Forword -- Contributors -- Abbreviations -- 1 Introduction - Adolescent medicine: Pharmacotherapeutics in general, mental, and sexual health -- 2 Overview on adolescence -- 2.1 Introduction -- 2.1.1 Terminology -- 2.1.2 Demography of adolescent population -- 2.1.3 Normal adolescent sexuality stages -- 2.1.4 The process of CNS maturation -- 2.2 Puberty -- 2.3 Sexual behavior -- 2.3.1 Homosexuality -- 2.3.2 Prevalence -- 2.3.3 Caring for the gay, lesbian, bisexual, and transgendered (GLBT) youth -- 2.3.4 The adolescent sex offender -- 2.4 Health status of adolescents -- 2.4.1 Mental health -- 2.4.2 Youth violence -- 2.4.3 Mortality -- 2.4.4 Homicide and suicide -- 2.4.5 Motor vehicle accidents -- 2.4.6 Abuse -- 2.4.7 Dating violence -- 2.4.8 Runaway and homeless youth -- 2.5 Caring for adolescents -- 2.5.1 Involvement of parents -- 2.5.2 Confidentiality -- 2.6 Immunizations -- 2.7 Counseling -- 2.8 Conclusions -- 3 Concepts of health care in adolescents in the twenty-first century -- 3.1 Introduction -- 3.2 Adolescents: The population -- 3.2.1 Financing of the adolescent population -- 3.2.2 Subgroups of the adolescent population -- 3.2.3 Complexity of the adolescent population -- 3.3 Use of modern health-ITs -- 3.3.1 Text messaging -- 3.3.2 Internet -- 3.3.3 Multifaceted approaches -- 3.4 Challenges: Use of modern health-ITs -- 3.4.1 Accuracy and validity of data and data sources -- 3.4.2 Privacy and security responsibilities -- 3.4.3 Health literacy and health-IT literacy -- 3.4.4 Cost and lack of revenue -- 3.5 Opportunities: Use of modern health-ITs -- 3.5.1 Provider-adolescent engagement at visit -- 3.5.2 Provider-adolescent engagement between visits -- 3.5.3 Provider-provider engagement -- 3.6 Practicalities: Use of modern health-ITs -- 3.7 Conclusions -- 4 Principles of pharmacology -- 4.1 Introduction.

4.2 Pharmacokinetics -- 4.2.1 Absorption -- 4.2.2 Distribution -- 4.2.3 Metabolism -- 4.2.4 Excretion -- 4.2.5 Drug dosing and therapeutic drug monitoring -- 4.3 Pharmacodynamics -- 4.4 Pharmacogenetics and Pharmacogenomics -- 4.5 Conclusions -- 5 Basic concepts of neurotransmission -- 5.1 Introduction -- 5.2 Neurotransmission -- 5.2.1 The neuron -- 5.2.2 The synapse -- 5.2.3 Chemical neurotransmission -- 5.3 Allosteric modulation -- 5.4 Nonsynaptic (volume) neurotransmission -- 5.5 Divergence and covergence -- 5.5.1 Agonists and antagonists -- 5.6 Major neurotransmitter systems -- 5.6.1 Cholinergic system -- 5.6.2 Dopaminergic system -- 5.6.3 GABAergic system -- 5.6.4 Glutamatergic system -- 5.6.5 Noradrenergic system -- 5.6.6 Serotonergic system -- 5.7 Conclusions -- 6 Genetics and adolescent medicine -- 6.1 Introduction -- 6.2 How genetic disease occurs -- 6.3 Chromosomal inheritance -- 6.4 Single gene disorders -- 6.5 Multifactorial inheritance and complex traits -- 6.6 Other etiologies -- 6.6.1 UPD -- 6.6.2 Imprinting -- 6.6.3 Mitochondrial disorders -- 6.6.4 Syndromes associated with SCD as an example -- 6.6.5 Syndromes associated with the structurally normal heart -- 6.6.6 Syndromes associated with the structural heart disease -- 6.6.7 Factors to be considered regarding the syndromes associated with SCD -- 6.7 Complex disorders: Behavioral phenotypes as an example -- 6.7.1 Smoking behavior -- 6.7.2 Alcohol and drug use -- 6.7.3 Eating disorders -- 6.8 Predispositional testing -- 6.9 Conclusions -- 7 Concepts of emergency care -- 7.1 Introduction -- 7.2 Advanced cardiac life support (ACLS) -- 7.3 Anaphylaxis -- 7.4 Asthma -- 7.5 Conclusions -- 8 Concepts of surgical disorders in adolescents -- 8.1 Introduction -- 8.2 Abdominal surgery -- 8.2.1 Esophagus -- 8.2.2 Stomach -- 8.2.3 Small bowel -- 8.2.4 Billiary system.

