discussion
Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleagues assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not
Akanno
Hyperkalemia, Rhabdomyolysis
COLLAPSE
A 27yr old male was found unresponsive by his roommate called EMT. With the patient having a history of substance abuse, they quickly concluded that the patient was having an opioid overdose and quickly administered naloxone, the antidote to opioids. Upon waking up, the patient complained of burning over the left hip and forearm, which can result from excessive damage to the nervous system. The extreme damage resulted in necrotic tissue of the trochanter and the forearm, which can be suspected as Rhabdomyolysis. Upon being rushed to the emergency room, the patient had a potassium level of 6.9mEq/L with an EKG reading of prolonged PR interval and peaked T waves, which concluded the suspicion of hyperkalemia, resulting in the patient passing out.
The role genetics plays in the disease
Substance abuse is a combination of environmental, family, and socioeconomic factors contributing to the patient’s lifestyle. When substance use is clustered within families, it implicates the role of both genetic and environmental influences (Prom-Wormley et al., 2017).
Why the patient is presenting with the specific symptoms described
Since the patient is presented with a burning sensation over his left hip and forearm with necrotic tissue, it could symbolize Rhabdomyolysis. Rhabdomyolysis is the breakdown of muscle cells, causing a release of intercellular molecules such as potassium, calcium, phosphate, uric acid, and creatinine kinase (Long, Koyfman, & Gottlieb, 2019). This can be caused by exertion, ischemia, immobility, drugs, etc. Another symptom the patient presented with is the EGK findings of prolonged PR interval and peaked T waves with the elevated potassium level of 6.9mEq/L suggested substance abuse such as cocaine or alcohol abuse.
The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
The patient experienced tissue injury on a cellular level. This will cause intracellular potassium to move into the extracellular space. This can be due to Rhabdomyolysis from a crash injury (Simon et al., 2022). This can be caused by substance abuse. Hyperkalemia can result from rhabdomyolysis cocaine abuse or alcohol-induced, which was presented by burning the left hip and forearm with necrotic tissue.
The cells that are involved in this process.
Cells involved are the midbrain dopamine neurons (Prom-Wormley et al., 2017). Dopamine encodes substance abuse, and over time, they get weak and are unable to decode, resulting in overdose.
How another characteristic (e.g., gender, genetics) would change your response.
Biologic factors such as stress can also contribute to substance abuse. Regarding gender roles, males are highly susceptible. Psychological factors can also be present, such as mental health, trauma such as a death in the family, and abuse, which can lead to substance abuse. Medical conditions use as heart attack or diabetes can also be a factor.
References
Long, B., Koyfman, A., & Gottlieb, M. (2019). An evidence-based narrative review of the emergency department evaluation and management of rhabdomyolysis. The American journal of emergency medicine, 37(3), 518-523. https://doi.org/10.1016/j.ajem.2018.12.061
Prom-Wormley, E. C., Ebejer, J., Dick, D. M., & Bowers, M. S. (2017). The genetic epidemiology of substance use disorder: A review. Drug and alcohol dependence, 180, 241259. https://doi.org/10.1016/j.drugalcdep.2017.06.040
Simon, L. V., Hashmi, M. F., & Farrell, M. W. (2022). Hyperkalemia. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK470284/
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