Neurobiology and Medication Adherence Concepts NURS 6630

Walden University Neurobiology and Medication Adherence Concepts NURS 6630-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University Neurobiology and Medication Adherence Concepts NURS 6630 assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for Neurobiology and Medication Adherence Concepts NURS 6630                     

Whether one passes or fails an academic assignment such as the Walden University Neurobiology and Medication Adherence Concepts NURS 6630 depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for Neurobiology and Medication Adherence Concepts NURS 6630                     

The introduction for the Walden University Neurobiology and Medication Adherence Concepts NURS 6630 is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for Neurobiology and Medication Adherence Concepts NURS 6630                     

After the introduction, move into the main part of the Neurobiology and Medication Adherence Concepts NURS 6630 assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for Neurobiology and Medication Adherence Concepts NURS 6630                     

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for Neurobiology and Medication Adherence Concepts NURS 6630                     

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Neurobiology and Medication Adherence Concepts NURS 6630

A Sample Answer For the Assignment: Neurobiology and Medication Adherence Concepts NURS 6630

Neurons are information messengers whose role is to transmit information between the areas of the brain and the rest of the nervous system. They have three main parts namely the cell body, axon, and the dendrites (Kringelbach et al., 2020). The cell body is made up of a nucleus and cytoplasm and produces protein required to construct other parts of the neuron.

The axon, on the other hand, extends from the cell body and carries signals away from the cell body while the dendrites carry signals toward the cell body and have numerous synapses to receive the signal from nearby neurons. Upon stimulation, neurons transmit an electrical impulse that passes through the dendrite, to the cell body, axon, axon terminal, and finally, the stimulus is passed (Kringelbach et al., 2020). At the axonal terminal, the axon releases neurotransmitters that depolarize neighboring cells through synapses and by binding to the membrane of the dendrite.

Specifically, the hippocampus is used to mediate a cognitive/spatial form of memory. It controls learning and declarative memory which covers the memory of facts and events (Malinowski, 2019).  The dorsal striatum also helps in memory by mediating the stimulus-response habit memory. Addiction on the other hand is linked to the limbic system through the orbitofrontal cortex and anterior cingulate gyrus (Malinowski, 2019). In line with motor control, the nigra striatal region offers two anatomically and functionally distinct portions knowns as the substantia nigra pars compacta and the substantia nigra pars reticulata.

Other essential components in the central nervous system are the glial cells. They include the astrocytes whose role is to maintain the environment for neuronal signaling by controlling the level of neurotransmitters surrounding the synapses (Hirbec et al., 2020).

Equally, oligodendrocytes wrap around the axons forming a protective layer called myelin sheath which enhances neuron signaling. The cells also include microglia, ependymal cells, and radial glial whose roles are clearing dead cells or removing harmful toxins, maintaining homeostasis, and regenerating neurons and other glial cells like astrocytes and oligodendrocytes respectively.

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Neurons communicate with each other through synaptic transmission. A chemical synapse is registered at the axon terminal of the presynaptic neuron and the dendrite of the postsynaptic neuron (Malinowski, 2019). The dendrite picks up signals and passes the signals down to the axon, into the axon terminals, and into the synapses. The role of the chemical synapse is to transform the electrical signal in the presynaptic cell’s axon into a chemical signal and back into an electrical signal in the postsynaptic cell.

Neurobiology and Medication Adherence Concepts

Resources

 

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

By Day 7

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

Attempt History

	Attempt	Time	Score
LATEST	Attempt 1	5,882 minutes	0 out of 0

Neurobiology and Medication Adherence Concepts

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 

WEEKLY RESOURCES

By Day 7

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

Attempt History

	Attempt	Time	Score
LATEST	Attempt 1	5,882 minutes	0 out of 0

Score for this quiz: 0 out of 0

Submitted Dec 18, 2022 at 3:17am

This attempt took 5,882 minutes.

Question 1

0 / 0 pts

Neurotransmitters are defined by four essential characteristics. These are:

Neurotransmitters are synthesized within presynaptic neurons.

Depolarization of a neuron results in the release of a neurotransmitter, which exerts a multitude of actions on the postsynaptic neuron.

Their action on postsynaptic neurons can be replicated by administering a drug that mimics the activity of the endogenous neurotransmitter.

Their action in the synaptic cleft is terminated by a specific action.

Correct!

A, C, and D only

Answer B should read a “discrete” (not multitude) action on the post synaptic neuron.

