Cocaine Intoxication
First Things First (assess & treat for the following)
- Assess for life-threatening complications.
- Hypoxia, altered mental status: airway mgt, O2 supplementation
- Hypotension, shock: vascular access, IV fluids
- Arrhythmias: follow ACLS guidelines
- Status epilepticus: IV benzodiazepines, correct structural defects
- Severe hyperthermia: initiate cooling
- Control agitation w/ benzodiazepines IV/IM.
- Focused evaluation for specific complaints
Pharmacology
- Available forms of cocaine
- Cocaine hydrochloride: snorted, injected or ingested
- Crack cocaine (alkaloid form): inhaled
- Route of administration determines intensity & duration of action.
- Inhalation has fastest onset & shortest duration.
- Intranasal has slower onset, longer duration.
- Major pathophysiologic effects
- Increases release of catecholamines: primarily norepinephrine, also dopamine & serotonin
- Blocks reuptake of these catecholamines at preganglionic neurons
- Catecholamines lead to profound sympathomimetic effects.
- Local anesthetic effect due to blockade of fast sodium channels
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Last updated: April 14, 2010
Citation
"Cocaine Intoxication." Pocket ICU Management, PocketMedicine.com, Inc, 2010. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534198/all/Cocaine_Intoxication.
Cocaine Intoxication. Pocket ICU Management. PocketMedicine.com, Inc; 2010. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534198/all/Cocaine_Intoxication. Accessed November 17, 2024.
Cocaine Intoxication. (2010). In Pocket ICU Management. PocketMedicine.com, Inc. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534198/all/Cocaine_Intoxication
Cocaine Intoxication [Internet]. In: Pocket ICU Management. PocketMedicine.com, Inc; 2010. [cited 2024 November 17]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534198/all/Cocaine_Intoxication.
* Article titles in AMA citation format should be in sentence-case
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T1 - Cocaine Intoxication
ID - 534198
Y1 - 2010/04/14/
BT - Pocket ICU Management
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PB - PocketMedicine.com, Inc
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