Discussion-Respond 1

Foundational Neuroscience
The agonist-to-antagonist spectrum of psychopharmacologic agents
In Psychiatry, medications are generally small molecules and act differently (Berg & Clarke, 2018).  Traditional receptor theory states that ligands activate receptor sites and act as agonists with various degrees of intrinsic efficacy or as antagonists with zero intrinsic efficacy (Berg & Clarke, 2018).  Inverse agonists have the opposite effect of an agonist and reduce the “constitutive” activity of the receptor (Berg & Clarke, 2018).  Psychopharmacologic agents can be agonists, antagonists, and simultaneously agonists, antagonists, and inverse agonists acting at the same receptor (Berg & Clarke, 2018). Agonists act to mimic the action of an endogenous neurotransmitter (Berg & Clarke, 2018).  Antagonists block the effects of endogenous neurotransmitters and oppose normal synaptic transmission (Berg & Clarke, 2018).  Partial agonists act somewhat like agonists in that they directly act on receptors, but if used in the presence of an agonist, they compete for the receptor and have partial blocking properties; hence they are sometimes called agonist–antagonists (Berg & Clarke, 2018).
G Couple Proteins and Ion Gated Channels
A neurotransmitter can affect the activity of a postsynaptic cell via two different types of receptor proteins (Purves et al., 2001).  Ionotropic receptors are linked directly to ion gated channels. These receptors contain two features: an extracellular site that binds neurotransmitters and a “membrane-spanning domain” that forms an ion channel (Purves et al., 2001).  The second family of neurotransmitters receptors does not have ion channels as part of their structure; instead, they affect channels by activating intermediate molecules called G-proteins (Purves et al., 2001).  G protein-coupled receptors (GPCRs) are the largest known class of membrane receptors and are the target of about 30-50% of modern medicinal drugs (Purves et al., 2001).  When signaling molecules, or ligands, bind to GPCRs, G-protein activation triggers the production of second messengers, like hormones (Purves et al., 2001).  Like in GPCRs, ligands also bind to ion gated channels and initiate a chemical response.  Once the ligand binds to the allosteric site of the ligand-gated ion receptor, the channel opens, and the ion permeability of the entire plasma membrane can quickly change (Purves et al., 2001).  When the channel opens, ions like potassium, sodium, or calcium can move through the open channel, and an electrical signal is generated inside the cell (Purves et al., 2001).  Ligand-gated ion channel receptors generally mediate rapid postsynaptic effects, while activating metabotropic receptors (GPCRs) typically produce a much slower response (Purves et al., 2001).
Epigenetics are chemical modifications that can silence or activate genes without modifying the nucleotide sequence (Stefanska & MacEwan, 2015).  It describes “genetic information that is ‘beyond’ or ‘above’ that information coded solely by our genetic code”  (Stefanska & MacEwan, 2015, p. 2702).  Often epigenetic variations are the cause of an underlying disease (Stefanska & MacEwan, 2015).  Drugs may not be designed to be as exact to a particular ligand or specific to a particular gene or protein subtype; they may indeed have to be able to be broader ‐ acting over a range of epigenetic large-scale events (Stefanska & MacEwan, 2015).  Pharmacological intervention may need to focus on one type of ligand or a particular gene. Still, rather drugs may need to be more “broad” to work more effectively against certain diseases (Stefanska & MacEwan, 2015).   Such knowledge can provide a strong biological foundation for developing better targeted personalized medication strategies (Stefanska & MacEwan, 2015). Epigenetic modification can be influenced by environmental factors such as recreational drugs, diet, and exercise (Stefanska & MacEwan, 2015).  “Transcription and numerous other genomic functions are epigenetically controlled via heritable but potentially reversible changes in DNA modification and histones (acetylation, methylation, phosphorylation)” (Browne et al., 2020, p. 22).  
Impact on patients
Psychiatric nurse practitioners need to consider epigenetics when prescribing medications.  An example would be in the treatment of patients who have opioid use disorder.  Susceptibility to opioid addiction is known to be strongly influenced by environmental factors. Thus, epigenetics could be important for understanding individual vulnerability to addiction and response to treatment (Hurd & O’Brien, 2018).  “The epigenetic mechanisms that turn genes on and off to set the state of gene expression patterns and thus cellular function include methylation of DNA and modifications (e.g., methylation, acetylation, and phosphorylation) of histones” (Hurd & O’Brien, 2018, p. 938).  An example of an epigenetic change in chronic heroin users includes increased methylation of the OPRM1 gene, which leads to reduced mu-opioid receptors(Hurd & O’Brien, 2018).  A reduction of mu-opioid receptors translates to a higher dose of opioids needed to satisfy the prior therapeutic effect (Hurd & O’Brien, 2018).  Frontline treatment of opioid addiction with mu OR agonists or partial agonists, such as methadone or buprenorphine, produces epigenetic modifications (Browne et al., 2020).
Berg, K. A., & Clarke, W. P. (2018). Making sense of pharmacology: Inverse agonism and functional selectivity. International Journal of Neuropsychopharmacology, 21(10), 962–977. https://doi.org/10.1093/ijnp/pyy071
Browne, C. J., Godino, A., Salery, M., & Nestler, E. J. (2020). Epigenetic mechanisms of opioid addiction. Biological Psychiatry, 87(1), 22–33. https://doi.org/10.1016/j.biopsych.2019.06.027
Hurd, Y. L., & O’Brien, C. P. (2018). Molecular genetics and new medication strategies for opioid addiction. American Journal of Psychiatry, 175(10), 935–942. https://doi.org/10.1176/appi.ajp.2018.18030352
Nutt, D., & Lingford-Hughes, A. (2007). Key concepts in psychopharmacology. Psychiatry, 6(7), 263–267. https://doi.org/10.1016/j.mppsy.2007.05.002
Purves, D., Augustine, G. J., Fitzpatrick, D., Katz, L. C., LaMantia, A.-S., McNamara, J. O., & Williams, S. M. (2001). Neuroscience (2nd ed.). Sinauer Associates.
Stefanska, B., & MacEwan, D. J. (2015). Epigenetics and pharmacology. British Journal of Pharmacology, 172(11), 2701–2704. https://doi.org/10.1111/bph.13136
Stern, T. A., Fava, M., Wilens, T. E., & Rosenbaum, J. F. (2016). Massachusetts general hospital psychopharmacology and neurotherapeutics e-book (1st 