Question 2

0 / 0 pts

Upon blocking a Serotonin reuptake pump, what happens in the synaptic cleft and on the post synaptic cell membrane?

The result will be an increase in available Serotonin in the synaptic cleft causing the post synaptic cell to increase the number of Serotonin receptors.

Correct!

The result will be an increase in the available Serotonin in the synaptic cleft causing the post synaptic neuron to reduce the number of Serotonin receptors.

The result will be an increase in Serotonin in the synaptic cleft resulting in an increase in reuptake pumps on the presynaptic neuron.

The result will be an increase in Serotonin in the synaptic cleft resulting in a decrease in reuptake pumps on the pre-synaptic neuron.

A, C, and D are misrepresentations of what occurs when you increase Serotonin in the synaptic cleft. There is no effect on the pre-synaptic neuron, and the increases in Serotonin result in a reduction of receptor concentration on the post-synaptic neuron.

Question 3

0 / 0 pts

Neurotransmission is unidirectional insofar as chemical and electrical conduction is concerned within the individual neuron. Of the following descriptions, which best characterizes the order of neurotransmitter/receptor interaction that results in an electrical signal impulse and the release of another neurotransmitter for interaction in the synaptic cleft (signal conduction through a neuron)?

Cell body, dendrites, Axon, Axon terminals

Dendrites, Axon, Cell body, Axon, Axon terminals

Correct!

Dendrites, Cell body, Axon, Axon terminals

Axon terminals, Axon, Cell body, Dendrites

All of the other options are mis-sequenced in signal conduction.

Question 4

0 / 0 pts

¹Neurons are classified in several different ways. From the following statements, select which ones are true.

1. The two structural classifications are projection neurons and local inter-neurons.
2. Function classifications are made up of two subcategories: excitatory and inhibitory.
3. Histological classification includes bipolar, unipolar, and multipolar.
4. Classifications using a combination of structural, functional, and neurotransmitter type provide the most robust and useful description.
5. Classification by neurotransmitter type alone provides the most useful description.

I only

III only

I, II, and V only

I, II, III, IV, and V

Correct!

I, III, and IV

Statement II would need to include modulatory function to be correct, and Statement V does not include structural and functional classification systems.

Question 5

0 / 0 pts

Receptors trigger one of two effector pathways resulting in changes in neuronal activity. These changes will, ultimately, effect gene expression. Which effector pathway is characterized by ion flux through transmitter-activated channels resulting in an altered membrane potential and neuronal activity?

Slow effector pathways

Modulated effector pathways

Correct!

Rapid effector pathways

NMDA glutamate receptor pathways

Answer B is fictitious, D is a type of rapid effector pathway, and A represents G-protein coupled receptors.

Question 6

0 / 0 pts

Introducing adherence in facilitating treatment goals is something that would be necessary in a patient who has previously displayed nonadherence patterns.

True

Correct!

False

It is introduced as early as possible in treatment to mitigate the risks associated with nonadherence.

Question 7

0 / 0 pts

Serotonin (5HT) is a neurotransmitter associated with mood, sleep, and psychosis. There are several serotonin receptors all over the human body. A unique aspect of the second generation antipsychotics is their ability to block 5HT2a receptors. What is the effect of this inhibition?

Correct!

Stabilizes dopamine concentrations in the CNS

Induces anxiety

Causes hallucinations

Reduces platelet function

B represents antagonism of 5HT1a, C represents a 5HT2a agonist, and D represents what happens when you inhibit SERT.

Question 8

0 / 0 pts

Treatment adherence is affected by several different factors. Clinical factors include mood, anxiety, psychosis, and substance misuse. There are also patient factors such as knowledge, attitude, and beliefs; economic and racial/ethnic disparities, and clinical encounters. A patient who presents hopeless, with decreased energy, and poor concentration is affected by which factor?

Substance misuse

Knowledge deficits

Attitude ad belief system

Correct!

Mood

These are signs of an altered mood.

Question 9

0 / 0 pts

If a patient admits to taking his medication every other day (instead of daily, as prescribed), a potential concern would be:

Sufficient understanding or acceptance of the illness

Abuse of the medication

Correct!

Expense

Is the desired effect recognized at a lower daily dose?

