Month: November 2019

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.

 

 

                                                  Main Post

Agonist-to-Antagonist Spectrum

The agonist-to-antagonist spectrum of action refers to  the action  that is taken by a neurotransmitter to produces a  conformational change  (Stahl, 2013).  The spectrum starts with the  agonist action, which,  with the help of a second-messenger, can turn on  the full potential of  change (Stahl, 2013). Full agonists can be natural  transmitters used to  produce change.  An antagonist blocks the  conformational change of the  potential of the transmitter for binding  with the intended agonist  (Stahl, 2013).  The role of the antagonist is  to keep the receptors in a  baseline state in order to reverse what the  agonist has done (Stahl,  2013). This is the opposite end of the spectrum  and seeks to block  agonists.  In the middle, some partial agonists  mimic its agonist  partner to a lesser degree, and inverse agonists stop  all activity from  occurring on the receptor (Stahl, 2013).  The  conformational change is  needed for a receptor to open to the action of  drugs, particularly,  psychopharmaceutical medications in this case.

G couple proteins and Ion gated channels

G couple proteins are used at the binding site of a  neurotransmitter  to act as a conduit for enzymes (Stahl, 2013). Whereas,  ion gated  channels exist as targets to regulate chemical  neurotransmitters  (Stahl, 2013).  Ion gated channels consist of channels  and receptors  that can only be opened by the neurotransmitters.   Conversely, G couple  proteins attach to neurotransmitters and conform to  enzymes to serve  as a channel for a second messenger (Stahl, 2013).   Most psychotropic  medications aim for the ion gated channels, which open  through chemical  neurotransmission and initiate the signal transduction  cascade (Stahl,  2013).  The cascade results in faster uptake of  psychotropic  medications into the system.

The Role of Epigenetics

According to DeSocio (2016), epigenetics is the study  of how genomes  that undergo changes with certain molecular compounds and   environmental changes can leave the essential DNA unchanged.  It is a   modification of gene expression that is independent of the DNA  (DeSocio,  2016).  DNA is the code that determines much of who we are.   Changes in  that code can be seen as a result of heredity, the  environment, or  neurotransmission (Stahl, 2013).  These alterations  affect individuals  at a physical, emotional, and psychological level.   Stress and adversity  play a significant role in epigenetics by changing  the genomes, which  in turn leads to changes in a person’s DNA (Park et  al., 2019).  These  alterations influence psychological issues related  to many individuals.   It is essential to know how to combat these  changes when determining a  plan of care for clients.

Implications of Findings to Prescribing

As nurse practitioners, it is essential to have an  extensive  understanding of how the above processes affect the way we  prescribe  medications to clients.  It is also essential to take into   consideration how the environment impacts maintaining optimal health  and  healing (DeSocio, 2016).  Knowing the mechanisms of action for   medications that we are prescribing is vital to providing competent   care.  For example, a patient with a generalized anxiety disorder (GAD)   is prescribed Venlafaxine.  The PMHNP needs to understand that the   Venlafaxine works by boosting the serotonin, norepinephrine, and   dopamine neurotransmitters (Stahl, 2014).  This action blocks serotonin   reuptake, norepinephrine reuptake, and the dopamine reuptake (Stahl,   2014).  Each of these actions then increases these neurotransmissions  in  the brain providing therapeutic results. 

                                          References

DeSocio, J.E. (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

Park, C.,  Rosenblat, J.D., Brietzke, E.,  Pan, Z., Lee, Y., Cao, B.,  Zuckerman, H., Kalantarova, A., McIntyre,  R.S. (2019). Stress,  epigenetics, and depression: A systematic review. Neuroscience and Biobehavioral Reviews, 102, 139-152. https://doi.org/10.1016/j.neubiorev.2019.04.010

Stahl, S.M. (2014). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

Stahl, S.M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications. (4th ed.). New York, NY: Cambridge University Press.

Describe some ways that psychologists provide services to jail inmates

 

Discuss the benefits of Multisystemic Therapy (MST) in the treatment of juvenile offenders. 

 

Suppose you are the judge responsible for sentencing Jason Miller, a 20 year-old man convicted of robbing a convenience store. At trial, the prosecution showed that Jason was the getaway driver for his older brother and another man (both of whom had lengthy criminal histories). Jason was not armed and did not have any interaction with anyone inside the store. The other two men brandished firearms and struck the clerk, causing severe head trauma. Jason’s attorney presented evidence at his sentencing hearing that Jason had only been arrested once before for stealing a cell phone from another student in high school; Jason had successfully completed diversion for that offense. His attorney also presented evidence that Jason had maintained a job for two years after high school graduation as a construction worker. In your jurisdiction, you have the option of sentencing Jason to prison (for 1-25 years) or to probation (for up to five years). How would you determine an appropriate sentence for Jason?

 

Becky Williams works on a road crew for the City of Palm Springs. She often works early in the morning to repair potholes on the busy streets. One day, a vehicle sped through the construction zone and veered off the road, pinning Becky between the vehicle and a work truck. Becky was trapped for an hour while emergency crews freed her. As a result of the incident, Becky suffered tremendous physical damages, including the amputation of both of her legs. Becky filed a civil suit; her attorney asked for damages to compensate Becky for her physical injuries as well as for the trauma caused by the accident. At the trial, evidence was presented as to the medical costs, lost wages, and loss of future earning capacities. Discuss any issues Becky’s attorney may have in presenting her case for psychological injuries.

 

Discuss factors that are considered when setting bail. 

 

Plea bargaining is encouraged in the criminal system for many reasons. It can help reduce the caseload, eliminate the need for victims to testify, result in charges being dropped for a defendant, and can secure a defendant’s testimony against co-defendants. Plea bargaining does not occur in every case. Those defendants who instead request a trial are sentenced to prison at a higher rate than those who accept a plea bargain. Consider the role of the judge in sentencing. Explain why a judge may sentence a defendant who is convicted of a crime after trial more harshly than one who accepted a plea bargain for the same charge.

 

In 2016, a jury in Omaha, Nebraska convicted Anthony Garcia in two separate double murders. The first occurred in 2008 and involved the slaying of a nanny and an 11-year-old boy. The second occurred in 2013 and involved a retired doctor and his wife. Defense attorneys requested that the trial be moved outside of the Omaha area due to the extensive media coverage; that request was denied. Given the information you have studied about juror bias, describe the type of information that the defense should have presented to the judge in support of their request.

Instructions

Think about a recent project/endeavor that you have participated in. Do you agree with the following statement: “With proper planning it is possible to eliminate most/all risks from a project/endeavor”? Why, or why not? 

Your journal entry must be at least 200 words. No references or citations are necessary.