cocaine toxicity

Sympathomimetic toxidrome

A condition characterized by adrenergic excess caused by sympathomimetic drugs, leading to increased levels of adrenaline, noradrenaline, and dopamine.

Catecholamine surge

A sharp increase in catecholamines (adrenaline, noradrenaline, dopamine) circulating in the bloodstream, heavily stimulating the fight or flight response.

Beta adrenergic receptor agonists

Medications (e.g., salbutamol) that stimulate beta receptors, leading to various sympathomimetic effects.

Monoamine oxidase inhibitors (MAOIs)

A class of medications that inhibit the monoamine oxidase enzyme, increasing levels of neurotransmitters and potentially contributing to sympathomimetic effects.

Tachycardia

An abnormally rapid heart rate, often seen in sympathomimetic toxidrome.

Hyperthermia

An elevated body temperature that can occur as a result of sympathomimetic drug use.

What are common CNS effects of sympathomimetic toxidrome?

Excitation, anxiety, euphoria, agitation, tachypnoea, delirium.

How can one differentiate between sympathomimetic syndrome and anticholinergic syndrome?

Sympathomimetic syndrome is characterized by sweating, while anticholinergic syndrome often leads to dry skin.

Cocaine toxicity

A potentially life-threatening condition caused by the use of cocaine, leading to sympathomimetic syndrome and sodium channel blockade.

What is the mechanism of toxicity for cocaine?

Cocaine inhibits the reuptake of biogenic amines, particularly affecting serotonin and catecholamines, leading to increased psychomotor agitation and other symptoms.

Dilated pupils

A clinical sign often observed in sympathomimetic toxidrome, associated with increased sympathetic activity.

What is a key treatment for severe agitation in sympathomimetic toxidrome?

Benzodiazepines are the preferred treatment to achieve sedation.

What are the risks associated with cocaine use during pregnancy?

Cocaine is teratogenic, leading to increased risk of miscarriage and fetal demise.

Coke nose

A condition resulting from excessive snorting of cocaine, leading to damage of nasal membranes and disfigurement.

Rapidly absorbed

Cocaine is rapidly absorbed after exposure through various routes, contributing to its rapid onset of action.

Sodium bicarb IV

A treatment used for QRS widening on ECG due to cocaine toxicity.

What are common complications of sympathomimetic toxidrome?

Hyperthermia, cardiac conduction abnormalities, seizures, and various neurological deficits.

Psychoactive substances

Drugs that affect the mind or behavior, which can include sympathomimetic agents like cocaine and amphetamines.

Volume depleted

Hyperthermic patients demonstrating tachycardia and high blood pressure are typically volume depleted and may require cold IV fluid therapy.

Agranulocytosis

A potentially severe condition characterized by a dangerously low white blood cell count, associated with levamisole toxicity.