A represents a patient taking his medication sporadically, B represents a patient taking too much medication, and D represents a patient taking a lower-than-prescribed dose but daily

Question 10

0 / 0 pts

The human brain is subcategorized into four major structures. These structures include the cerebral cortex, brainstem, subcortical structures, and the cerebellum. Of these major categories, which one houses the area of the brain that has been found in some neuropathological studies of patients with schizophrenia to be of smaller size?

Cerebral cortex

Brainstem

Correct!

Subcortical structures

Cerebellum

The area of the brain in question is part of the thalamus, which is located in the subcortical structures. The other options are incorrect, geographically speaking.

Question 11

0 / 0 pts

Of the components of patient-focused interventions to enhance adherence, which component includes the following strategies: adaptive thinking, use of cues, and support?

Motivation

Correct!

Skills

Logistics

Education

Skills include adaptive thinking, problem solving, use of cues, and support.

Question 12

0 / 0 pts

Which of the following consists of all the known major neurotransmitters that are relevant in psychiatry?

glutamate, GABA, dopamine, serotonin, norepinephrine, histamine, steroids, nitric oxide

Correct!

glutamate, GABA, dopamine, norepinephrine, serotonin, acetylcholine, histamine, endogenous opioids, steroids, cannabinoids, nitric oxide

glutamate, GABA, dopamine, serotonin, acetylcholine, endogenous opioids, nitric oxide, cannabinoids, steroids

glutamate, GABA, dopamine, serotonin, norepinephrine, endogenous opioids, steroids, histamine, nitric oxide

all the other options are missing neurotransmitters considered important in psychiatry

Question 13

0 / 0 pts

Glia cells play a supportive role to the neuron. A few of the functions of the glial cells include providing nutrition, maintaining homeostasis, stabilizing synapses, and myelinating axons. The glial cells are categorized as microglia and macroglia. Of these two cell types, which one plays an active and critical role in glutamatergic neurotransmission by providing a co-agonist required for glutamate receptor function?

microglial

Correct!

macroglial

Microglial cells are small, phagocytic cells related to peripheral macrophages.

Question 14

0 / 0 pts

The synaptic cleft is best characterized by which of the following statements?

The synaptic cleft is the space between a single neuron’s dendrites and axon terminals in which intracellular communication occurs through the release of neurotransmitters allowing for signal conduction throughout the central nervous system.

The synaptic cleft is the space between the cell body and axon terminals that allows for release of neurotransmitters from the presynaptic neuron for intercellular communication with an adjacent neuron (post synaptic neuron).

Correct!

The synaptic cleft is an area where dendrites and axon terminals are within close proximity, allowing for the release of a neurotransmitter from a presynaptic neuron that can interact with receptors on dendritic cells of a post synaptic neuron, which is the main basis for intercellular communication of neurons.

Answer A represents a neuron communicating with itself and Answer B states that the synapse is the space between the cell body (not dendrites) and axon terminals.

Question 15

0 / 0 pts

A patient arrives in the ED via EMS having a grand mal seizure. The ED physician instructs the RN to give 10 milligrams of Diazepam IV X1 dose STAT. The patient’s seizure breaks within 2 minutes of the Diazepam being administered. The mechanism by which this medication causes rapid resolution of seizure activity is via which receptor type (effector pathway/receptor subtype)?

Slow effector pathways/G-protein coupled receptor

Slow effector pathway/ion channel

Rapid effector pathways/G-protein coupled receptor

Correct!

Rapid effector pathway/ion channel

Options B and C are mismatched, and Option A shows effects days to weeks after activation.

Question 16

0 / 0 pts

G-protein coupled receptors are targets for several psychiatric medications. Given what we know about these receptors, what is the ultimate result we will see when one of them is activated in a way that would potentiate an action?

Intracellular activation of second messengers

Protein phosphorylation

Correct!

Modification of gene expression

A and B are both steps in the activities seen leading up to modification of gene expression.

Question 17

0 / 0 pts

G-protein coupled receptors are examples of what type of effector pathway?

Correct!

Slow effector pathways

Rapid effector pathways

NMDA glutamate receptor pathways

Modulated effector pathways

Answer D is fictitious, B represents ion channel receptors, and C is a type of rapid effector pathway.

Question 18

0 / 0 pts

When dopamine (subtype 2) receptors are blocked in this pathway (system), it is evident by EPS.

Mesocortical

Tuberoinfundibular

Correct!

Nigrostriatal

Mesolimbic

D is associated with positive symptoms in schizophrenia, B is associated with lactation, A is associated with affect.

Question 19

0 / 0 pts

Which neurotransmitter is considered the major excitatory neurotransmitter?

