| Cocaine intoxication | |
|---|---|
| Other names | Cocaine toxicity, cocaine poisoning |
 | |
| Cocaine | |
| Specialty | Toxicology |
| Symptoms | Fast heart rate, high blood pressure, agitation, high body temperature, sweating[1] |
| Complications | Acute coronary syndrome, seizures, stroke, pneumothorax, rhabdomyolysis, excited delirium[1][2] |
| Usual onset | Within 5 sec to 5 min[1] |
| Causes | Cocaine[3] |
| Diagnostic method | Urine drug test[1] |
| Differential diagnosis | Low blood sugar, anticholinergic toxicity, delirium tremens, schizophrenia, neuroleptic malignant syndrome[2] |
| Medication | Lorazepam, labetalol, sodium bicarbonate[1] |
| Frequency | 19 million people (2018)[4] |
| Deaths | 15,900 (2019, USA)[5] |
Cocaine intoxication refers to the negative and potentially life threatening effects of cocaine.[3] Symptoms that occur shortly after use often include fast heart rate, high blood pressure, and agitation.[1] Other effects may include high body temperature and sweating.[1] Complications may include acute coronary syndrome, seizures, stroke, pneumothorax, and excited delirium.[1][2]
Cocaine may be smoked, injected, or snorted.[1] Onset of effects is within 5 seconds when smoked, a minute when injected, and within 5 minutes when snorted.[1] Effects last for 5 to 90 minutes.[1] Toxicity may also occur due to body packing or body stuffing.[1] Diagnosis can be supported by urine testing which remains positive for one or two days after a single us and potentially weeks with long term use.[1] False positives are uncommon.[1]
The initial treatment is typically with a benzodiazepine such as lorazepam or midazolam by injection.[1] If high blood pressure persists, it may be managed with nicardipine or labetalol.[1] High temperature may require additional cooling techniques.[1] Aspirin and nitroglycerin may be used in those with chest pain.[1] Those with a wide QRS complex may be treated with sodium bicarbonate.[1]
About 19 million people used cocaine globally in 2018, most commonly in North America and Western Europe.[4] In the United States about half a million episodes of cocaine use required emergency department care in 2011 and such use was involved in 15,900 deaths in 2019.[2][5] Cocaine intoxication can result in death.[2] Cocaine is frequently mixed with levamisole which may result in low white blood cells and vasculitis.[2]
References edit
- ^ a b c d e f g h i j k l m n o p q r s Zimmerman, Janice L. (2012-10-01). "Cocaine intoxication". Critical Care Clinics. 28 (4): 517–526. doi:10.1016/j.ccc.2012.07.003. ISSN 1557-8232. PMID 22998988.
- ^ a b c d e f Richards, JR; Le, JK (January 2021). "Cocaine Toxicity". PMID 28613695.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b "Cocaine Toxicity • LITFL • CCC Toxicology". Life in the Fast Lane • LITFL. 13 January 2019. Retrieved 12 April 2021.
- ^ a b WORLD DRUG REPORT 2020 (SET OF 6 BOOKLETS) (PDF). [S.l.]: UNITED NATIONS. 2020. pp. 17–18. ISBN 978-92-1-148345-1. Retrieved 12 April 2021.
- ^ a b Abuse, National Institute on Drug (29 January 2021). "Overdose Death Rates". National Institute on Drug Abuse. Retrieved 12 April 2021.