cocaine

what plant is cocaine derived from?

coca plant

what is the moa of cocaine?

inhibits the reuptake of dopamine, noradrenaline and serotonin

what are the adverse CVS effects?

- coronary artery spasm - MI

- tachy/bradycardia

- hypertension

- QRS widening

- QT prolongation

- aortic dissection

what are the adverse neuro effects?

- seizures

- mydriasis

- hypertonia

- hyperreflexia

what are the adverse psychiatric effects?

- agitation

- psychosis

- hallucinations

what are the other effects of cocaine?

- ischaemic colitis following ingestion

- hyperthermia

- metabolic acidosis

- rhabdomyolysis

what is the management of cocaine toxicity?

first line - benzodiazepines

what is given in chest pain?

benzos + GTN

what is given in hypertension?

benzos + sodium nitroprusside

can beta blockers be given?

controversial topic but generally avoided

what are the two forms of cocaine?

- powder - sniffed/snorted/injected

- heated and inhaled through pipe (crack)

what is cocaine often injected with?

heroin - called speedball - very dangerous