Cocaine

Question 1

What is cocaine derived from?

Answer 1

The coca plant.

It is an alkaloid

Question 2

How does cocaine work?

Answer 2

It blocks the uktake of dopamine, noradrenaline and serotonin.

Question 3

The use of cocaine is associated with a wide variety of adverse effects. What CVD effects is cocaine associated with?

Answer 3

• Myocardial infarction
• Both tachycardia and bradycardia may occur
• Hypertension
• QRS widening and QT prolongation
• Aortic dissection

Question 4

The use of cocaine is associated with a wide variety of adverse effects. What neurological effects is cocaine associated with?

Answer 4

• Seizures
• Mydriasis
• Hypertonia
• Hyperreflexia

Similar to Serotonin Syndrome.

Question 5

The use of cocaine is associated with a wide variety of adverse effects. What psychiatric effects is cocaine associated with?

Answer 5

• Agitation
• Psychosis
• Hallucinations

Question 6

What are some other side effects that cocaine is associated with?

Answer 6

• Hyperthermia
• Metabolic acidosis
• Rhabdomyolysis

Question 7

How do you manage cocaine toxicity?

(HINT THE GENERAL RULE FOR MOST COCAINE RELATED PROBLEMS)

Answer 7

• First line - Benzodiazipines

Question 8

How do you manage chest pain induced by cocaine toxicity?

Answer 8

Benzodiazepines + GTN.

Question 9

How do you manage hypertension induced by cocaine toxicity?

Answer 9

Benzodiazipines + Sodium Nitroprusside

Question 10

Can beta blockers be used to treat cocaine induced CVD problems?

Answer 10

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.