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Opioid dependence: mechanisms of development of withdrawal syndrome and its treatment
Hosenseidlová, Pavla ; Novotný, Jiří (advisor) ; Ujčíková, Hana (referee)
This work deals with opioids, opioid-induced withdrawal syndrome, and its treatment. Opioids are the most commonly used analgesics in medicine, and so far, there hasn't been a better alternative for them in most health cases. However, with long-term use, dependence can develop relatively quickly, and they have a high potential for abuse. When opioid use is discontinued, withdrawal syndrome occurs, and its symptoms resemble those of the flu, including muscle and joint pain, feeling cold and having a runny nose, nausea and vomiting, diarrhea, and tachycardia. These symptoms can be very intense and are often accompanied by psychological manifestations such as anxiety and depression. The treatment of opioid withdrawal syndrome is based on alleviating both physical and psychological symptoms. Most commonly, treatment involves using opioid agonists or antagonists with accompanying therapy for psychological manifestations. It is also important to include psychotherapy in the treatment process because the addiction in many cases stems from unresolved psychological or socio-economic issues.
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The specifics of care for a newborn baby of a drug-addicted mother
PEKÁRKOVÁ, Barbora
The neonatal abstinence syndrom occures in newborns of addicted mothers to any kind of drug. The drugs may be soft (legal) or hard (illegal). The manifestation of neonatal abstinence syndrom is mostly of neurological symptoms, such as seizures, restlessness and tremble. The neonatal abstinence syndrom can also be manifested by gastrointestinal, respiratory and termoregulation problems. Neonatal abstinence syndrom begins to manifest within 24 to 72 hours after birth and the most conclusive examination drug testing is from newborn's meconium. The newborns are assesed by the Finnegan score and if the result is higher than eight points, the neonatal abstinence syndrome can be diagnosed. The first goal was to reveal and describe the differences in care between a newborn of a drug-addicted mother and a physiological newborn, second goal was to specify nursing problems of a newborn of a drug-addicted mother and the third goal was to concretize the role of the nurse in a care of a newborn of a drug-addicted mother. The research part of this work was processed by the qualitative research method, using semi-structured interviews. The interviews took place in june 2022. Five interviews were recorded on a recording device and three interviews were written down on a paper due to dissapproval of said nurses to record the interviews. All interviews were transcribed into Microsoft Word programme. The ATLAS.ti programme was used to analyse, code and create schemes. The data was split into parts and codes were added to the said parts. The codes were put into categories related to the research questions. Afterwards, the schemes were made from said categories and subcategories. Based on data collected from the research we can say that the most common nursing problem in a newborn with neonatal abstinence syndrom is restlessness, crying, tremor, scream, sleep deprivation, instability of temperature, gulping and vomiting. Futhermore, the analysed data showed that the role of a nurse in taking care of a newborn with NAS are mainly "nurse as a provider of nursing care" and "nurse as a educator". The main differences in care between the newborn of a drug-addicted mother and a physiological newborn are in nutrition, contact with mother, when it also depends on her presence and the condition of the baby, in participation of other profesionals. There are hardly any differences in education, but it also depends on the condition of a baby and its needs. In conclusion, the most common nursing problems in a baby with neonatal abstinence syndrom are neurological problems, following the problems with sleep, temperature and nutrition. The nurse is mainly in a role of a nurse educator and provider of a nursing care. The differences in care between the baby with NAS and the physiological baby depend on the presence of its mother, the condition of the baby and its gestational age. The differences are mostly in nutrition and the participation of profesionals, for example the child protect services. The results of this research can be used in improving the quality of care for newborns with NAS, in an education of the future pediatric nurses in Pediatric nursing study programme and in further education of pediatric nurses in NAS in hospital through lectures.
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Patterns of kratom use among regular users: qualitative analysis
Kunová, Vendula ; Vacek, Jaroslav (advisor) ; Mravčík, Viktor (referee)
Background: Kratom is becoming a more famous psychoactive substance in the Czech Republic. However the research fields is not that fast as its use so there are not many studies in czech describing kratom or its use across his users. Aim: The aim of this master thesis is to findout patterns of drug use in regular useres from age 15 - 34.. Sample: The sample for this study is respondents aged 15 - 34 (young adults). The sample consisted of 10 respondents, 5 were women and 5 were men. The average age of the respondents was 27.2 years. The grat majority of respondents (N=9) are working and the last respondent (N=1) is still a student. Methods: Target group is selected by snowball sampling method. Data will be obtained through semi-structured interview and screenings questionnaires. The method of pattern formula and tuft creation method will be used to analyze collected data. We assume that the result of the work will be not only findinng patterns of kratom use, a description of its addiction or possible withdrawal syndrome, but also the elaboration of professional text Results: Respondents use kratom at least once a week, but their frequency and amount of the substance varies. Those who use kratom only once a day use 2,5 - 3 g. Those who use it 2 - 4 times a day consume a dose of 7,5 - 20 g. Users...
