Patho – 6501 week 1 Discussion

Patho – 6501 week 1 Discussion

The purpose of this paper is to describe the role of genetics in the pathophysiology of an opiate overdose in a 27-year-old and the reasons the patient presented with the specific symptoms described. It also discusses the physiologic response to the stimulus presented, the cells involved in the process, and how another characteristic such as genetics or gender would change the response.Patho – 6501 week 1 Discussion

Case Overview

The case study involves a patient aged 27 years old with a substance abuse history who was found unresponsive by EMS after being called by a roommate who stated that he did not know how long the patient had been lying there. While in the field, the patient became responsive after the administration of naloxone but complained of burning pain over the forearm and left hip, and ED evaluation revealed a huge amount of necrotic tissue over the greater trochanter and the forearm. An EKG demonstrated that he had a prolonged PR interval tat peaked T waves and the serum potassium level was 6.9 mEq/L.

Role of Genetics

Genetics contributes significantly to addiction. A person’s risk of substance abuse is greatly proportional to the degree of a person’s genetic relationship to a relative with addiction. The vulnerability to addiction involves complex factors involving life experiences and genes, most notably, the D2 subtype (Donaldson et al., 2017). When an individual takes alcohol or drugs, the brain becomes stimulated to the existence of dopamine Therefore, a person with the D2 subtype gene tends to have a much stronger compulsion for drugs or alcohol in huge amounts, in comparison to other people who do not have the D2 subtype gene. Individuals lacking D2 genes do not feel the dopamine effects as much as individuals with the gene do (Donaldson et al., 2017). Therefore, they tend to drink for longer periods and have a lot of difficulty in achieving a similar effect.Patho – 6501 week 1 Discussion


Reasons the Patient Presented With the Symptoms Described and Physiologic Response to Presented Stimulus

An opiate overdose caused the patient to be unresponsive. From the case study, the patient reportedly became responsive after the administration of naloxone. Naloxone is an opioid antagonist used in medical practice to reverse the effect of overdoses from opioids resulting in respiratory depression. Respiratory depression invokes an involuntary decrease in the respiratory rate and such severe cases, leads to oxygen saturation thus a patient presents with both low oxygen saturation and respiratory rate (Fox, et al., 2018). The likely cause of the huge amount of necrotic tissue found over the greater trochanter left hip and forearm was a fall, which may have occurred immediately after the patient lost consciousness. Necrosis is cellular death due to a lack of oxygen and blood in tissues. Cold, chemicals, radiation, trauma, or chronic illness that impair the flow of blood can trigger necrosis.

It is also likely that the patient could have developed Rhabdomyolysis triggered by muscle injury from the fall. The EKG revealed that the patient had a prolonged PR interval with peaked T waves. Besides, the level of potassium in the serum was 6.9 mEq/L. As highlighted by Hoskins (2018), high amounts of potassium were the potential cause of the prolonged PR intervals and peaked T waves. Besides, high amounts of myoglobin and creatinine kinase in urine and blood are signs of damage to muscles.

Cells Involved In the Process

Immunosuppression refers to a decrease in the efficacy of activation of the immune system. It may occur in the form of an adverse event following treatment or because of addiction and long-term use of drugs causing significant damage to body systems, particularly the immune system. According to Plein & Rittner (2018), immune cells play a huge role in this process and modulate the balance of T-helper cells. Opioid overdoses can induce the production of interleukin (IL)-4 on the T lymphocytes resulting in a partial anti-inflammatory effect.

How Gender Would Change the Response

The study by Serdarevic, Striley & Cottler (2017) reveals that there exists variations in the use of opioids, overdose, and gender. Women have a high likelihood to use prescription opioids, increasing their risk of opioid overdoses as compared to men.  Besides, women have a low sensitivity to pain compared to men and suffer more from painful chronic illnesses. This is linked to the use of strong pain relievers such as opioids (Serdarevic, Striley & Cottler, 2017). Further evidence suggests that men will hardly seek professional assistance from healthcare providers when compared to women. Thus, men are less likely to receive opioid prescriptions, which translates to low opioid-related overdoses.Patho – 6501 week 1 Discussion


Donaldson, K., Demers, L., Taylor, K., Lopez, J., & Chang, S. (2017). Multi-variant genetic panel for genetic risk of opioid addiction. Annals of Clinical & Laboratory Science47(4), 452-456.

Fox, L. M., Hoffman, R. S., Vlahov, D., & Manini, A. F. (2018). Risk factors for severe respiratory depression from a prescription opioid overdose. Addiction113(1), 59-66.

Hoskins, A. (2018). Physical Therapy Management of a Patient with Opioid-Induced Rhabdomyolysis: A Case Study.

Plein, L. M., & Rittner, H. L. (2018). Opioids and the immune system–friend or foe. British Journal of Pharmacology175(14), 2717-2725.

Serdarevic, M., Striley, C. W., & Cottler, L. B. (2017). Sex differences in prescription opioid use. Current opinion in psychiatry30(4), 238–246.



Patho – 6501 week 1 Discussion