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adolescent > substance abuse > Flashcards

substance abuse Flashcards

1
Q

percentage of high school seniors that have reported using illicit drug at least once

A

half

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2
Q

percentage of high school seniors that have reported being drunk in last month

A

1/3

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3
Q

what is more common in high schoolers- single or multiple drug use?

A

multiple

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4
Q

most common substance of abuse in teens

A

alcohol

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5
Q

most common illicit drug used by young people

A

mj

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6
Q

which substance causes the most ED visits

A

MJ

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7
Q

typically drug screens can test for drug use in what time period?

A

48 hrs

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8
Q

is obtaining information from the school or law in teens considered appropriate?

A

yes

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9
Q

what is the next step after a positive drug screen?

A

confirm with gas chromatography and mass spectroscopy

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10
Q

immediate effects of inhalants (5) & how quickly do they take affect

A
  • decreased inhibition
  • drowsiness
  • lightheadedness
  • ataxia
  • disorientation

**EFFECTS WITHIN SECONDS
LAST 5-15 5minutes

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11
Q

PE findings of individual who took inhalants (3)

A
  • sluggish pupils
  • bradycardia
  • glue sniffer’s rash around the nose and mouth
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12
Q

affects of extreme intoxication with inhalants (7)

A
  • generalized muscle weakness
  • confusions
  • hallucinations
  • ataxia
  • delirium
  • nystagmus
  • can have a hangover
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13
Q

population that uses inhalants

A
  • low SES
  • hispanics
  • native americans
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14
Q

what are the repeated effects of using inhalants (10)

A
  • psychosis
  • dementia
  • bone marrow suppression
  • asphyxia
  • arrhythmia
  • aspiration
  • liver damage
  • kidney damage
  • encephalopathy
  • lead toxicity (gasoline)
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15
Q

what percentage of high school seniors have used MJ?

A

almost half!

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16
Q

what percentage of high school seniors use MJ daily?

A

5%

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17
Q

what are the psychological consequences of using MJ (5)

A
  • learning problems
  • deficits in problem solving skills
  • memory impairment (which may last up to 1 mo)
  • symptoms of UNDERLYING personality d/o, depression and anxiety can worsen
  • worsening school performance
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18
Q

acute effects of MJ

A

4Ds

  • dry mouth
  • dilated pupils
  • drowsiness
  • distortion of time
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19
Q

how do you monitor the discontinuation of marijuana use?

A

serial measurements of urine THC:creatinine

decreases as MJ is dced

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20
Q

vital sign changes with MJ use

A

tachycardia (lasting up to 3 h) and hypertension

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21
Q

chronic physiologic effects of MJ use (6)

A
  • compromised immune function
  • decreased sperm ct (reversible)
  • pulmonary complications from carcinogens
  • tachycardia and poor stamina
  • impaired coordination
  • gynecomastia
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22
Q

withdrawal effects of MJ (4)

A
  • irritability
  • insomnia
  • tremors
  • nystagmus
  • peaks at 4 days and can last for 2 weeks
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23
Q

how long can you test MJ for

A

a month
- drug is lipid soluble and is stored in fat tissue and released slowly
although effects begin within seconds and fall rapidly over 30 minutes

24
Q

what is the most common substance of abuse?

A

alcohol

25
Q

what percent of high school seniors report using alcohol at some point?

A

80%

26
Q

glucose in alcohol intoxication?

A

hypoglycemia

27
Q

GI complications of adolescents with chronic EtOH

A

esophagitis
gastritis
peptic ulcer disease

28
Q

short term physiological signs of amphetamines (7)

A
  • tachycardia
  • HTN
  • sweating
  • agitation
  • fever/hyperthermia
  • dilated pupils that react slow
  • insects crawling on skin
29
Q

treatment of amphetamine/cocaine OD

A

gastric lavage and activated charcoal
haloperidol for psychosis
cooling blanket
dialysis

30
Q

how long can you test for stimulants in blood and urine

A

48h

31
Q

pupils with cocaine

A

dilated

32
Q

pupils with amphetamines

A

dilated and slow to react

33
Q

findings with chronic cocaine use

A

choreoathetotic movement- d/t depletion of dopamine storage

34
Q

organophosphate toxicity (5)

A

cholinergic!