Glycine

GABA

Correct!

Glutamate

Serotonin

A and B are inhibitory, and D is involved in mood and sleep.

Question 20

0 / 0 pts

Motivation is a component of patient-focused interventions to enhance adherence. Based on the transtheoretical model, readiness to change can fluctuate across five stages. Which stage is represented by the patient who is aware that a problem exists and, while seriously thinking about overcoming it, has not yet committed to a plan of action?

Preparation

Action

Correct!

Contemplation

Maintenance

Quiz Score: 0 out of 0

Case Study: Management of Gambling Disorder Co-occurring with Alcohol Use Disorder

Alcohol use disorder contributes a significant proportion of the mental disorder substance use disorder which often occurs as a consequence of maladaptation to pressures in life. Alcohol use disorder co-occurrence with gambling disorder is increasing in prevalence over the years. Each disorder is a known predisposing factor for the other.

There is a greater predisposition to morbidity and mortality than when the disorders occur separately (Atkinson, 2018). The purpose of this paper is to discuss the management of this patient in line with pharmacotherapy and psychotherapy, the expectations during and after treatment, and the ethical considerations during management.

Introduction to the Case

This week’s case study discusses a 53-year-old Puerto Rican female Mrs. Perez who has had alcohol use disorder for more than 25 years and has been part of Alcoholic Anonymous though intermittently. Her alcohol use has deteriorated over 2 years since a casino was opened close to her home. She also reports spending huge sums of money on gambling and her alcohol consumption also increases during gambling sprees.

She also reports an increase in the frequency of smoking cigarettes over the past 2 years. She has gained 7lb. In her mental state exam, she is alert and oriented with clear speech. She cannot maintain appropriate eye contact and is avoidant. Her subjective mood is sad and her impulse control is impaired. She has no hallucinations, no involuntary stereotyped movements, no suicidal ideations, and her insight and judgment are intact. Her diagnosis is gambling disorder co-occurring with alcohol use disorder.

In this case, decision-making in treatment is influenced by the goal of therapy, treatment duration, the dosage of the drug, socioeconomic status of the patient, gender, the individual drug pharmacokinetics, side effects, and toxicity profile. The purpose of this paper is to discuss the management of this patient in line with pharmacotherapy and psychotherapy, the expectations during and after treatment, and the ethical considerations during management.

Decision 1

Naltrexone 380mg Intramuscularly every 4 weeks.

Why did you select this decision?

Naltrexone is considered one of the first-line drugs in the management of alcohol use disorder. Naltrexone is highly efficacious in the prevention of relapse and reduction in heavy consumption of alcohol. It has also been found to have an average efficacy in the promotion of total abstinence in alcohol use disorder patients (Kedia et al., 2022).

According to the American Psychiatry Association, naltrexone proves to have modest efficacy in the treatment of alcohol use disorder with few side effects. The extended-release intramuscular naltrexone greatly improves the adherence to medication by reducing the pill burden and limiting the dose to one monthly injection (Edelman et al., 2018). Naltrexone has also been shown to extinguish the urge to gamble (Kraus et al., 2020). These reasons make Naltrexone the most appropriate in Mrs. Perez’ management.

Why did you not select the other two options provided in the exercise?

Acamprosate offers an alternative to naltrexone in the case of a contraindication to naltrexone use. The three-times daily dose of 666mg of Acamprosate is high and often associated with severe side effects like suicidal ideations, anxiety, and tipping into major depression, especially for this patient whose subjective mood is already sad. Disulfiram is an FDA-approved second-line pharmacotherapy for alcohol use disorder (Stokes & Abdijadid, 2019).

Disulfiram usage is marred with a lot of adverse effects ranging from confusion states, and convulsions, to death (Patel & Balasanova, 2021). Its use is restricted to patients who are highly motivated to cease alcohol use. Because of these serious side effects, disulfiram use is marred with non-adherence to therapy. For this particular patient, it may be used when the first-line therapy fails. There is no approved pharmacotherapy for gambling disorder hence there is a further need for patient counseling and cognitive behavioral therapy.

What were you hoping to achieve by making this decision?

After induction of treatment, it is expected that the patient will abstain completely from alcohol and there will be long periods before relapse. Reduced craving for alcohol and reduce total alcohol consumption during therapy (Fairbanks et al., 2020). Few adverse effects are expected as the long-acting slow release is effective at minimizing side effects.

