NURS 6501 UMES Wk1 Advance Pharmacology Substance Abuse Essay

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Because of the increased rates of death from substance overdose, substance misuse has been a hot issue in recent years. Drug overdose is currently the top cause of injury fatality in the United States, having tripled in incidence between 1999 and 2014. (Li et al., 2018). Illicit opioids have a substantial role in the rise of opioid-related mortality. Substance misuse continues to have a significant public health cost, as seen by rising overdose mortality and a fast expanding need for substance use disorder treatment (McHugh et al., 2015).

In the scenario provided a 27 year with substance abuse hx was found unresponsive by his roommate. Regarding the role genetics play on his substance abuse more medical history will be needed, but studies are discovering that substance abuse can have genetic components. Per the National Institution of Drug Abuse (2020) family studies that include identical twins, fraternal twins, adoptees, and siblings suggest that as much as half of a person’s risk of becoming addicted to nicotine, alcohol, or other drugs depends on his or her genetic makeup. In this scenario genetics could have played a role but further investigation needs to be completed. NURS 6501 UMES Wk1 Advance Pharmacology Substance Abuse Essay

The patient is presenting with signs and symptoms of being unresponsive because he overdosed on an opioid as evidenced by Narcan being effective regarding regaining his responsiveness. Naloxone hydrochloride (Narcan) reverses opioid intoxication symptoms such as respiratory and central nervous system (CNS) depression (Li et al., 2018). This patient is displaying several signs and complications related to his overdose. One sign was that he was unresponsive for an unknown amount of time. NURS 6501 UMES Wk1 Advance Pharmacology Substance Abuse Essay

Being unresponsive for that long can cause decreased oxygen levels to vital organs; hypoxia. His vital organs like his brain, kidneys and heart are not receiving enough vital oxygen. So, organ and tissue death will be a result. NURS 6501 UMES Wk1 Advance Pharmacology Substance Abuse Essay

The patient was given Narcan to illicit a physiologic response of breathing and responding. The Narcan reversed the opioid overdose because the patient took too much and suppressed his central nervous system leading to respiratory suppression. I feel this response of becoming responsive was directly related to his overdosing that is why the Narcan was effective. NURS 6501 UMES Wk1 Advance Pharmacology Substance Abuse Essay

There are numerous cells involved in this process, from epithelial skin cells, to heart muscles, to kidney and brain cells. This patient is reporting pain to L hip and forearm. NURS 6501 UMES Wk1 Advance Pharmacology Substance Abuse Essay And he was diagnosed with necrotic tissue covering the L hip and forearm. This condition could have been caused by IV drug use. Massive tissue necrosis and septic shock have recently been reported in a series of injection drug users (Hengge et al., 2003). So, this may explain the findings.

Per his labs he is hyperkalemic, having too much or too little potassium in the blood can cause irregular heart beat and heart activity and even death. In his case his EKG showed prolonged PR interval and peaked T waves. These readings correlate with hyperkalemia and how it looks on an EKG reading. Per Levis (2013), PR interval and t waves are reflecting typical ECG findings in hyperkalemia progress from tall, “peaked” T waves and a shortened QT interval to lengthening PR interval and loss of P waves. In his case his diagnosis of hyperkalemia could have caused a cascade of events to occur including arrhythmias causing his oxygen to be compromised coupled with the drug overdose.

Regarding if my response would change if gender or genetics were different would require obtaining more history. My response would still be the same if the gender or age was different I would just be mindful of the lifespan changes and how it can impact the care I provide for example, if he were elderly I would still administer the Narcan but I would know that there could be some age related comorbidities that could be exacerbated by Narcan and I would just be mindful of the dosing and how there are responding to treatment, it is also worrisome that a young person would want to end their life other than those adjustments this how I would handle this scenario.

NURS 6501 UMES Wk1 Advance Pharmacology Substance Abuse Essay References

1. Hengge, U. R., Beiderlinden, M., Otterbach, F., Groeben, H., Nast-Kolb, D., Mehnert, W. H., Peters, J., & Schmid, K. W. (2003). 31-year-old injection drug user with massive skin necrosis and shock. Dermatology (Basel, Switzerland), 206(2), 169–171. https://doi.org/10.1159/000068458
2. Levis, J. T. (2013). ECG Diagnosis: Hyperkalemia. NURS 6501 UMES Wk1 Advance Pharmacology Substance Abuse Essay Permanente Journal, 17(1), 69. https://doi-org.ezp.waldenulibrary.org/10.7812/TPP…
3. Li, K., Armenian, P., Mason, J., & Grock, A. (2018). Narcan or Nar-can’t: Tips and Tricks to safely reversing opioid toxicity. Annals of Emergency Medicine, 72(1), 9–11. https://doi-org.ezp.waldenulibrary.org/10.1016/j.a…
4. McHugh, R. K., Nielsen, S., & Weiss, R. D. (2015). Prescription drug abuse: from epidemiology to public policy. Journal of Substance Abuse Treatment, 48(1), 1–7. https://doi-org.ezp.waldenulibrary.org/10.1016/j.j…
5. NIDA. 2020, June 16. Genetics and Epigenetics of Addiction DrugFacts. Retrieved from https://www.drugabuse.gov/publications/drugfacts/g… on 2020, September 1