  • constricted pupils
  • sweating
  • abdominal pain
  • wheezing
  • respiratory distress
35
Q

what is propoxyphene

A

narcotic analgesic
can p/w ventricular arrhythmias
seizures
pulm edema

36
Q

pupils size with barbituates

A

normal but slow to react

also have nystagmus

37
Q

signs of barbituate overdose

A

BARB HAS BRADY TWINS & HYPOTRIPLETS

  • bradycardia
  • bradypnea
  • hypotension
  • hypothermia
  • hypoactive BS

normal pupil size that react slow

38
Q

types of hallucinogens (6)

A
  • mescaline (peyote)
  • psilocybin (mushrooms)
  • jimsonweed
  • LSD
  • PCP
  • ecstasy (amphetamine-derived)
39
Q

what is the most potent hallucinogen

A

LSD

40
Q

physiologic effects of hallucinogens

A 
SYMPATHOMIMETIC
-tachycardic
-hypertension
-hyperreflexia
CHOLINERGIC
-diaphoresis
-flushing
-miosis
41
Q

pupils in PCP

A

mydriatic (dilated) + asymmetric

horizontal and vertical nystagmus

42
Q

aggressive teen with tremulousness and dilated pupils

A

cocaine

43
Q

aggressive teen with hallucinations, generalized muscle weakness, and nystagmus

A

inhalants

don’t see nystagmus with amphetamines

44
Q

combative teen with horizontal and vertical nystagmus

A

PCP

45
Q

adverse affects of nicotine (other than addiction)

A

peptic ulcer dz

46
Q

adverse effects of chewing tobacco

A

early fatigue in sports

tachycardia and vasoconstriction

47
Q

name the intox:

euphoria, time distortion, increased talking, auditory/visual enhancements

antimotivational syndrome, psychomotor retardation, impaired executive fxning, impaired pulm fxn, increased sympathetic tone

A

marajuana

48
Q

name the intox:

central and peripheral NS stimulant, local anesthetic, potent vasoconstrictor, feelings of extreme pleasure, power, strength, increased alertness and confidence

psychosis, hallucination, delirium, seizures, cerebral hemorrhage, hyperactive reflexes, tachycardia, dysrhythmias, CV collapse, MI

A

cocaine

49
Q

name the intox:

increased energy, euphoria, feelings of extreme pleasure, power, strength, increased alertness and confidence

dental caries, delirium, psychosis, seizures, cerbral hemorrhage, tachycardia, dysrhythmias, MI

A

amphetamines

50
Q

name the intox:

stimulant effects, hallucinogenic, enhanced sense of wellbeing and introspection, intense feelings of love and affection, increased sense of energy

water loading, sweating, hyperthermia, SIADH leading to hyponatremic dehydration, confusion, depression, fatigue, paranoia, seizures, tachycardia, HTN, hepatic damage

A

methylenedioxymethamphetamine (MDMA)

ecstasy

51
Q

name the intox:

analgesia, euphoria, pleasant floating feeling

respiratory depression, sedation, apathy, delirium, stupor, decreased reflexes, hypothermia, hypotension, CV disease, constipation

A

opioids

52
Q

name the intox:

colorless and odorless
anterograde and retrograde amnesia

bradycardia, hypotension, respirator depression, hypothermia, ataxia, seizure, coma, confusion, sedation, hallucination

A

date raoe/rave
rohypnol- flunitrazepam
GHB- gamma hydroxybutryate
ketamine

53
Q

name the intox:

euphoria, decreased inhibition, pleasant floating sensation, disinhibition, feelings of grandiosity/omnipotence

perinasal and perioral rash, anorexia, vomiting, abdominal pain, HA, ataxia, dizziness, respiratory irritant, cardiopulmonary arrest, respiratory arrest

A

inhalants

54
Q

name the intox:

hallucination, out of body experience, delusion, disinhibition

nystagmus, diaphoresis, flushing, HTN, muscle rigidity, brisk reflexes, seizures, arrhythmias, aggressive, agitated, combative behavior, extreme anxiety and psychosis, prolonged and fluctuating confusional state

A

hallucinogens

LSD
PCP
jimson weed
morning glory seeds
mescaline
55
Q

name the intox:

psychosis, mania, severe mood swings, violent behavior, HTN, ventricular remodeling, MI, HCC, increased LFTs, shortened stature, decreased HDL

males have testicular atrophy, decreased libido, infertility
females with male pattern hair loss, clitoromegaly, voice change

A

performance enhancing drugs

exogenous testosterone
androgenic steroids
HCG

adolescent (2 decks)

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