Respond at least 2 times each . The goal is for the discussion forum to function as robust clinical conferences on the patients. Provide a response to 1 of the 3 discussion prompts that your colleagues provided in their video presentations. You may also provide additional information, alternative points of view, research to support treatment, or patient education strategies you might use with the relevant patient.

Discussion Topic

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This week our readings took us into Specific Aspects of Health Promotion for the following conditions: Weight Management and Digestive Wellness, Cardiovascular Wellness, and Respiratory Wellness.

Imagine you are leading a focus group which is implementing one of the nursing interventions learned for a specific health problem. 

Having you as a moderator of a community focus group that will explore knowledge, believes, attitudes and behaviors about your selected health problem [you may select any health problem]:

1.
Define your group and the setting for the activity, applying statistical principles of sample size and homogeneity.

2.
Create and share an opening question to explore perceptions of the health risks associated with your topic of interest.

3.
Create a question that should explore beliefs and perceptions about external influences related to your selected topic.

4.
Create a third question that will help you in understanding the perception (in group members) of roles towards improving the health problem.

Please remember for discussion posts: the initial post must be uploaded by the WEDNESDAY of the week and two replies to your peers by Saturday at 2359.

Please note the grading rubric for the discussion board.

As a reminder, all discussion posts must be a minimum of 250 words, references must be cited in APA format 7th Edition and must include a minimum of 2 scholarly resources published within the past 5 years.

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Discuss the safety and effectiveness of alternative and complementary medicine for the treatment of specific illnesses such as cancer, diabetes, and hypertension. 

 

Agonist-to-Antagonist Spectrum of Action

The agonist-to-antagonist spectrum refers to the  range of actions that psychopharmacologic agents can have when they  interact with receptors. Agonists activate receptors, while antagonists  block them. Partial agonists and inverse agonists provide intermediate  or opposite actions (Stahl, 2021).

Understanding the agonist-to-antagonist spectrum is  critical for achieving the desired therapeutic effect while minimizing  side effects. For instance, clozapine is an atypical antipsychotic that  acts as an antagonist at various neurotransmitter receptors, including  dopamine D2 and serotonin 5-HT2A receptors. Unlike typical  antipsychotics, which are primarily dopamine D2 antagonists, clozapine’s  broader receptor profile may explain its efficacy in  treatment-resistant schizophrenia as well as its different side-effect  profile (Stahl, 2021).

Partial Agonists: Buspirone is a  partial agonist at serotonin 5-HT1A receptors and is used to treat  generalized anxiety disorder (GAD). Its partial agonist activity allows  for anxiolytic effects without the sedation seen with benzodiazepines,  which are full agonists at GABA receptors (Stahl, 2021).

Inverse Agonists: The antihistamine  loratadine acts as an inverse agonist at the H1 histamine receptor, not  only blocking the action of histamine but reducing the baseline activity  of the receptor, which can be beneficial for controlling allergic  symptoms (Stahl, 2021).

Clozapine, an atypical antipsychotic, acts primarily  as an antagonist at various neurotransmitter receptors, demonstrating  how multi-receptor targeting can be beneficial for certain psychiatric  conditions. On the other hand, buspirone serves as a partial agonist at  5-HT1A receptors, providing anti-anxiety effects with less potential for  sedation. Loratadine, an antihistamine, acts as an inverse agonist,  reducing the baseline activity of H1 histamine receptors.

G-Protein-Coupled Receptors vs. Ion-Gated Channels

G-Protein-Coupled Receptors (GPCRs) and Ion-Gated  Channels are two different types of protein structures that drugs can  target to produce therapeutic effects. GPCRs are involved in slow,  modulatory signaling, while Ion-Gated Channels provide fast synaptic  transmission (Stahl, 2021).

Beta-blockers like propranolol interact with GPCRs,  specifically beta-adrenergic receptors, to modulate cardiac activity by  reducing heart rate and blood pressure. They do this by antagonizing the  beta-adrenergic receptors, thereby inhibiting the action of adrenaline  and noradrenaline (Stahl, 2021)

In contrast, via Ion-Gated Channels, drugs like  gabapentin act on voltage-gated calcium channels, not by blocking them  but by modulating their activity. This makes gabapentin useful for  conditions like neuropathic pain and epilepsy (Stahl, 2021).

Role of Epigenetics in Pharmacologic Action

Epigenetics in pharmacology refers to the  modification of gene expression rather than altering the genetic code  itself. These modifications can affect how an individual responds to  medications (Stahl, 2021).

Antidepressants like fluoxetine (Prozac) may not only  affect neurotransmitter levels but also induce epigenetic changes that  impact long-term mood regulation. They can modify DNA methylation  patterns related to the expression of neuroplasticity-related genes,  possibly contributing to their therapeutic effect (Castrén & Kojima,  2017).

Impact on Prescription Decisions

The impact on prescription decisions refers to how  the aforementioned factors might influence a healthcare provider’s  choice of medication, dosage, and treatment plan for individual  patients(Stahl, 2021).

Understanding the agonist-antagonist spectrum can be  vital in cases like dual diagnosis of opioid addiction and anxiety.  Here, a partial agonist like buspirone could be more appropriate than a  benzodiazepine due to its lower potential for abuse. Also, for patients  with treatment-resistant depression, considering a medication like  ketamine that works through different mechanisms and has potential  epigenetic impacts could offer another treatment avenue (Zanos et al.,  2016).

For example, in a patient with a dual diagnosis of  opioid addiction and anxiety, a nurse practitioner might opt for a  partial agonist like buspirone for the treatment of anxiety instead of a  benzodiazepine, which has a higher abuse potential. Similarly, if a  patient has treatment-resistant depression and has not responded to  typical SSRIs, considering an agent like ketamine, which works through  NMDA receptor antagonism and also induces epigenetic changes, could be a  thoughtful next step (Zanos et al., 2016).

 

 

Visit http://www.aha.org/advocacy-issues/communicatingpts/pt-care-partnership.shtml and review the American Hospital Association’s Patients’ Bill of Rights. Discuss how health care professionals can ensure that patients’ rights are upheld and protected.

Instructions: 

Post your discussion to the Moodle Discussion Forum.  Initial post must be made by Day #3.  Word limit 500 words.  Reply to at least two other student posts with a reflection of their response.  Please make sure to provide citations and references (in APA, 7th ed. format) for your work.