Psychopharmacologic Approaches to Treatment of Psychopathology Essay
The agonist/antagonist spectrum represents how drugs can act on specific receptors. In psychophamacotherapy, G-protein-linked receptors are often targeted by medications using this spectrum (Stahl et al., 2021). On one side, you have an agonist. It is meant to fully activate a specific receptor (Stahl et al., 2021). Without an agonist, you still have the potential for particular receptors to be acted on naturally, but more weakly; this is called constitutive activity (Stahl et al., 2021). Agonists, as stated previously, can fully activate a receptor. They can do this both directly, by binding to a neurotransmitter site, or indirectly, by blocking both inactivation processes and eliminating neurotransmitters (Stahl et al., 2021). In sort of the middle of the spectrum are antagonists. Antagonists may erroneously be categorized as the opposite of an agonist. But, antagonists are simply silent security that lay in wait to block the specific neurotransmitter agonist they’ve been set for (Stahl et al., 2021). Psychopharmacologic Approaches to Treatment of Psychopathology Essay
Between agonist and antagonist, you have a partial agonist. An antagonist also blocks partial agonists. They act more strongly than no agonist but less than a full one. They can be used when less action is needed or if stabilization is the goal (Stahl et al., 2021). Lastly, we have inverse agonist, which is actually on the opposite end of the spectrum from agonist. There is more than just something blocking the receptor to specific agonists with an inverse agonist. An inverse agonist can decrease signal transduction and completely stop an agonist from working on a receptor to the point of causing an opposite reaction (Stahl et al., 2021). Psychopharmacologic Approaches to Treatment of Psychopathology Essay
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Both ion-gated channels and G-couple proteins use receptors to collect ligands from extracellular space (though there are rare exceptions where the receptors are in the intracellular area). Specific ligands fit perfectly into their bio channel receptor, changing their shape (Weir, n.d.) How they do this, though, is entirely different. Ion channels are closed until a specific ligand attaches to an allosteric site; from there, it can control the opening of the channel (Weir, 2010). The permeability of the plasma membrane is changed, and ions are free to move through. They can cause either hyperpolarization or depolarization (Weir, 2010). Psychopharmacologic Approaches to Treatment of Psychopathology Essay
On the other hand, G-couple proteins have seven transmembrane alpha helixes that bind to GTP and GDP. A specific ligand binds to the receptor and causes a conformational change. The GPCR exchanges GDP for GTP, which causes the alpha subunit to separate from beta and gamma, and then they can both interact with target proteins (Weir, 2010.) The alpha unit can activate selected protein and relay signals until the process is stopped by the hydrolysis of GTP, forming GDP and ending the loop (Weir, 2010) Psychopharmacologic Approaches to Treatment of Psychopathology Essay
Epigenetics studies molecularly mediated interaction between genomes and the environment (DeSocio, 2016). The mechanism of epigenetics works by altering chromatin, which can then control the expression of a gene (Stahl et al., 2021). The critical distinction between epigenetics and genetics is that epigenetic changes are reversible (Camprodon & Roffman, 2016). Epigenetic studies supply evidence that supports the combination approach of medication, therapy, and education in psychiatry (DeSocio, 2016). This means that epigenetics can help to guide pharmaceutical strategies. Psychopharmacologic Approaches to Treatment of Psychopathology Essay
All of this information is valuable to a Nurse Practioner. Being conscious of how the drug class works on the receptor and what pathway we are targeting can be vital to care. Epigenetics also proves crucial as it helps establish a multifaceted approach as ideal in psychiatric care. There are many instances in which this knowledge could be beneficial. One particular example that comes to mind would be in the case of schizophrenia. Dopamine is thought to be the primary neurotransmitter involved (Camprodon & Roffman, 2016). Antipsychotics are typically antagonists that target dopamine receptors, but some are different, like ariprpazole, a partial agonist. So if we find that a typical antipsychotic isn’t working well to control symptoms or causes unwanted side effects, we might try something like aripiprazole that will work a little differently and perhaps help regulate dopamine more evenly. Psychopharmacologic Approaches to Treatment of Psychopathology Essay
References
Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital Psychopharmacology and Neurotherapeutics. Elsevier.
DeSocio, J. (2016) Epigenetics: An emerging framework for advanced practice psychiatric nursing. Perspectives in Psychiatric Care, 52(3), 201-207. https://doi.org/10.1111/ppc.12118
Stahl, S. M., Grady, M. M., & Muntner, N. (2021). Stahl’s essential psychopharmacology neuroscientific basis and practical applications. Cambridge University Press.
Weir, C. J. (2010). Ion channels, receptors, agonists, and antagonists. Anaesthesia & Intensive Care Medicine, 11(9), 377–383. ht Psychopharmacologic Approaches to Treatment of Psychopathology Essay
