Cocaine Flashcards
What are the 5 uses of cocaine (good + bad)
Antiarrhythmic (xylocaine)
Local anaesthetic (marcaine)
Anorexigenic
Sports
Druge abuse
4 routes of administration…
Sniffing
Smoking (crack)
Inhalation
IV (usually with heroin)
4 MOA of cocaine…
CNS stimulant effects:-
Inhibit reuptake of epinephrine and norepinephrine
Inhibit reuptake of dopamine
Interferes with serotonin activity
Local anesthetic effect:-
Blocks fast inward Na channels
Cocaine dound in leaves of which plant?
Erythroxylon
3 causes of death…
Hyperthermia (most common)
Central asphxia
Circulatory collapse
CNS manifestations include…
Euphoria, agitation, insomnia, headache, STATUS EPILEPTICUS, huperthermia, exagerrated reflex that eventually becomes loss of reflexes, hallucination, convulsions, increased respiratory depth and rate
CVS manifestations include….
Arrhythmia
Hypertension
Coronary artery spasm (MI)
Other manifestations include…
Rhabdomyolysis
myoglobinurea
COKE BURNS (accidental subcutaneus injection causing localized necrotic ulcer)
Renal failure
Investigations done include…
RFT, CBC, serum enzymes
Detection of benzoylecgonine in urine (metabolite of cocaine)
Treatment for cocaine intake…
Supportive:
-CNS stimulation: chloropromazine
-Convulsion: diazepam
-hypertension: a blocker (sodium nitroprusside)
-Hyperthermia: chloropromazine + salicylate
GIT decontamination:
-Gastric lavage and emesis
Enhance elimination
-Forced acid diuresis (risk of metabolic acidosis tho)
Synptimatic
- lithium for psychosis
Cool quiet environment
Cocainism is…
Dependance to cocaine due to chronic use
5 clinical pictures of cocainism…
Lost sense of smell (too much sniffing)
Pallor of face due to vasoconstriction
Perforated nasal septum
Cocaine bugs felt underskin
Magnan’s syndrome ( sand under skin)
2 withdrawal symptoms of cocaine…
Neurological pain and arms and legs
Irritation
Treatment of cocainism…
Abrupt withdrawal in an institute
B blockers for hypertension and arrhythmia
