Acute pulmonary toxicity from crack cocaine: Difference between revisions
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==Background== | ==Background== | ||
[[File:Rocks of crack cocaine.jpg|thumb|"Rocks" of crack [[cocaine]]]] | |||
[[File:Lung and diaphragm.jpg|thumb|Lobes of the lung with related anatomy.]] | |||
*Also known as "crack lung" | *Also known as "crack lung" | ||
*Usually presents within 48 hours of crack cocaine inhalation. | |||
*Due to hemorrhagic alveolitis from inhalational crack cocaine use <ref>Forrester JM. Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings. Am Rev Respir Dis. 1990;142(2):462-7.</ref> | *Due to hemorrhagic alveolitis from inhalational crack cocaine use <ref>Forrester JM. Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings. Am Rev Respir Dis. 1990;142(2):462-7.</ref> | ||
**Crack cocaine vaporizes at 187°C<ref name="Devlin" /> | **Crack cocaine vaporizes at 187°C<ref name="Devlin" /> | ||
==Clinical Features== | ==Clinical Features== | ||
*Characterized by dyspnea and hypoxia after crack cocaine use<ref name="Devlin">Devlin RJ, Henry JA. Clinical review: Major consequences of illicit drug consumption. Critical Care. 2008;12(1):202. doi:10.1186/cc6166.</ref> | *Characterized by [[dyspnea]] and [[hypoxia]] after crack cocaine use<ref name="Devlin">Devlin RJ, Henry JA. Clinical review: Major consequences of illicit drug consumption. Critical Care. 2008;12(1):202. doi:10.1186/cc6166.</ref> | ||
*May also see: | *May also see: | ||
**[[Fever]] | **[[Fever]] | ||
**[[Hemoptysis]] | **[[Hemoptysis]] | ||
**Respiratory failure | **[[Respiratory failure]] | ||
**Pulmonary edema | **[[Pulmonary edema]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 21: | Line 24: | ||
*[[Pneumothorax]] | *[[Pneumothorax]] | ||
*Subcutaneous emphysema/[[pneumomediastinum]] | *Subcutaneous emphysema/[[pneumomediastinum]] | ||
{{Drugs of abuse types}} | |||
==Evaluation== | ==Evaluation== | ||
*Generally a clinical diagnosis | *Generally a clinical diagnosis | ||
*Consider CXR and labs | *Consider [[CXR]] and labs | ||
**May have eosinophilia, which suggests an immune mediated component<ref>Kissner DG.Crack lung: pulmonary disease caused by cocaine abuse. Am Rev Respir Dis. 1987;136(5):1250-2.</ref> | **May have [[eosinophilia]], which suggests an immune mediated component<ref>Kissner DG.Crack lung: pulmonary disease caused by cocaine abuse. Am Rev Respir Dis. 1987;136(5):1250-2.</ref> | ||
==Management== | ==Management== | ||
*Supportive care | *Supportive care | ||
*Systemic corticosteroids<ref name="Devlin" /> | *Systemic [[corticosteroids]]<ref name="Devlin" /> | ||
==Disposition== | ==Disposition== | ||
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*[[Cocaine toxicity]] | *[[Cocaine toxicity]] | ||
*[[Cocaine withdrawal]] | *[[Cocaine withdrawal]] | ||
*[[Drugs of abuse]] | |||
==External Links== | ==External Links== | ||
Latest revision as of 18:20, 29 July 2025
Background
"Rocks" of crack cocaine
- Also known as "crack lung"
- Usually presents within 48 hours of crack cocaine inhalation.
- Due to hemorrhagic alveolitis from inhalational crack cocaine use [1]
- Crack cocaine vaporizes at 187°C[2]
Clinical Features
Differential Diagnosis
- Acute eosinophilic pneumonia
- Acute respiratory distress syndrome
- Pulmonary embolism
- Congestive heart failure
- Pneumonia
- Acute coronary syndrome
- Pneumothorax
- Subcutaneous emphysema/pneumomediastinum
Drugs of abuse
- 25C-NBOMe
- Alcohol
- Amphetamines
- Bath salts
- Cocaine
- Difluoroethane
- Ecstasy
- Gamma hydroxybutyrate (GHB)
- Heroin
- Inhalant abuse
- Hydrocarbon toxicity
- Difluoroethane (electronics duster)
- Marijuana
- Kratom
- Phencyclidine (PCP)
- Psilocybin ("magic mushrooms")
- Synthetic cannabinoids
- Chloral hydrate
- Body packing
Evaluation
- Generally a clinical diagnosis
- Consider CXR and labs
- May have eosinophilia, which suggests an immune mediated component[3]
Management
- Supportive care
- Systemic corticosteroids[2]
Disposition
- Admit
See Also
External Links
References
- ↑ Forrester JM. Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings. Am Rev Respir Dis. 1990;142(2):462-7.
- ↑ 2.0 2.1 2.2 Devlin RJ, Henry JA. Clinical review: Major consequences of illicit drug consumption. Critical Care. 2008;12(1):202. doi:10.1186/cc6166.
- ↑ Kissner DG.Crack lung: pulmonary disease caused by cocaine abuse. Am Rev Respir Dis. 1987;136(5):1250-2.