Cocaine

Cardiovascular effects
myocardial infarction
both tachycardia and bradycardia may occur
hypertension
QRS widening and QT prolongation
aortic dissection

Neurological effects
seizures
mydriasis
hypertonia
hyperreflexia

Psychiatric effects
agitation
psychosis
hallucinations

Others
ischaemic colitis is recognised in patients following cocaine ingestion. This should be considered if patients complain of abdominal pain or rectal bleeding
hyperthermia
metabolic acidosis
rhabdomyolysis

Management of cocaine toxicity
in general benzodiazipines are generally first-line for most cocaine related problems
chest pain: benzodiazipines + glyceryl trinitrate. If myocardial infarction develops then primary percutaneous coronary intervention
hypertension: benzodiazipines + sodium nitroprusside
the use of beta-blockers in cocaine-induced cardiovascular problems is a controversial issue. The American Heart Association issued a statement in 2008 warning against the use of beta-blockers (due to the risk of unopposed alpha-mediated coronary vasospasm) but many cardiologists since have questioned whether this is valid. If a reasonable alternative is given in an exam it is probably wise to choose it

Unless otherwise stated, the content of this page is licensed under Creative Commons Attribution-ShareAlike 3.0 License