Drugs - core_Hutchinson

Drugs - core_Hutchinson - Adolescent Medicine 16 May 2006...

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Unformatted text preview: Adolescent Medicine 16 May 2006 0900 Routine Appt Case 1 TC a 16 y/o male TC a 16 y/o male CC: Allergies per mother CC: Allergies per mother HPI His mother comes back to the room His mother comes back to the room and says his eyes have been red for and says his eyes have been red for the last 4 months the last 4 months She thinks he has allergies. She thinks he has allergies. He doesn’t think there is any problem. He doesn’t think there is any problem. What do you want to know? Symptoms FH Medications HEADSS LABS Physical HEADSS Parents recently divorced Parents recently divorced Failing independent studies. Failing independent studies. Hanging out with friends Hanging out with friends Smokes Smokes Has had 1 LTP Has had 1 LTP Not suicidal Not suicidal PE Alert normal vital signs Alert normal vital signs Presence of gynecomastia Presence of gynecomastia Otherwise normal exam Otherwise normal exam Marijuana Marijuana Tools of use “New” Marijuana Marijuana of the 60’s had a THC concentration of 0.5% to 1% Marijuana of today has been engineered to have a THC concentration of 6% to 15% 6% to 15% Effects Elation Elation Euphoria Euphoria Impaired short-term memory Impaired short-term memory Divided attention tasks difficult Divided attention tasks difficult (e.g. driving) (e.g. driving) Loss of critical judgment Loss of critical judgment Distortion of time perception Distortion of time perception Bad effects Visual hallucinations Visual hallucinations Perceived body distortions Perceived body distortions Panic attacks Panic attacks Paranoia Paranoia Amotivational syndrome Amotivational syndrome Clinical manifestations Clinical manifestations Lowered Lowered temperature temperature Tachycardia Tachycardia Hypertension Hypertension Tachypnea Tachypnea (experienced user) (experienced user) Plasma testosterone Plasma testosterone suppression suppression Lowers sperm count Lowers sperm count Gynecomastia Gynecomastia Questionable Questionable physiologic physiologic dependency dependency Back to TC His mom said she wants a drug test Marijuana drug screen Detection window 7 to 30 days Screen RIA/EIA Confirmation GC / MS Interpretation Second-hand exposure foods 2230 Sat Case 2 CC a 17 year old boy Stat consult to ER for strange behavior HPI 17 Y/O male being restrained in the E.D. Says the terrorists are after him. What do you do? ABCDE PE LABS Meds PE Pulse 160 BP 180/100 Temp 101 Agitated His pupils are dilated. UDS AMPHETAMINES……………….PENDING BENZODIAZEPINES……………PENDING COCAINE…………………………PENDING OPIATES………………………….PENDING THC(CANNABINOIDS)………… PENDING BARBITUATES………………….. PENDING PCP(PHENCYCLIDINE)……….. PENDING METHADONE…………………….PENDING TCAs(DeWitt) Cocaine Epidemiology Epidemiology Use dropped from 1985 – 1990 Use dropped from 1985 – 1990...
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Drugs - core_Hutchinson - Adolescent Medicine 16 May 2006...

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