answer this discussion based on this:
Respond to at least two of your colleagues on two different days in one of the following ways:
1. If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.
1. 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.
References at least 2-3 no more than 5 years ago.
do not make negative critique
Agonist-to-Antagonist Spectrum of Action of Psychopharmacologic Agents
According to Stahl (2021), an agonist is any neurotransmitter or drug that brings about conformational changes in the G-protein-linked receptor, which in turn causes the neurotransmitter’s full effect. For example, the maximum amount of genes are impacted, or the maximum amount of proteins are phosphorylated. A partial agonist can be described as an agonist, either drug or neurotransmitter, that causes conformational changes in the G-protein-linked receptor. However, this change is reduced compared to a full conformational change caused by a full agonist (Stahl, 2021). An antagonist, as the name suggests, works against an agonist and partial agonist by blocking it from causing the conformational change in the receptor. Thus, an antagonist is a neutralizer of any agonist actions (Stahl, 2021). Lastly, an inverse agonist does the opposite of what an agonist does. While the latter increases signal transduction, the former binds to the receptor in a way that decreases signal transduction, even from levels below the baseline (Stahl 2021).
An example of an agonist in psychopharmacologic treatment is opioid overdose, like oxycodone, heroin, and morphine. Suppose one has a heroin overdose; doctors use an antagonist known as Naloxone, which has a rapid reaction in binding to the receptors and blocking any more drugs from binding with the receptor (Kalmoe & Gold, n.d.). Subsequently, partial and inverse agonists, such as naltrexone, are used to treat opioid addiction to help reduce severe withdrawal symptoms.
The Actions of G Couple Proteins versus Ion Gated Channels
The similarity between ion gated channels and G couple protein channels is that both are postsynaptic receptors. However, these channels also have variations. For instance, ion gated channels have two domains, each with a different role; one binds to neurotransmitter while the other forms the ion channel. Contrastingly, G couple protein channels utilize second messenger systems, which depend on various metabolic receptors and tend to be slower (Morrow et al., 2008).
How Epigenetics May Contribute to Pharmacologic Action
The basic concept of epigenetics is that various facts can lead to alteration in a gene’s function without changing its coding, also known as epigenetic events. Notably, these genes affected by epigenetics are inheritable. Therefore, suppose a certain drug is meant to work on a gene but that gene has encountered an epigenetic event. This means that the drug’s efficacy will also likely be affected. For instance, people who have undergone traumatic events and later on have PTSD have been shown to have significantly reduced levels of dopamine by affecting its receptors (Blum et al., 2019). This is an example of an epigenetic event. Now suppose such a person is administered dopamine-targeted drugs. There is a high likelihood that the drugs will not work, and they would require a higher dosage than the usual amount.
The Impact of This Information during Medication Prescription
This information is crucial when prescribing drugs because epigenetic events can either lead to drug resistance or high affinity of the drugs, which in turn can cause addiction. For example, people with depression are known to have low dopamine levels. Accordingly, any medication prescribed to such people includes ones that increase the dopamine levels in the brain. Suppose a patient with depression also has schizophrenia, a disease caused by dopamine imbalance (Howes et al., 2017); it is only prudent that a nurse practitioner uses alternative medications other than dopamine-targeted ones.
References
Blum, K., Gondré-Lewis, M. C., Modestino, E. J., Lott, L., Baron, D., Siwicki, D., & Badgaiyan, R. D. (2019). Understanding the scientific basis of post-traumatic stress disorder (PTSD): precision behavioral management overrides stigmatization. Molecular neurobiology, 56(11), 7836-7850.
Howes, O. D., McCutcheon, R., Owen, M. J., & Murray, R. M. (2017). The role of genes, stress, and dopamine in the development of schizophrenia. Biological psychiatry, 81(1), 9-20.
Kalmoe, M. C., & Gold, M. S. (n.d.). Naloxone and Naltrexone: The Story of Opioid Antagonists. Directions in, 87.
Morrow, E. M., Roffman, J. L., Wolf, D. H., & Coyle, J. T. (2008). Psychiatric neuroscience: incorporating pathophysiology into clinical case formulation. In Massachusetts General Hospital Comprehensive Clinical Psychiatry (pp. 543-564). Mosby.
Stahl, S. M. (2021). Stahl’s essential psychopharmacology: neuroscientific basis and practical applications. Cambridge university press.