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Rat gut microbiome composition and metabolic faecal markers upon morphine withdrawal
Mičke, Bianka ; Novotný, Jiří (advisor) ; Pácha, Jiří (referee)
The primary purpose of this pilot study was a long-term monitoring of the gut microbiome composition and fecal markers of metabolism in rats following the completion of 10-day intraperitoneal administration of increasing morphine doses (from 10 to 50 mg/kg/day) and in the corresponding control groups of rats that didn't administrate morphine. This study involved the introduction of new methods for microbiome and metabolome research, statistical evaluation of results and interpretation of data, or hypothesis to explain the effects of morphine on the gut microbiome and fecal metabolome composition compared to the resulting data of similarly oriented studies. The actual experiment was conducted on male Wistar rats aged 2 months and weighing approximately 300 g, which were maintained on a standard chow diet. The analysis and evaluation of the resulting data showed that there were changes in the composition of the gut microbiome and fecal metabolome in the experimental group compared to the control group during the reporting period but the induced changes were rather temporary. Further studies should be performed using a significantly larger experimental and control group as well as higher time series granularity. Keywords: morphine, opioids, withdrawal, gut microbiome, faecal metabolome
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The effect of morphine withdrawal on the adenylyl cylclase signaling system in rat brain
Nováková, Daniela ; Novotný, Jiří (advisor) ; Rudajev, Vladimír (referee)
The aim of this bachelor thesis is to study the effect of morphine withdrawal on the adenylyl cyclase signal system in the rat brain. Theoretical part of this thesis summarizes basic information known about opioids and its leading representative morphine, molecular mechanisms of its effect on the organism and yet determined knowledge about effects of morphine addiction and subsequent withdrawal on the organism and above all on the central nervous system. There is still much unknown about exact mechanism of development of morphine addiction and withdrawal. This thesis also summarizes briefly the Western blot method used in analysing the effect of morphine withdrawal on selected proteins of the adenylyl cyclase signal system in the rat brain. Experimental part of this thesis is based on the detection of expression of key components of the adenylyl cyclase pathway in selected regions of the rat brain after long-term administration and subsequent withdrawal of increasing doses of morphine. Results of this study did not reveal statistically significant differences in the expression of adenylyl cyclase signaling system components between the withdrawal and the corresponding control groups of animals, confirming high ability of the organism to withstand morphine administration and to return to...
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Neonatal abstinence syndrome as a result of the use of illegal substances by pregnant women
NEKOLNÁ, Lucie
The diploma thesis deals with neonatal abstinence syndrome which occur to newborns whose mothers were on addictive illegal drugs in the time of pregnancy. The most frequently taken drugs are canabinoids, stimulancias, opiods and opiates, halucinogens, and drugs taken during substitutional therapy. Neonatal abstinence syndrome is a multisystem disorder that frequently affects central nervous system, gastrointestinal system, respiratory system and autonomic system. To diagnose neonatal abstinence system is the most important careful monitoring of baby in the first days of its life. There are different scoring systems which have been developed for assessing the severity of neonatal abstinence syndrome, we use the Finnegan scoring system. Treatment of neonatal abstinence syndrome is mainly supportive and pharmacological therapy. There are also social serious consequences of this problems; mothers are usually not able to take care of babies and children live in children's homes. The aims of this study were to find out special needs of newborns born to mothers using addictive illegal drugs during pregnancy, to find care interventions which help newborns with neonatal abstinence syndrome in their first days of life and to discover interventions helping mothers stop using addictive illegal drugs. The theoretical part of this study is based on research of already presented scientific studies. The practical part of the study problems of neonates of mothers using addictive illegal drugs in first days after delivery. We have used Virginia Henderson's need theory to evaluate neonate's need. We have chosen only the most important elementary components out of 14 components in Virginia Henderson's need theory. I was also trying to find out if nurses know how to help neonates with neonatal abstinence syndrome and what nursing interventions have positive influence to neonates. Another goal was to know how nurses communicate with mothers and if they have positive influence on mothers. The method of communication with mother using addictive illegal drugs was semistructured interview. I wanted to know what kind of addictive drugs mothers were using during pregnancy and if mothers tried to solve their problem in pregnancy, before delivery. Results are sorted into categories and subcategories and showed in diagrams and tables. Neonates of mothers using addictive illegal drugs during pregnancy have problems in all investigated needs such as breathe, eat and drink adequately, sleep and rest, thermoneutral zone and social need. I also found out that some nursing intervences have positive influence on neonates with neonatal abstinence syndrome. Very important intervenes were individual contact with each neonate and quick reaction to every change in behavior. It is also necessary to respect their sleep and rest time, take nursing and medical care together in blocks, use non-pharmacological treatment of pain, feed them individually according to their needs and also try different techniques of feeding, put babies into the right position and eventually nestle, rock or touch them. In last part of the study we discuss mothers who use addictive illegal drugs. We found out that nurses did not speak with them very actively, did not offer them to breast-feed in special conditions, did not tell them about possibility to be with neonate together in the hospital until a discharge. On the other hand, mothers were not interested in the breast-feeding or staying with babies. The goal of the study was to create brochure with information of negative consequences of taking addictive drugs on babies. This brochure is convenient for education of mother and students as well.
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PHARMACOTERAPEUTIC INTERVENTIONS IN ADDICTION TREATMENT
Kozinski, Jan ; Minařík, Jakub (advisor) ; Oktábec, Zbyněk (referee)
Drug dependence is one of the most common psychiatric diagnosis besides with affective disorders and anxiety disorders. Drug abuse may entail many somatic and psychiatric comorbidities which complicate treatment and substantially worsen its prognosis. Allthough the main reason of keeping dependence behaviour are maladaptive behavioural patterns, on the cell level there are mainly pathophysiological processes in the central nervous systém. Similarly, it can be supposed that centre of treatment lies in psychotherapy, nevertheless parallel medication may significantly reduce subjective difficulties connected with abstinence from drug, which are common reason from treatment terminating from the side of patient. In the urgent addictology, or acute psychiatry it is possible to meet with situations, when psychotherapeutic techniques have only limited effectiveness. It is possible to use for example de-escalate approach with anxious patient that is intoxicated by cannabinoids or halucinogens, but it has no efficacy in the case of life-threatening acute intoxication by anticholinergics, opioids or tranquillisers. Similarly, in the case of acute withdrawal syndrome after long abuse of drugs with strong physical dependence, such as alcohol or benzodiazepines may physician almost exclusively rely on...
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