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.

Order a unique copy of this paper
(550 words)

Approximate price: $22

Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

We value our customers and so we ensure that what we do is 100% original..
With us you are guaranteed of quality work done by our qualified experts.Your information and everything that you do with us is kept completely confidential.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism guarantee

The Product ordered is guaranteed to be original. Orders are checked by the most advanced anti-plagiarism software in the market to assure that the Product is 100% original. The Company has a zero tolerance policy for plagiarism.

Read more

Free-revision policy

The Free Revision policy is a courtesy service that the Company provides to help ensure Customer’s total satisfaction with the completed Order. To receive free revision the Company requires that the Customer provide the request within fourteen (14) days from the first completion date and within a period of thirty (30) days for dissertations.

Read more

Privacy policy

The Company is committed to protect the privacy of the Customer and it will never resell or share any of Customer’s personal information, including credit card data, with any third party. All the online transactions are processed through the secure and reliable online payment systems.

Read more

Fair-cooperation guarantee

By placing an order with us, you agree to the service we provide. We will endear to do all that it takes to deliver a comprehensive paper as per your requirements. We also count on your cooperation to ensure that we deliver on this mandate.

Read more

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
The price is based on these factors:
Academic level
Number of pages

Order your paper today and save 30% with the discount code HAPPY

error: Content is protected !!
Open chat
You can contact our live agent via WhatsApp! Via + 1 323 412 5597

Feel free to ask questions, clarifications, or discounts available when placing an order.