8.3 Bariatric surgery -- 8.3.1 Etiology -- 8.3.2 Clinical presentation -- 8.3.3 Workup -- 8.3.4 Treatment -- 8.3.5 Follow-up -- 8.4 Abdominal wall hernias -- 8.4.1 Etiology -- 8.4.2 Clinical presentation -- 8.4.3 Differential diagnosis -- 8.4.4 Workup -- 8.4.5 Treatment -- 8.4.6 Follow-up -- 8.5 Breast disease -- 8.5.1 Breast mass -- 8.5.2 Gynecomastia -- 8.6 Endocrine surgery -- 8.6.1 Thyroid disorders -- 8.6.2 Adrenal tumors -- 8.7 Skin and soft-tissue lesions -- 8.7.1 Benign skin lesions -- 8.7.2 Malignant lesions -- 8.7.3 STSs -- 8.8 Conclusions -- 9 Concepts of psychotherapy in adolescents -- 9.1 Introduction -- 9.2 Definition -- 9.3 Epidemiology -- 9.3.1 Controversey surrounding the use of evidence-based treatment approaches -- 9.3.2 Obstacles to psychopharmacotherapy -- 9.3.3 Obstacles to psychotherapy -- 9.3.4 Insurance providers -- 9.3.5 Access to therapists -- 9.3.6 Differential diagnosis -- 9.3.7 Treatment modalities used with adolescents -- 9.4 Management -- 9.5 Conclusions -- MENTAL HEALTH -- 10 Substance abuse disorders -- 10.1 Introduction -- 10.2 Alcohol -- 10.2.1 Alcohol abuse management -- 10.3 Tobacco -- 10.3.1 Management of tobacco abuse -- 10.4 Marijuana -- 10.5 Amphetamines -- 10.5.1 Methamphetamine -- 10.6 Cocaine -- 10.6.1 Management of cocaine addiction -- 10.7 Opioids -- 10.7.1 Heroin -- 10.7.2 Naltrexone -- 10.7.3 Methadone -- 10.7.4 Buprenorphine -- 10.7.5 LAAM -- 10.8 Hallucinogens -- 10.9 MDMA (Ecstasy) -- 10.10 Date rape drugs -- 10.10.1 Flunitrazepam (Rohypnol®) -- 10.10.2 GHB -- 10.10.3 Ketamine -- 10.11 Inhalant drugs -- 10.12 Sedatives -- 10.12.1 BZDs -- 10.12.2 Barbiturates -- 10.13 Conclusions -- 11 Pharmacotherapy of adolescent attention deficit/hyperactivity (ADHD) disorder -- 11.1 Introduction -- 11.2 Assessment and treatment principles -- 11.2.1 Diagnosis.

