Clinicalprevandpublichealth Flashcards
leading causes of death in adults
- heart disease
- cancer
- chronic lower res disease
- accidents
- stroke
- .alzheimer
- diabetes
- influenza and pneumonia
- nephritis, nephrotic syndrome and nephrons is
- intentional self-harm
principles of prevention
- preventing disease or illness
- early detection and intervention of diseases in early stages
- improve QOL and extend healthy life expectancy
- older patients are never too late for preventative care
considerations in practicing preventive care in geriatric population
- age and life expectancy
2. cost-effectiveness of screening and potential risks of screening
acute pain
pain that usually starts suddenly and has a known cause, like an injury or surgery.
Benzodiazepines
sedatives often used to treat anxiety, insomnia, and other conditions
chronic pain
pain that lasts 3 months or more and can be cuased by a disease or condition, injury, treatment, inflammation, or unknown
drug misuse
the use of prescription drugs without a prescription or in a manner other than as directed by a doctor, including use without a prescription of one’s own; use in greater amounts or longer than told to take a drug or use in any other way not directed by a doctor
drug abuse or addiciton
dependence on a legal or illegal drug
extended-release or long-acting opiods
slower-acting medication with a longer duration of pain-relieving action
heroin
illegal, highly addictive opioid drug processed from morphine
illicit drugs
the non medical use of a variety of drugs that are prohibite by law these drugs can include: amphetamine type stimulants, marijuana/cannabis. cocaine, herion and other opioids, synthetic drugs, and MDMA
immediate-release opioids
faster-acting medication with a shorter duration of pain-relieving action
medication-assisted treatment (MAT)
treatment for opioid use disorder combining the use of medications with counseling and behavioral therapies
Morphine milligram equivalents (MME)
the amount of milligrams of morphine an opioid dose is equal to with prescribed. this is how to calculate the total amount of opioids accounting for differences in opioid drug type and strength
naloxone (narcan)
a prescription drug that can reverse the effects of opioid overdose and can be life-saving if administered in time
tolerance
reduced response to a drug with repeated use
prescription drug monitoring programs (PDMPs)
state-run electronic databases
physical dependence
adaptation to a drug that produces symptoms of withdrawal with the drug is stopped
overdose
injury to the body (poisoning) that happens when a drug is taken in excessive amounts. fatal or nonfatal
opioid use disorder
a problematic pattern of opioid us that causes significant impairment or distress
a diagnosis based on specific criteria such as unsuccessful efforts to cut down or control use, or use resulting in social problems and a failure to fulfill obligations at work, school, or home amoung other criteris. .
opioid analgesics
prescriptioin opioids, medications that have been ued to treat moderate to severe pain in some patients
natural opioid analgesics
morphine and codeine
Semi-synthetic opioid analgesics
drugs such as oxycodone, hyrdocodone, hydromorphone, and oxymorphone
methadone
synthetic opioid
synthetic opioid analgesics
drugs such as tramadol and fentanyl
opioid
natural or synthetic chemicals that interact with opioid receptors on nerve cells in the body and brain, and reduce the intensity of pain signals and feelings of pain. this class of drufs that include the illegal drug heroin, synthetic opioids such as fentanyl and pain medications available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and many others.
