Cocaine intoxication

Also known as: Intoxication - cocaine

Definition

Cocaine is a powerful central nervous system stimulant with potent cardiovascular (heart and blood vessel) side effects. Signs of intoxication typically begin with enlarged pupils, a feeling of being "high" (euphoria), agitation, and increased heart rate and blood pressure.

With higher doses, sweating, tremors, confusion, hyperactivity, seizures, stroke, cardiac arrhythmias (irregular heart beats), and sudden death can occur.

See also:

• Cocaine
• Drug abuse
• Drug abuse and dependence
• Drug abuse first aid
• Stroke secondary to cocaine

Causes, incidence, and risk factors

Bleeding into the lungs, fluid in the lungs, and damage to lung tissue have become more common as a result of crack cocaine smoking.

Those who are thought to have swallowed poorly packaged cocaine following police pursuit are called “body stuffers.” Because of the large quantities of relatively pure drug contained in these packages, toxicity and death can occur if even a single bag ruptures.

Treatment

A person with cocaine intoxication is most always admitted to a hospital, often on a heart-monitoring unit.

The cornerstone of therapy is adequate sedation and monitoring of vital signs.

The patient with high blood pressure and rapid heart beat (tachycardia) will often respond to treatment with benzodiazepines, a class of medications that includes diazepam and lorazepam.

Seizures may also be treated with benzodiazepines.

Chest pain and high blood pressure is treated as appropriate.

Long-term treatment will require drug counseling in combination with medical therapy.

References

Perrone J, Hoffman RS. Cocaine, amphetamines, caffeine, and nicotine. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 168.

See also:

• Injury

  Drug abuse first aid

  is the misuse or overuse of any medication or drug, including alcohol. This article discusses first aid for drug and withdrawal.

• Special Topic

  Cardiovascular

  

  The term cardiovascular refers to the heart (cardio) and the blood vessels (vascular). The cardiovascular system includes arteries, veins, arterioles, venules, and capillaries.

• Disease

  Stroke related to cocaine use

  

  Stroke related to cocaine use is a blockage in the blood supply to the brain and loss of brain function in someone who has used the drug, cocaine.

• Disease

  Stroke

  

  A stroke is an interruption of the blood supply to any part of the brain. A stroke is sometimes called a “brain attack.” See also: (AVM)

• Test

  Toxicology screen

  

  A toxicology screen refers to various tests to determine the type and approximate amount of legal and illegal drugs a person has taken.

• Disease

  Drug dependence

  

  Drug dependence means that a person needs a drug to function normally. Abruptly stopping the drug leads to withdrawal symptoms. Drug addiction is the compulsive use of a substance, despite its negative or dangerous effects. A person may have a physical dependence on a substance without having an ...

• Special Topic

  Central nervous system

  

  The central nervous system is composed of the brain and spinal cord. Your brain and spinal cord serve as the main “processing center” for the entire nervous system, and control all the workings of your body.

• Disease

  Arrhythmias

  

  An arrhythmia is a disorder of the (pulse) or heart rhythm, such as beating too fast (tachycardia), too slow (bradycardia), or irregularly.

• Special Topic

  Drug abuse

  Drug abuse is the use of illegal drugs, or the misuse of prescription or over-the-counter drugs for at least a year with negative consequences. See also:

Review date:

April 20, 2009

Reviewed by:

Jacob L. Heller, MD, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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