Tobacco, alcohol, drugs, and sexual history

Question 1

Tobacco Social history

Answer 1

88% of smoker began smoking by age 18

99% of smokers began smoking by the age of 26

DOCUMENT tobacco use for EVERY visit and calculate pack years

years x packs per day = pack years

Question 2

Tobacco cessation treatments

Answer 2

Gradual scheduled decrease

Nicotine replacement

Medications

Question 3

Two primary tobacco cessation meds

Answer 3

Buproprion (wellbutrin, zyban)

Varenicline (chantix

Question 4

Buproprion

Answer 4

Increases dopamine

Not an SSRI

Question 5

Varenicline

Answer 5

Binds with the nicotine receptor in the brain

Question 6

Nicotine replacement therapies

Answer 6

Patch

Gum

Lozenge

Inhaler

Nasal spray

Question 7

Alcohol social history

Answer 7

Ask about frequency, amount, perception of problem, problems with alcohol in the past

Question 8

CAGE

Answer 8

Have you ever felt you should Cut down on your drinking?

Have people Annoyed you by criticizing your drinking?

Have you ever felt bad of Guilty about your drinking?

Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener)?

Question 9

When using CAGE a score of what is significant?

Answer 9

> 2

Question 10

Street drugs social history

Answer 10

Pursue if evidence suggests a problem.

Question 11

Why take a sexual history

Answer 11

Identify need for screening of infection

Assess risk of patients acquisition of infection

Assess risk of patient transmission of infection

Risk of pregnancy

determine the need of education