Cocaine poisoning

cocaine is a whitish crystalline powder produced from the dried juice extracted from the leaves of the coca plants.

cocaine is used as local anesthetic, antiarrhythmic, sports doping, anorexigenic.

Conditions of cocaine poisoning is mainly accidental as over dose in addicts and therapeutic over dose in surgeries.

cocaine could be taken by sniffing , smoking or intra_venous injection.

clinical picture:

On CNS:-

  1. CNS stimulation followed by depression.
  2. Euphoria,agitation and insomnia.
  3. Mental confusion ,hallucinations and headache.
  4. Exaggerated reflexes and convulsions.
  5. Hyperthermia.
  6. Drowsiness and confusion ,up to coma.
  7. Circulatory collapse due to depression of vasomotor area.
  8. Cyanosis and central asphyxia.

On CVS:-

  1. Hypertension and intracranial hemorrhage.
  2. Tachyarrhythmia.
  3. Coronary artery spasm and myocardial infarction.

On different organs:-

  1. Renal failure.
  2. Coke Burns.

causes of death from cocaine poisoning are central asphyxia ,circulatory collapse ,renal failure and multiple organ failure.

investigations done for cocaine poisoning are routine laboratory investigation , toxicological screening of benzoylecgonine ( detected up to 3 days) ,serum enzymes like CPK to indicate rhabdomyolysis.

treatment:-

  1. Support the air way , breathing and circulation first.
  2. GIT decontamination through emesis and gastric lavage (done only in absence of seizures)
  3. Symptomatic treatment as diazepam( anticonvulsant) and sodium nitroprusside ( antihypertensive).

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