Situation: A 27-year-old patient with a history of substance abuse is found unresponsive by emergency medical services (EMS) after being called by the patient’s roommate. The roommate states that he does not know how long the patient had been lying there. Patient received naloxone in the field and has become responsive. He complains of burning pain over his left hip and forearm. Evaluation in the ED revealed a large amount of necrotic tissue over the greater trochanter as well as the forearm. EKG demonstrated prolonged PR interval and peaked T waves. Serum potassium level 6.9 mEq/L.
Explanation of Disease: Drug addiction, also known as Substance abuse disorder, is a disease that affects a person’s brain. People who suffer from substance abuse overindulge or depend on the drug and cannot control their addiction despite the negative consequences (Drug Addiction (Substance Use Disorder), 2022).
The role genetics plays in the disease: Risk factors for substance abuse include genetics, family history, peer pressure, early use, lack of family involvement, taking a highly addictive drug, and mental health disorders (Drug Addiction (Substance Use Disorder), 2022). Genetics plays a significant role in the disease; a person inherits genes that can make them less susceptible or more prone to fall into addiction. “Genes are functional units of DNA that make up the human genome; they provide the information that directs a body’s basic cellular activities.”(Genetics and Epigenetics of Addiction DrugFacts, 2019, para. 2).
Why the patient is presenting with the specific symptoms described, the physiologic response to the stimulus presented, and the cells involved: In this scenario, the patient presents several symptoms. The patient was initially found unresponsive; he became responsive with Naloxone, an opioid antagonist, meaning that he overdosed on opioids. He has necrotic tissue on his left greater trochanter and left forearm, most likely due to an untreated infection. He complains of burning pain on his left greater trochanter and left forearm. Burning pain often refers to nerve pain, most likely due to an untreated infection. The patient was unconscious for an unknown time period; hypoxemic respiratory failure can lead to rhabdomyolysis, which is the breakdown of skeletal muscle. When damaged, muscle cells release a protein called myoglobin and potassium (Stanley et al., 2022). Damaged muscle cells that are releasing potassium are most likely causing the patient’s hyperkalemia (K+ of 6.9); hyperkalemia can cause prolonged PR intervals and peaked T waves.
How another characteristic (e.g., gender, genetics) would change your response: There are no other characteristics that would change my response in this situation.
References
Drug Addiction (Substance Use Disorder). (2022, October 4). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112Links to an external site.
Genetics and Epigenetics of Addiction DrugFacts. (2019, August 5). National Institute on Drug Abuse. Retrieved February 24, 2023, from https://nida.nih.gov/publications/drugfacts/genetics-epigenetics-addictionLinks to an external site.
Stanley, M., Chippa, V., Aeddula;, N., Quintanilla Rodriguez, B. S., & Adigun, R. (2022, August 10). Rhabdomyolysis. National Library of Medicine. Retrieved February 25, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK448168/Links to an external site.
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