11.2.2 Diagnostic workup -- 11.2.3 Discussing treatment options, medications, and monitoring with patients and caretakers -- 11.3 Psychopharmacology of ADHD -- 11.4 FDA-approved stimulant agents -- 11.4.1 AMP preparations -- 11.4.2 Short-acting AMP formulations (about 6 hours' duration) -- 11.4.3 Long-acting AMP formulations (about 8-10 hours' duration) -- 11.4.4 Prodrug formulation -- 11.4.5 MPH preparations -- 11.4.6 Oral short-acting MPH formulations (about 3-5 hours' duration) -- 11.4.7 Oral intermediate-acting MPH formulations (about 8 hours' duration) -- 11.4.8 Long-acting MPH formulations (about 12 hours' duration) -- 11.4.9 MPH transdermal formulation -- 11.5 Special safety considerations regarding stimulants -- 11.5.1 Growth -- 11.5.2 Tics -- 11.5.3 Cardiovascular effects -- 11.6 FDA-approved nonstimulant agents -- 11.6.1 Atomoxetine (Strattera) -- 11.6.2 Guanfacine XR (Intuniv) -- 11.6.3 Clonidine XR (Kapvay) -- 11.7 Non-FDA-approved treatments -- 11.8 General treatment guidelines -- 11.8.1 Child versus adolescent symptom presentation -- 11.8.2 ADHD and driving -- 11.8.3 Abuse potential -- 11.8.4 Differential diagnosis versus comorbidity -- 11.8.5 Pretreatment procedures -- 11.8.6 Choosing a starting agent -- 11.8.7 Short-versus long-acting stimulant formulations -- 11.8.8 AMP versus MPH -- 11.8.9 Medication titration -- 11.8.10 What to do when side effects develop -- 11.8.11 Nonimprovement using FDA-approved treatments -- 11.8.12 Duration of successful treatment -- 11.9 Summary -- 12 Disorders of disruption, violence, and cognitive abilities -- 12.1 Introduction -- 12.2 Definitions -- 12.2.1 Disruptive behavior disorders -- 12.2.2 ODD -- 12.2.3 CD -- 12.2.4 Developmental disorders (DDs) -- 12.2.5 Aggression and violence -- 12.3 Epidemiology -- 12.4 Differential diagnosis -- 12.4.1 SUDs -- 12.4.2 GMCs.

12.4.3 Psychiatric disorders -- 12.4.4 DDs -- 12.5 Management -- 12.5.1 SUDs -- 12.5.2 GMCs -- 12.5.3 Psychiatric disorders -- 12.5.4 DDs -- 12.6 Summary -- 13 Mood disorders -- 13.1 Introduction -- 13.2 Epidemiology -- 13.3 Differential diagnosis -- 13.4 Management -- 13.4.1 Depressive disorders -- 13.4.2 BDs -- 13.4.3 Mood disorder NOS -- 13.5 Conclusion -- 14 Anxiety disorders -- 14.1 Introduction -- 14.1.1 SAD -- 14.1.2 Panic disorder -- 14.1.3 GAD -- 14.1.4 Social anxiety disorder -- 14.1.5 OCD -- 14.1.6 Specific phobia -- 14.2 Epidemiology -- 14.3 Differential diagnosis -- 14.4 Management -- 14.4.1 Role of parents -- 14.4.2 Role of teachers -- 14.4.3 Psychotherapy -- 14.4.4 Pharmacotherapy -- 14.4.5 SSRIs -- 14.4.6 Other agents -- 14.4.7 Treatment of comorbidities -- 14.5 Conclusions -- 15 Schizophrenia -- 15.1 Introduction -- 15.1.1 Delusions -- 15.1.2 Hallucinations -- 15.1.3 Disorganized speech -- 15.1.4 Disorganized behavior -- 15.1.5 Negative symptoms -- 15.2 Diagnosis -- 15.2.1 Premorbid symptoms -- 15.3 Epidemiology -- 15.4 Differential diagnosis -- 15.4.1 Substance use disorders (SUDs) and drug intoxications -- 15.4.2 Bipolar disorder (BD) -- 15.4.3 Anxiety disorder -- 15.5 Treatment -- 15.5.1 Consultations -- 15.5.2 Atypical antipsychotics -- 15.5.3 Clozapine -- 15.5.4 Typical antipsychotics -- 15.5.5 Psychosocial interventions -- 15.6 Conclusions -- SEXUAL AND GYNECOLOGIC HEALTH -- 16 The adolescent breast -- 16.1 Introduction -- 16.2 Clinician's breast examination -- 16.3 Congenital anomalies -- 16.3.1 Athelia and amastia -- 16.3.2 Polythelia and polymastia -- 16.3.3 Other nipple anomalies -- 16.4 Asymmetric breast development -- 16.5 Underdeveloped breasts -- 16.5.1 Tuberous breasts -- 16.6 Virginal hypertrophy -- 16.7 Breast masses -- 16.7.1 Cystosarcoma phylloides -- 16.7.2 Cystic breast disease.

16.7.3 Fibrocystic change.