The patient is expected to be adherent to the medication as there is no pill burden and the injection is only once a month (Kedia et al., 2022). It is expected that the patient will continue smoking and gambling as these drugs do not treat gambling disorders.

How ethical considerations may impact the treatment plan and communication

The treatment of this patient is based on the four tenets of ethical considerations which include justice, non-maleficence, beneficence, and autonomy. Informed consent is important in patient care. The condition is explained to the patient and she is provided with the best treatment choices based on her condition.

The side effects of each of the drug choices are explained to the patient (Davis, 2020). Continuous monitoring of these side effects and the well-being of the patient is mandatory. Preservation of patient confidentiality is essential.

Decision 2

Refer to a counselor to address gambling issues

Why did you select this decision?

Counseling is the mainstay of the management of gambling disorders.  According to Atkinson et al (2018), psychotherapy is the most effective treatment of gambling disorder. The aspects of counseling may include gambling anonymous groups, cognitive behavioral therapy, and group therapy (Jonas et al., 2019). Pharmacotherapy only deals to reduce the co-morbidities associated with gambling disorder which in this case is alcohol use.

Why did you not select the other two options provided in the exercise?

Mrs. Perez’ anxiety is a direct consequence of gambling disorder. Psychotherapy is provides a higher efficiency in the management of anxiety than pharmacotherapy (Jonas et al., 2019). For this reason, diazepam will be ineffective. Diazepam is not an indicated treatment for gambling disorder.

Diazepam would potentiate depression of the central nervous system. Varenicline is effective in aiding in quitting smoking as a nicotine replacement therapy when used alongside counseling as an adjunct therapy (Rigotti et al., 2022). However, it is important to maintain a monotherapy to prevent any drug-drug interactions.

What were you hoping to achieve by making this decision?

Following counseling, the patient’s anxiety is expected to be allayed. The gambling disorder and smoking are expected to have regressed and stopped after 12 weeks of counseling and cognitive behavioral therapy. With continuation and adherence to the monthly dose of naltrexone, the alcohol use disorder is expected to be distinguished with no withdrawal effects.

How ethical considerations may impact the treatment plan and communication

Counseling employs patient privacy and confidentiality to help build trust between the patient and the counselor. Competence and empathetic listening are vital values for a counselor (Palmer & Burrows, 2020). Informed consent is pivotal. The counselor must be registered under the professional body of counselors. Other tenets like justice, beneficence, and nonmaleficence still apply.

Decision 3

Explore the issue that the patient has with the counselor and encourage attendance of the Gamblers’ anonymous meetings.

Why did you select this decision?

The counseling sessions, however, the challenges ensued prove to have started working for this patient. The anxiety is resolved and she feels supported in the support group she joined. This is a worthwhile path that is proving efficacious in her management.

There is a need to look into the issue that the patient holds against the counselor and resolve it if possible. If it is unresolvable, referral to another counselor would be the best course (Atkinson, 2018). This poor relationship would lead to default in therapy. Default in therapy may lead to reverting to gambling.

Why did you not select the other two options provided in the exercise?

Naltrexone use in the treatment of alcohol use disorder runs for a minimum of 6 months (Kedia et al., 2022). Discontinuation of naltrexone after 8 weeks of therapy is too soon and this may give room for relapsing to alcohol use disorder. If the patient continues visiting the counselor yet has an issue with her, it could prove detrimental to the course of therapy (DeAngelis, 2019). From this, it is key to aim at improving the patient-counselor relationship.

What were you hoping to achieve by making this decision?

Exploration of the issue with the counselor will fuel a positive interaction with the patient which in turn will improve the outcome of therapy (DeAngelis, 2019). The patient is also expected to stay in remission for the whole duration of therapy. There will be no adverse effects of the drugs.

How ethical considerations may impact the treatment plan and communication

The right of a patient to choose their counselor is important. Respecting the autonomy of the patient in decision-making is another important consideration (Davis, 2020). Maintenance of patient privacy and confidentiality of patient information is golden.

Conclusion

Co-occurrence of gambling disorder with alcohol use disorder is rising in prevalence as one is likely to tip a person into the other. This co-occurrence increases morbidity and mortality among these patients. This case study offers a perfect avenue for discussion of alcohol use disorder co-occurring with gambling disorder and cigarette smoking.

