Cocaine: not that good for you

15 Oct

cribbed from some old posts, but good material to review:

 

BAD THINGS COCAINE DOES:

  • coronary vasoconstriction
  • Enhanced platelet aggregation 
  • early atherosclerosis 
  • Worsens LVH, can lead to myocarditis and dilated cardiomyopathy.
  • increases heart rate and BP, resulting in increased myocardial oxygen demand.
  • Is often associated with tobacco abuse, which exacerbates all of these

 

PATHOPHYSIOLOGY:

  • Release of NE, blocks NE reuptake
  • Release & reuptake blockade of serotonin and dopamine
  • Na channel blockade – local anesthetic effect
  • Fat soluble – crosses blood brain barrier
  • Stimulates CNS, especially limbic system, which potentiates dopaminergic transmission – pleasurable behavioral effects
  • REMINDER: don’t treat with a beta-blocker (shunts to unopposed alpha receptors)

 
NOTABLE NUMBERS:

Route
Onset
Peak(min)
Duration(min)
 Half-life (min)
Inhalation
7s
1-5
20
40-60
IV
15s
3-5
20-30
40-60
Nasal
3min
15
45-90
60-90
Oral
10min
60
60
60-90

 

BOTTOM LINE:

say no to drugs

 

Submissions by J. Gullo, M. Smith.

 

Reference(s): post 1; post 2; picture
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