Cocaine: Difference between revisions

Latest revision as of 14:35, 16 March 2018

This page is for the drug cocaine; for clinical effects see cocaine toxicity

Administration

Type: Local anesthetic
Dosage Forms: 4% solution; 10% solution
Routes of Administration: Topical
Common Trade Names: Cocaine

Adult Dosing

1-3 mg/kg, max dose of 200 mg
- Some literature suggests maximum dose of 100 mg
- Ideally use lowest effective dose

Pediatric Dosing

1 mg/kg
- No clear safe dose established

Special Populations

Pregnancy Rating: Category C
Lactation risk: Infant risk has been demonstrated

Renal Dosing

Adult: N/A
Pediatric: N/A

Hepatic Dosing

Adult: N/A
Pediatric: N/A

Contraindications

Allergy to class/drug

Adverse Reactions

Cocaine-associated chest pain
Sympathomimetic qualities
- Tachycardia
- Fever
- Agitation
- Diaphoresis

Pharmacology

Half-life: 50 to 75 minutes (5.5 hours benzoylecgonine metabolite)
Metabolism: Plasma cholinesterase; liver
Excretion: Renal

Mechanism of Action

Blocks reuptake of serotonin, dopamine and norepinephrine
Anesthetic effects achieved through sodium channel blockade

Comments

References

Micromedex

Authors:

@@ Line 1: / Line 1: @@
-==Background==
+''This page is for the drug cocaine; for clinical effects see [[cocaine toxicity]]''
-[[File:Kokain_-_Cocaine.svg.png |thumb|Cocaine chemical structure]]
+==Administration==
-*A [[Sympathomimetic toxicity|sympathomimetic]] stimulant derived from an alkaloid paste made from the leaves of the coca plant
+*Type: Local anesthetic
-*Both a legitimate medical drug and a drug of abuse
+*Dosage Forms: 4% solution; 10% solution
+*Routes of Administration: Topical
+*Common Trade Names: Cocaine
-===Forms of Abuse===
+==Adult Dosing==
-*Cocaine can be smoked, snorted, injected or ingested
+*1-3 mg/kg, max dose of 200 mg
-*Smoked form is often in a free-base or crack form
+**Some literature suggests maximum dose of 100 mg
+**Ideally use lowest effective dose
-===Detection===
+==Pediatric Dosing==
-*Unreliable in very acute intoxication<ref>McCord J, et al. Management of Cocaine-associated chest pain and myocardial infarction. Circulation. 2008; 117: 1897-1907.</ref>
+*1 mg/kg
-*Qualitative urine detection of cocaine metabolite benzoylecgonine at cut-off of 300 ng/ml
+**No clear safe dose established
-**On average, shows up in urine 24-48 hrs after use
-**Up to 22 days in chronic users
-==Adverse effects==
+==Special Populations==
-*Acute
+*[[Drug pregnancy categories|Pregnancy Rating]]: Category C
-**Chest pain
+*Lactation risk: Infant risk has been demonstrated
-**Sympathomimetic qualities
+===Renal Dosing===
-***Tachycardia
+*Adult: N/A
-***Fever
+*Pediatric: N/A
-***Agitation
+===Hepatic Dosing===
-***Diaphoresis
+*Adult: N/A
-**Pulmonary Complications:
+*Pediatric: N/A
-***"Crack lung"<ref>Forrester, J. M., Steele, A. W., Waldron, J. A. and Parsons, P. E. (1990) ‘Crack Lung: An Acute Pulmonary Syndrome with a Spectrum of Clinical and Histopathologic Findings’, American Review of Respiratory Disease, 142(2), pp. 462–467. doi: 10.1164/ajrccm/142.2.462.</ref>
-***Diffuse alveolar hemorrhage<ref>Ettinger, N. A. and Albin, R. J. (1989) ‘A review of the respiratory effects of smoking cocaine’, The American Journal of Medicine, 87(6), pp. 664–668. doi: 10.1016/s0002-9343(89)80401-2.</ref>
-***[[ARDS]]
-***Acute eosinophilic pneumonia
-***[[Pneumothorax]]
-***[[Pneumomediastinum]]
-***Thermal epiglottitis - hot cocaine
-*Chronic
-**Atherosclerosis
-**Cardiomyopathy
-**Nasal Septum damage
-**Up to 70% of US cocaine tainted with [[levamisole]], potentially leading to [[neutropenia]], [[vasculitis]]
-==Mechanism of action==
+==Contraindications==
+*Allergy to class/drug
+==Adverse Reactions==
+*[[Cocaine-associated chest pain]]
+*Sympathomimetic qualities
+**Tachycardia
+**Fever
+**Agitation
+**Diaphoresis
+==Pharmacology==
+*Half-life: 50 to 75 minutes (5.5 hours benzoylecgonine metabolite)
+*Metabolism: Plasma cholinesterase; liver
+*Excretion: Renal
+==Mechanism of Action==
 *Blocks reuptake of serotonin, dopamine and norepinephrine
 *Anesthetic effects achieved through sodium channel blockade
-==Differential Diagnosis==
+==Comments==
-{{Sympathomimetic types}}
 ==See Also==
-*[[Sympathomimetic Toxicity]]
+*[[Cocaine toxicity]]
-*[[Cocaine Intoxication]]
-*[[Cocaine Chest Pain]]
-*[[Cocaine Withdrawal]]
-*[[Levamisole toxicity]]
-[[Category:Tox]]
-[[Category:Pharmacology]]
 ==References==
+Micromedex
 <references/>
+[[Category:Pharmacology]]