The management is mainly based on pharmacotherapy and cognitive behavioral therapy. This patient displays binge alcohol drinking, smoking cigarettes, and spending excess money in her gambling endeavors. The first line of treatment for Alcohol use disorder co-occurring with a gambling disorder is naltrexone and acamprosate (Kedia et al., 2022).

Combination therapy of naltrexone and cognitive behavioral therapy is highly efficacious in the management of this particular case (Jonas et al., 2019). Naltrexone is indicated to reduce alcohol cravings, minimize relapse, and abstain and it is also proven to greatly reduce the urge and the frequency of gambling sprees.

The slow-release naltrexone greatly improves adherence. Acamprosate on the other hand has a limited advantage profile. It only promotes abstinence. Disulfiram is an FDA second line in the treatment of alcohol use disorder with limited use only in patients who aim at the complete cessation of alcohol use.

Its adverse effects profile is severe ranging from light autonomic disturbances to commas and death (Stokes & Abdijadid, 2019). the pharmacotherapy of choice is greatly influenced by the goal of therapy, treatment duration, the dosage of the drug, socioeconomic status of the patient, the individual drug pharmacokinetics, side effects, and toxicity profile of the drug.

The ethical considerations are based on justice, non-maleficence, beneficence, and autonomy. Informed consent, preservation of patient confidentiality, privacy, and respect for a patient’s decision is pivotal (Davis, 2020). The effective treatment of alcohol use disorder co-occurring with gambling disorder and cigarette smoking requires a wholesome treatment of the patient involving physical therapy and psychotherapy.

References

Atkinson, J. (2018). Commonalities in the Association of Behavioral Activation and Behavioral Inhibition with Problem Gambling and Alcohol Use in Young Adult College Students. Journal of Gambling Studies, 35(1), 125–141. https://doi.org/10.1007/s10899-018-9788-5

Davis, C. N. (2020). Guidelines and recommendations for training ethical alcohol researchers. Training and Education in Professional Psychology, 14(1), 52–59. https://doi.org/10.1037/tep0000257

DeAngelis, T. (2019, November 1). Better relationships with patients lead to better outcomes. Https://Www.apa.org. https://www.apa.org/monitor/2019/11/ce-corner-relationships

Edelman, E. J., Moore, B. A., Holt, S. R., Hansen, N., Kyriakides, T. C., Virata, M., Brown, S. T., Justice, A. C., Bryant, K. J., Fiellin, D. A., & Fiellin, L. E. (2018). Efficacy of Extended-Release Naltrexone on HIV-Related and Drinking Outcomes Among HIV-Positive Patients: A Randomized-Controlled Trial. AIDS and Behavior, 23(1), 211–221. https://doi.org/10.1007/s10461-018-2241-z

Fairbanks, J., Umbreit, A., Kolla, B. P., Karpyak, V. M., Schneekloth, T. D., Loukianova, L. L., & Sinha, S. (2020). Evidenced-Based pharmacotherapies for Alcohol Use Disorder. Mayo Clinic Proceedings, 95(9). https://doi.org/10.1016/j.mayocp.2020.01.030

Jonas, B., Leuschner, F., Eiling, A., Schoelen, C., Soellner, R., & Tossmann, P. (2019). Web-Based Intervention and Email-Counseling for Problem Gamblers: Results of a Randomized Controlled Trial. Journal of Gambling Studies. https://doi.org/10.1007/s10899-019-09883-8

Kedia, S. K., Ahuja, N., Dillon, P. J., Jones, A., Kumar, S., & Satapathy, S. (2022). Efficacy of Extended-Release Injectable Naltrexone on Alcohol Use Disorder Treatment: A Systematic Review. Journal of Psychoactive Drugs, 1–13. https://doi.org/10.1080/02791072.2022.2073300

Kraus, S. W., Etuk, R., & Potenza, M. N. (2020). Current pharmacotherapy for gambling disorder: a systematic review. Expert Opinion on Pharmacotherapy, 21(3), 287–296. https://doi.org/10.1080/14656566.2019.1702969

Palmer, K. M., & Burrows, V. (2020). Ethical and Safety Concerns Regarding the Use of Mental Health–Related Apps in Counseling: Considerations for Counselors. Journal of Technology in Behavioral Science. https://doi.org/10.1007/s41347-020-00160-9

Patel, A. K., & Balasanova, A. A. (2021). Treatment of Alcohol Use Disorder. JAMA, 325(6), 596. https://doi.org/10.1001/jama.2020.2012

Rigotti, N. A., Kruse, G. R., Livingstone-Banks, J., & Hartmann-Boyce, J. (2022). Treatment of Tobacco Smoking. JAMA, 327(6), 566. https://doi.org/10.1001/jama.2022.0395

Stokes, M., & Abdijadid, S. (2019, April 10). Disulfiram. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459340/

Discussion: Neurotransmitters and Receptor Theory

Within the framework of traditional receptor theory, drugs that are essential to human bodies behave as agonists to antagonists.  Agonist drugs have both affinity that is they bind to the target receptor and they are also intrinsic efficacy that is they change receptor activity to produce a response (Berg & Clarke, 2018).

