Cocaine: Difference between revisions
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***Agitation | ***Agitation | ||
***Diaphoresis | ***Diaphoresis | ||
**Pulmonary Complications: | |||
***"Crack lung"<ref>Forrester, J. M., Steele, A. W., Waldron, J. A. and Parsons, P. E. (1990) ‘Crack Lung: An Acute Pulmonary Syndrome with a Spectrum of Clinical and Histopathologic Findings’, American Review of Respiratory Disease, 142(2), pp. 462–467. doi: 10.1164/ajrccm/142.2.462.</ref> | |||
***Diffuse alveolar hemorrhage | |||
***[[ARDS]] | |||
***[[Pneumothorax]] | |||
***[[Pneumomediastinum]] | |||
*Chronic | *Chronic | ||
**Atherosclerosis | **Atherosclerosis | ||
**Cardiomyopathy | **Cardiomyopathy | ||
**Nasal Septum damage | **Nasal Septum damage | ||
==Mechanism of action== | ==Mechanism of action== | ||
Revision as of 13:24, 26 August 2015
Background
- A sympathomimetic stimulant derived from an alkaloid paste made from the leaves of the coca plant
- Both a legitimate medical drug and a drug of abuse
Forms of Abuse
- Cocaine can be smoked, snorted, injected or ingested
- Smoked form is often in a free-base or crack form
Detection
- Unreliable in very acute intoxication[1]
- Qualitative urine detection of cocaine metabolite benzoylecgonine at cut-off of 300 ng/ml
- On average, shows up in urine 24-48 hrs after use
- Up to 22 days in chronic users
Adverse effects
- Acute
- Sympathomimetic qualities
- Tachycardia
- Fever
- Agitation
- Diaphoresis
- Pulmonary Complications:
- "Crack lung"[2]
- Diffuse alveolar hemorrhage
- ARDS
- Pneumothorax
- Pneumomediastinum
- Sympathomimetic qualities
- Chronic
- Atherosclerosis
- Cardiomyopathy
- Nasal Septum damage
Mechanism of action
- Blocks reuptake of serotonin, dopamine and norepinephrine
- Anesthetic effects achieved through sodium channel blockade
Differential Diagnosis
Sympathomimetics
- Cocaine
- Amphetamines
- Synthetic cathinones (khat)
- Ketamine
- Ecstasy (MDMA)
- Synthetic cannabinoids
- Bath salts
See Also
- Sympathomimetic Toxicity
- Cocaine Intoxication
- Cocaine Chest Pain
- Cocaine Withdrawal
- Levamisole toxicity
- ↑ McCord J, et al. Management of Cocaine-associated chest pain and myocardial infarction. Circulation. 2008; 117: 1897-1907.
- ↑ Forrester, J. M., Steele, A. W., Waldron, J. A. and Parsons, P. E. (1990) ‘Crack Lung: An Acute Pulmonary Syndrome with a Spectrum of Clinical and Histopathologic Findings’, American Review of Respiratory Disease, 142(2), pp. 462–467. doi: 10.1164/ajrccm/142.2.462.