieve optimal outcomes.

—Traeger, L., Brennan, M. M., & Herman, J. B. (2016, p. 20)

This week, you will explore how medication adherence can impact a patient’s success with treatment. You will examine the epidemiology of adherence, the impact of non-adherence from a clinical and economic viewpoint, risk factors for non-adherence, assessing adherence, and integrating adherence into a treatment plan. You will also complete a Quiz to test your understanding of this module’s content.

Reference:
Traeger, L., Brennan, M. M., & Herman, J. B. (2016). Treatment adherence. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 20–26). Elsevier.

Learning Objective

Students will:

Identify concepts related to neuroanatomy, receptor theory, and medication adherence in psychopharmacology

Learning Resources

Required Readings (click to expand/reduce)

Traeger, L., Brennan, M. M., & Herman, J. B. (2016). Treatment adherence. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 20–26). Elsevier.

Fialko, L., Garety, P. A., Kuipers, E., Dunn, G., Bebbington, P. E., Fowler, D., & Freeman, D. (2008). A large-scale validation study of the medication adherence rating scale (MARS). Schizophrenia Research, 100(1–3), 53–59. https://doi.org/10.1016/j.schres.2007.10.029

LaMorte, W. W. (2019). The transtheoretical model (stages of change). Boston University School of Public Health. https://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories6.html

The transtheoretical model of health behavior change by Prochaska, J. O., & Velicer, W. F., in American Journal of Health Promotion, Vol. 12/ Issue 1.

Copyright 1997 by Sage Publications, Inc.Reprinted by permission of Sage Publications, Inc. via the Copyright Clearance Center.

Required Media (click to expand/reduce)

Centers for Disease Control and Prevention. (2017). Overcoming barriers to medication adherence for chronic diseases [Video]. https://www.cdc.gov/grand-rounds/pp/2017/20170221-medication-adherence.html

Quiz: Neurobiology and Medication Adherence Concepts

Photo Credit: Getty Images

By Day 7

Complete the 20-question Quiz to gauge your understanding of this module’s content.

Submission Information

Submit Your Quiz by Day 7

To submit your Quiz:

Week 3 Quiz

What’s Coming Up in Module 2?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In the next module, you will begin to apply your assessment and therapy skills in treating patients for disorders with affective components.

Next Module

To go to the next module:

Module 2

Module 2: Disorders With Affective Components

As a psychiatric nurse practitioner (PNP), does that research finding surprise you? How do PNPs ensure that effective psychopharmacologic treatments are prescribed to address the prevalence of affective disorders?

Consider for example that current treatments are sub-optimal, resulting in poor patient responses and uncertain modes-of-action (Plant, 2017). While it is no surprise that mental health medicine and clinical approaches are constantly evolving, novel insights into the underlying mechanisms of how affective disorders arise, remain. Additionally, the use of psychopharmacologic treatments may not always be consistent with a patient’s preferred treatment plan. Thus, your skills and understanding of how to assess and treat patients with affective disorders are important in ensuring positive patient outcomes and may also contribute to the research needed to connect clinical observations to the neuroscience, physiology, and pharmacologic processes needed to treat these disorders.

Reference:
Plant, N. (2017). Can a systems approach produce a better understanding of mood disorders? Biochimica et Biophysica Acta, 1861(1), 3335-3344. https://doi.org/10.1016/J.BBAGEN.2016.08.016

What’s Happening This Module?

Module 2, Disorders With Affective Components, is a 6-week module. During Week 4, you will begin applying your assessment and therapy skills as you engage in your first Assignment assessing and treating pediatric patients with mood disorders. In Week 5, you will continue to apply your assessment and therapy skills as you assess and treat patients presenting with bipolar disorders. As you engage with the decision tree exercises, reflect on the critical decision-making skills that you, as a psychiatric nurse practitioner, are making, as these skills are essential to your current and future practice. In Week 6, you will assess and treat patients presenting with anxiety and posttraumatic stress disorder (PTSD). You will also complete your Midterm Exam. During Week 7, you will assess and treat patients presenting with schizophrenia. In Week 8, you will complete a Short Answer Assessment in which you will synthesize your understanding of sleep/wake disorders. You will also continue to apply your assessment and therapy skills as you assess and treat patients presenting with sleep/wake disorders. During Week 9, you will examine psychopharmacologic therapies for patients with ADHD/ODD and you will complete a Quiz to test your understanding of the content explored in this module

What do I have to do?
When do I have to do it?
Review your Learning Resources.
Days 1–7, Weeks 4–9
Assignment: Assessing and Treating Pediatric Patients With Mood Disorders
Submit your Assignment by Day 7 of Week 4.
Assignment: Assessing and Treating Patients With Bipolar Disorder
Submit your Assignment by Day 7 of Week 5.
Assignment: Assessing and Treating Patients With Anxiety Disorders
Submit your Assignment by Day 7 of Week 6.
Midterm Exam
Complete Midterm Exam by Day 7 of Week 6.
Discussion: Treatment for a Patient With Insomnia
Post by Day 3 of Week 7 and respond to your colleagues by Day 6 of Week 7.
Assignment: Assessing and Treating Patients With Psychosis and Schizophrenia
Submit your Assignment by Day 7 of Week 7.
Assignment 1: Short Answer Assessment
Submit your Assignment by Day 7 of Week 8.
Assignment 2: Assessing and Treating Patients With Sleep/Wake Disorders
Submit your Assignment by Day 7 of Week 8.
Assignment: Assessing and Treating Patients With ADHD/ODD
Submit your Assignment by Day 7 of Week 9.
Quiz: Assessing and Treating Patients With Psychopharmacology
Complete Quiz by Day 7 of Week 9.
Go to the Weekly Content

