Inhalants (solvents, gasoline) Like alcohol Inhaled
Common side effects (treatment) of substance abuse drugs are paranoia (haloperidol), seizures (diazepam), hyperthermia (slow cooling), hypertension (β-blockers), and opiate overdose (naloxone).
From Office of the Surgeon General: Reducing tobacco use: a report of the Surgeon General, August 9, 2000 (website).
http://www.surgeongeneral.gov/library/ reports/tobacco_use/index.html . Accessed October 31, 2013.
CNS, central nervous system; EDMA, 3,4-ethylenedioxy-N-methylamphetamine; LSD, lysergic acid diethylamide; PCP, phencyclidine.
Heavy alcohol use can cause acute gastritis and acute pancreatitis. Intravenous drug use can result in hepatitis B, bacterial endocarditis, osteomyelitis, septic pulmonary embolism, infection, or acquired immunodeficiency syndrome (commonly known as AIDS). Chronic marijuana or tobacco use is associated with bronchoconstriction and bronchitis. Compulsive drug or alcohol use results in an adolescent being unable to help himself or herself out of the psychosocial sequelae that attend such habituation (e.g., stealing, prostitution, drug dealing, unemployment, school failure, social isolation).
Specific management of substance use by adolescents depends on many individual patient factors. Because of the highly addictive (physical and psychological) nature of most substances, residential drug treatment facilities are suggested, especially for younger adolescents.
Black A, Fleming N, Rome E: Pregnancy in adolescents, Adolesc Med State
Art Rev Apr 23(1):123–138, 2012
Blake K, Mann K, Kutcher M: The structured communication adolescent guide (SCAG), MedEdPORTAL, 2008.
https:// www.mededportal.org/publication/798 . Accessed October 31, 2013.
The Emergency Contraception Website, Office of Population Research: Princeton, NJ.
http://ec.princeton.edu/ . Updated June 2012.
Hartman L, Monasterio E, Hwang L: Adolescent contraception: review and guidance for pediatric clinicians, Curr Probl Pediatr Adolesc Health Care 24:221–263, 2012
Keel PK, Brown TA: Update on course and outcome in eating disorders,
Int J Eat Disord 43(3):195–204, 2010
Williams C, Creighton S: Menstrual disorders in adolescents: review of current practice, Horm Res Paediatr 78(30):135–143, 2012
James W. Verbsky 13
The major components of host defense include anatomic barriers and the innate and adaptive immune systems. Integrity of the anatomic and mucociliary barrier (i.e., skin and mucous membranes) is essential for protection against infection, and defects in this barrier function can lead to infections (Table 72-1). The innate immune system acts as the first line of defense against pathogens, responding rapidly but nonspecifically before the development of the more versatile adaptive immune system. The innate immune system includes soluble factors, including acute-phase proteins, cytokines, chemokines,and complement, as well as cellular components, including neutrophils, monocytes/macrophages, and natural killer (NK) cells. The adaptive immune system is made up of T and B lymphocytes and their effector molecules (Table 72-2).