cocaine poisoning

From which plant is cocaine derived?

Cocaine is an alkaloid obtained from the leaves of the coca plant, primarily Erythroxylon coca and E. novogranatense.

What are common routes of cocaine administration?

Oral, injection, nasal/buccal absorption, and inhalation.

What is crack cocaine and how is it made?

Crack is a crude form of freebase cocaine made by heating cocaine with sodium bicarbonate.

How does cocaine affect the CNS initially?

Stimulates the cortex first (euphoria, hyperactivity), then lower motor centers (convulsions).

Which neurotransmitters' reuptake is inhibited by cocaine?

Dopamine, noradrenaline (norepinephrine), and serotonin.

What accounts for its local anaesthetic action?

Blockade of sodium channels stabilizes axonal membranes.

Major cocaine metabolites?

Benzoylecgonine and ecgonine methyl ester.

What is cocaethylene and when is it formed?

A longer-lasting active metabolite formed when cocaine is used with alcohol.

What are early signs of cocaine intoxication?

Euphoria, suspiciousness, hypervigilance, anxiety, talkativeness

CNS symptoms in acute intoxication?

Hallucinations, impaired judgement, seizures, coma, respiratory failure.

Common complications?

Cardiac arrhythmias, sudden death, pulmonary oedema, pneumothorax.

What are key signs of chronic cocaine use?

Compulsive use, toxic psychosis, paranoia, hallucinations, formication (Magnan symptom).

Effect on reproductive health?

In males: impotence, gynaecomastia.
In females: menstrual irregularities, infertility.

What is the effect of cocaine in pregnancy?

Risk of congenital defects ("crack babies"), maternal cardio-cerebrovascular disease.

Drug of choice for seizures in cocaine toxicity?

IV Diazepam (up to 0.5 mg/kg).

Drug for ventricular arrhythmias?

: IV Propranolol (0.5–1.0 mg).

Are there specific findings at autopsy?

Usually nonspecific, unlike heroin deaths, pulmonary oedema is rare.

What samples should be taken in suspected nasal use?

Swabs from both nostrils.

Is cocaine used for homicide or suicide?

Rarely. Most cases are accidental due to abuse.

What criminal behaviors are associated?

Violence from paranoia, economic compulsion, and systemic violence.