Week 4

Week 5

Week 6

Week 7

Week 8

Week 9

Week 4: Therapy for Patients With Major Depressive Disorder (MDD)

Mood disorders can impact every facet of a human being’s life, making the most basic activities difficult for patients and their families. This was the case for 13-year-old Jeanette, who was struggling at home and at school. For more than 8 years, Jeanette suffered from temper tantrums, impulsiveness, inappropriate behavior, difficulty in judgment, and sleep issues in Discussion: Foundational Neuroscience NURS 4430.

As a PNP working with pediatric patients, you must be able to assess whether these symptoms are caused by psychological, social, or underlying growth and development issues. You must then be able recommend appropriate therapies.

This week, as you examine antidepressant therapies, you explore the assessment and treatment of three populations: pediatrics, adults, and geriatrics. The focus of your assessment tool, a decision tree, will specifically center on one of the most vulnerable populations, pediatrics. Please remember, you must also consider the ethical and legal implications of these therapies. You will also complete a Quiz on the concepts addressed throughout this module.

Learning Objectives

Students will:

Assess patient factors and history to develop personalized plans of antidepressant therapy across the lifespan
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in pediatric, adult, and geriatric patients requiring antidepressant therapy
Synthesize knowledge of providing care to pediatric, adult, and geriatric patients presenting for antidepressant therapy
Analyze ethical and legal implications related to prescribing antidepressant therapy to patients across the lifespan

Learning Resources for Discussion: Foundational Neuroscience NURS 4430

Required Readings (click to expand/reduce)

Baek, J. H., Nierenberg, A. A., & Fava, M. (2016). Pharmacological approaches to treatment-resistant depression. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 44–47). Elsevier.

Fava, M., & Papakostas, G. I. (2016). Antidepressants. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 27–43). Elsevier.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Howland, R. H. (2008a). Sequenced Treatment Alternatives to Relieve Depression (STAR*D). Part 1: Study design. Journal of Psychosocial Nursing and Mental Health Services, 46(9), 21–24. https://doi.org/10.3928/02793695-20080901-06

Howland, R. H. (2008b). Sequenced Treatment Alternatives to Relieve Depression (STAR*D). Part 2: Study outcomes. Journal of Psychosocial Nursing and Mental Health Services, 46(10), 21–24. https://doi.org/10.3928/02793695-20081001-05

Lorberg, B., Davico, C., Martsenkovskyi, D., & Vitiello, B. (2019).  Principles in using psychotropic medication in children and adolescents. In J. M. Rey & A. Martin (Eds.), IACAPAP e-textbook of child and adolescent mental health. https://iacapap.org/content/uploads/A.7-Psychopharmacology-2019.1.pdf

Magellan Health. (2013). Appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf

Poznanski, E. O., & Mokros, H. B. (1996). Child depression rating scale—Revised. Western Psychological Services.

Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791. https://doi.org/10.1002/da.22171

Yasuda, S. U., Zhang, L. & Huang, S.-M. (2008). The role of ethnicity in variability in response to drugs: Focus on clinical pharmacology studies. Clinical Pharmacology & Therapeutics, 84(3), 417–423. https://web.archive.org/web/20170809004704/https://www.fda.gov/downloads/Drugs/ScienceResearch/…/UCM085502.pdf

Medication Resources (click to expand/reduce)

IBM Corporation. (2020). IBM Micromedex.

https://www.micromedexsolutions.com/micromedex2/librarian/deeplinkaccess?source=deepLink&institution=SZMC%5ESZMC%5ET43537

Note: To access the following medications, use the IBM Micromedex resource. Type the name of each medication in the keyword search bar. Be sure to read all sections on the left navigation bar related to each medication’s result page, as this information will be helpful for your review in preparation for your Assignments.

Review the following medications:

amitriptyline
bupropion
citalopram
clomipramine
desipramine
desvenlafaxine
doxepin
duloxetine
escitalopram
fluoxetine
fluvoxamine
imipramine
ketamine
mirtazapine
nortriptyline
paroxetine
selegiline
sertraline
trazodone
venlafaxine
vilazodone
vortioxetine

Required Media (click to expand/reduce)

Case Study: An African American Child Suffering from Depression
Note: This case study will serve as the foundation for this week’s Assignment.

Optional Resources FOR (click to expand/reduce)

El Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: A systematic review. European Child & Adolescent Psychiatry, 23(10), 973–992. https://doi.org/10.1007/s00787-014-0558-3

Gordon, M. S., & Melvin, G. A. (2014). Do antidepressants make children and adolescents suicidal? Journal of Pediatrics and Child Health, 50(11), 847–854. https://doi.org/10.1111/jpc.12655

Seedat, S. (2014). Controversies in the use of antidepressants in children and adolescents: A decade since the storm and where do we stand now? Journal of Child & Adolescent Mental Health, 26(2),

iii–v. https://doi.org/10.2989/17280583.2014.938497