The role genetics plays in the disease
Genetics plays a significant role in substance abuse and addiction. Research has consistently shown that genetic factors contribute to an individual’s susceptibility to developing substance use disorders. While genetics alone does not determine whether someone will develop an addiction, it can influence their vulnerability and response to substance use. Naloxone is an opioid blocker and since the patient responded to the medication, he was suffering from an opioid overdose. Agrawal et al., (2012) stated that “The gene encoding the mu-opioid receptor (OPRM1) to which opioids bind to produce their analgesic and rewarding effects is the most widely studied candidate gene for heroin and other opioid addictions”. According to Smith (2022), over half of the differences in how likely people are to develop substance use problems stem from DNA differences. Research suggests alcohol addiction is about 50 percent heritable, while addiction to other drugs is as much as 70 percent heritable.
Why is the patient presenting with the specific symptoms described?
The first symptom mentioned is unresponsiveness which is a result of opioid overdose resulting in respiratory depression, decreased cardiac output, and severe pulmonary edema (McCance & Huether, 2018, p.71). It is an opioid overdose because he responded to Naloxone which is an opioid receptor antagonist as it reverses the effect of the opioid by binding to opioid receptors and blocks the effects of other opioids (Naloxone for Opioid Overdose: Life-Saving Science, 2017). The second symptom is burning pain over his left hip and forearm which revealed a large amount of necrotic tissue over the greater trochanter as well as the forearm, which could most likely have resulted from the impact of a fall post-overdose. This led to ischemia and hypoxia causing cellular injury, which affects the plasma membrane of the cells leading to damage to the organelles leading to ATP depletion, and calcium level alteration and ultimately resulting in tissue necrosis, (McCance & Huether, 2018, pp. 49-51). The third symptom is hyperkalemia which resulted in the ECG reading as explained by this statement “Progressive hyperkalemia may result in ECG changes, including peaked T wave, flattened P wave, prolonged PR interval”, (Teymouri et al., 2022). Hyperkalemia resulted from cellular injury leading to the direct release of intracellular potassium into the extracellular fluid raising the potassium blood levels.
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