non-pharmacologic therapy
treatments that do not involve medications including physical treatments and behavioral treatments
Steps for screening patient for drug use
1. Ask about past year drug use if yes then 2.. 2. Begin the NIDA modified ASSIST 3. determine risk level 4. brief intervention the five As, ask, advise, assess, assist, and arrange
screening
the presumptive identification of unrecognized disease or defect by the application of tests, exams, or other procedures with can be applied rapidly to sort out apparently well persons who probably have a disease from those who probably do not
criteria to justify screening for a disease
- the disease must have a significant effect on quantity or quality of life
- frequency of the disease must be sufficient to justify the cost and risk of screening
- tests must be available at reasonable cost and risk to detect the disease in the asymptomatic phase
- acceptable methods of treatment must be available
- the disease must have an asymptomatic phase during which treatment must yeild a result superior to that obtained by delaying treatment until symptoms appear
validity
measures what is supposed to measure (related to bias)
- agreement between the measured quanitiy and its true value
- accuracy is affected by systematic error or bias
reliabilty
reproducibility (related to random error)
-agreement between repetitive measurements performed in the same way
sensitivity
ability of the test to identify correctly those who have disease
TP/TP+FN
speficity
the ability of the test to identify correctly those who do not have the disease
TN/TN+FP
positive predictive value
among those persons who tested positive, what proportion actually have the disease
TP/TP+FP
negative predictive value
among those persons who tested negative, what proportion actually do not have the disease
TN/TN+FN
Substance abuse disorder
when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment
How is abuse disorder diagnosed
by DSM-5 on the basis of evidence of: impaired control social impairment risky use pharmacological criteria
Most common substance use disorders in US
- Alcohol use disorder
- Tobaccos use disorder
- Cannabis use disorder
- stimulant use disorder
- hallucinogen use disorder
- opioid use disorder
Alcohol use disorder facts
cause of 88,000 deaths and more than 52.7% of americans 12 and up report being current drinkers
Moderate: 1 drink/day women, 2/day men
Binge: 5 or more drinks on same occasion on at least 1 day in last 30
Heavy: drinkning 5 or more drinks on the same occasion in each of the 5 days in the past 30 days
Genetics is a risk factor
Diagnosis criteria from AUD
- problems controlling intake
- development of tolerance
- drinking that leads to risky situations
- development of withdrawal symtpoms
Tobacco use disorder facts
480,00 deaths per year-cig smoking
damage to nearly every organ
leads to lung cancer, respiratory disorders, heart disease, stroke, etc
highest rate of current use is young adults 18-25
Cannabis use disorder facts
most used drug after alcohol and tobacco
in the past year 4.2 mil might criteria for this disorder
immed effects: distorted preception, difficulty with thinking and problem solving, loss of motor coordination
Long term use: respiratory infection, impaired memory, and exposure to carcinogens
heavy use among youths- increased risk for developing mental illness and poorer cognitive functioning
symptoms of use: cravings, tolerance, disruption in functioning due to use
symtpoms of withdrawal: inability to sleep, anger, depression, nervousness, restlessness within week of stopping
Facts about stimulant use disorder
- used to treat conditions such as obesity, ADHD, and depression
- Amphetamines (synthetic), meth, and cocaine (plant)
- taken orally, snorted or IV
- symptoms of use: cravings, failure to control use when attempted, continued use despite major obligations, use of the larger amts over time, tolerance, spending a lot time obtaining and using
- withdrawal: fatigue, vivid and unpleasant dreams, sleep problems, increased appetite, irregular problems controlling movement
Hallucinogen use disorder facts
chemically synthesized (LSD) or natural (psilocybin mushrooms, peyote) -cause visual & auditory hallucinations, distortions of time and perceptions
-symptoms: cravings, failure to control use, (similar to stimulant)
Opioid use disorder
- reduce perception of pain but also induce drowsiness, mental confusion, euphoria, nausea, constipation and depress respiration
- heroin (illegal), oxycodone and hydrocodone (legal)
- over dose deaths inc since 99 by 265% in men and 400% in women
- symptoms: strong desire for opioid
- withdrawal: negtive mood, nausea, vomiting, muscle aches, diarrhea, fever, and insomnia
Recommended limits of alcohol
Men under 65: no more thatn 4/day and no more that 14/week
Women under 65: no more than 3/day, and 7/week
The strongest health promotion recommendations are from.. and why
randomized controlled trials
-reduces bias, inc validity
What are the statistics used to characterize the performance of treatment or prevention intervention
- relative risk
- relative risk differences
- absolute risk differences
- numbers needed to treat and numbers needed to harm