Antagonist drugs are ligands that have affinity but with zero intrinsic efficacy, meaning they bind to the targeted receptor; however, they do not themselves have any pharmacological actions mediated by the response. For example, propranolol is a β-adrenoceptor antagonist which binds to β-adrenoceptors in the heart thereby preventing catecholamine-induced tachycardia, for example, in response to exercise.

A partial agonist cannot produce the maximal response of which the tissue is capable even when it binds to the full receptor occupancy (Berg & Clarke, 2018).  Additionally, an inverse agonist binds to a receptor producing a pharmacological impact that is opposite to that of the corresponding agonist. Thus both the partial and inverse agonist’s functionality affects the psychopharmacological treatments by reducing the receptor activity.

G-coupled protein receptors and chemically ion-gated channels are transmembrane proteins that make up the postsynaptic ion channels that occur on the postsynaptic neurons, meaning they have different structures and functions (Calebiro, et al., 2021). Both transmembrane proteins mediate ion channels to depolarize or hyperpolarize the plasma membrane of the postsynaptic neuron. One difference between these two transmembrane proteins is that ion-gated channels are ionotropic receptors, while the G protein-coupled receptors are metabotropic receptors.

The main difference between these two transmembrane proteins is that the ion-gated channels are pores found in the cellular membrane that is activated by ligands (Calebiro et al., 2021). They allow ions to pass in and out of the cell upon binding with neurotransmitters, thus they are responsible for the electrical activity of cells including the generation of action potentials.

G protein-coupled receptors on the other hand recognize a wide range of ligands that include the photons, small molecules, and proteins that open or close ion channels upon binding the neurotransmitters meaning they allow activation of ion channels resulting in changes in membrane potential.

Epigenetics summarizes mechanisms of DNA transcription regulation and thus has a passive role in biological processes. Epigenetics deals with the regulation of gene activity in maintaining the normal phenotypic activity of cells in the absence of changes in the DNA sequence. It also has a role in the development of diseases such as cancer and neurodegenerative disorders such as Alzheimer’s (Kringel, et al., 2021).

Epigenetics has helped researchers to better understand how diseases such as cancers are established and inherited, thus unveiling how they develop and respond to therapeutic intervention. It helps identify DNA modifications that are implicated in disease, thus assisting in coming up with new potential therapeutic targets to be explored in drug development (Kringel et al., 2021).

The majority of diseases, such as cancers, have underlying epigenetic factors, for example, cancers have different mutation variations, but their epigenetics-related mechanisms can be or maybe the key to more effective treatment.

Healthcare practitioners are required to better understand the biological and physical aspects of prescribing medications to the mental health population. Medications prescribed to patients often directly affect the receptors and neurons and thus, it is essential to understand the drug’s mechanism of action (Shin & Saadabadi, 2022).

Therefore this information is essential, for it will affect how I prescribe medications to patients. For example, if for instance, a patient with a urinary tract infection and insomnia problems required medication. Trazodone medication would be the ideal drug in this case however, it inhibits the reuptake of serotonin and thus, it is considered an antidepressant, it also blocks alpha-receptors that can result in orthostatic hypotension, more so in older patients.

References

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: 10.1093/ijnp/pyy071

Calebiro, D., Koszegi, Z., Lanoiselée, Y., Miljus, T., & O’Brien, S. (2021). G protein-coupled receptor-G protein interactions: a single-molecule perspective. Physiological Reviews, 101(3), 857-906. https://doi.org/10.1152/physrev.00021.2020

Kringel, D., Malkusch, S., & Lötsch, J. (2021). Drugs and epigenetic molecular functions. A pharmacological data scientometric analysis. International Journal of Molecular Sciences, 22(14), 7250. https://doi:10.3390/ijms22147250

Shin, J. J., & Saadabadi, A. (2022). Trazodone. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470560