Cocaine Toxicity Questions & Answers

Updated: Sep 01, 2018
  • Author: Lynn Barkley Burnett, MD, EdD, LLB(c); Chief Editor: Sage W Wiener, MD  more...
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Questions & Answers

Overview

What is cocaine toxicity?

How does cocaine toxicity progress?

What are the signs and symptoms of phase I (early stimulation) cocaine toxicity?

What are the signs and symptoms of phase II (advanced stimulation) cocaine toxicity?

What are the signs and symptoms of phase III (depression and premorbid) cocaine toxicity?

Which lab tests are performed in the diagnosis evaluation of cocaine toxicity?

What is the role of radiography in the diagnosis of cocaine toxicity?

When is electrocardiography indicated in the workup of cocaine toxicity?

How is cocaine toxicity treated?

How are hyperthermia and rhabdomyolysis treated in cocaine toxicity?

What is the effect of cocaine availability on the incidence of cocaine toxicity?

How common is cocaine toxicity in the US?

What is the historical background of cocaine use, abuse and toxicity?

What are the forms of cocaine that can lead to toxicity?

What is the pharmacology of cocaine toxicity?

How does the route of administration affect cocaine toxicity?

How is cocaine metabolized during the development of cocaine toxicity?

How does alcohol affect cocaine toxicity?

How does nicotine affect cocaine toxicity?

How does heroin affect cocaine toxicity?

How do agents used to enhance effect of cocaine contribute to toxicity?

Which drug interactions increase the severity of cocaine toxicity?

What is the role of adulterants in the development of cocaine toxicity?

What is the role of levamisole in the development of cocaine toxicity?

Which non-pharmacologic adulterants may affect cocaine toxicity?

What is the pathophysiology of cocaine toxicity?

What is the role of dysrhythmia in the pathophysiology of cocaine toxicity?

What are additional findings on the pathophysiology of cocaine toxicity in rat studies?

What is the pathophysiology of cocaine-induced MI?

What is the role of endothelial cells in cocaine-induced vasoconstriction?

What is the role of dopamine in the pathophysiology of cocaine-induced MI?

What types of cardiomyopathy are caused by cocaine toxicity?

What are the neurologic complications of cocaine toxicity?

What is the role of dopamine in cocaine-induced neurologic syndromes?

What is the pathophysiology of delirium in cocaine toxicity?

How do restraints increase the risk for sudden death from cocaine toxicity?

What is the pathophysiology of hyperthermia in cocaine toxicity?

What is the pathophysiology of cocaine-associated rhabdomyolysis (CAR)?

How does acidemia increase the risk for death from cocaine toxicity?

What is the prevalence of cocaine toxicity in the US?

What is the global prevalence of cocaine toxicity?

What is the mortality and morbidity associated with cocaine toxicity?

What are the sequelae of IV cocaine use?

What are the racial predilections of cocaine toxicity?

What are the sexual predispositions of cocaine toxicity?

How does the prevalence of cocaine toxicity vary by age?

Presentation

What is included in the clinical history of suspected cocaine toxicity?

What is the focus of present illness history in suspected cocaine toxicity?

How extensive is the review of systems for the evaluation of suspected cocaine toxicity?

What is the focus of medication and drug use history in the evaluation of suspected cocaine toxicity?

What are the signs and symptoms of "crack lung" in cocaine toxicity?

Which physical findings are characteristic of cocaine toxicity?

What is the association of cocaine toxicity with trauma?

Which conditions should be included in the differential diagnoses of cocaine toxicity?

Which vital sign findings suggest cocaine toxicity?

Which cardiovascular findings are characteristic of cocaine toxicity?

What is the prevalence of respiratory findings in cocaine toxicity?

Which respiratory findings are characteristic of cocaine toxicity?

What are the ENT signs and symptoms of cocaine toxicity?

What are ophthalmologic complications of cocaine toxicity?

Which GI findings are characteristic of cocaine toxicity?

Which cutaneous findings are characteristic of cocaine toxicity?

What causes increased heat production in cocaine toxicity?

Which neurologic and psychiatric findings suggest cocaine toxicity?

What are possible psychiatric complications of cocaine toxicity?

What are the neurologic and psychiatric signs and symptoms of cocaine toxicity?

Which renal findings are characteristic of cocaine toxicity?

Which endocrine and metabolic findings are characteristic of cocaine toxicity?

Which musculoskeletal findings are characteristic of cocaine toxicity?

What is included in the physical exam for cocaine toxicity when body stuffing is suspected?

How is the cause of an altered mental status differentiated in cocaine toxicity?

What are phases of acute cocaine toxicity?

What is the clinical presentation of phase I (early stimulation) cocaine toxicity?

What is the clinical presentation of phase II (advanced stimulation) cocaine toxicity?

What is the clinical presentation of phase III (depression and premorbid) cocaine toxicity?

What are the risk factors for cocaine toxicity?

What are the types of cocaine dependency?

What are the differences between type A and type B cocaine dependency?

Which mental disorders are comorbid with cocaine toxicity?

DDX

Which conditions should be included in the differential diagnoses of cocaine toxicity?

What are the differential diagnoses for Cocaine Toxicity?

Workup

What is the role of lab testing in the evaluation of cocaine toxicity?

How is toxicology screening performed in the evaluation of cocaine toxicity?

Which lab tests may be performed based on clinical presentation of cocaine toxicity?

What is the role of imaging studies in the workup of cocaine toxicity?

What is the role of radiography in the evaluation of body packing in cocaine toxicity?

What are the types of body packing in cocaine toxicity?

What is the risk of bag rupture or leaching in individuals with body-packed cocaine?

What is the role of CT scanning in the evaluation of cocaine toxicity?

What is the role of ECG in the evaluation of cocaine toxicity?

What is the role of EEG in the evaluation of cocaine toxicity?

What is the role of lumbar puncture in the workup of cocaine toxicity?

Treatment

What is included in prehospital care for cocaine toxicity?

What is included in emergency department (ED) care for cocaine toxicity?

Which medications may worsen the adverse effects of cocaine toxicity?

What is the role of epinephrine and vasopressin in the treatment of cocaine toxicity?

What is the role of lidocaine in the treatment of cocaine toxicity?

What is the role of beta-blockers in the treatment of cocaine toxicity?

How is cardiac arrest treated in cocaine toxicity?

How is acute coronary syndrome (ACS) treated in cocaine toxicity?

How are cardiac dysrhythmias treated in cocaine toxicity?

How is myocardial infarction (MI) treated in cocaine toxicity?

How is ST-segment elevation or depression treated in cocaine toxicity?

What is the role of fibrinolysis in the treatment of cocaine toxicity?

What cardiac monitoring should be performed during the treatment of cocaine toxicity?

Why is a rapid bedside test for cocaine required prior to administering beta-blocker therapy for MI?

How is hypertension treatment in cocaine toxicity?

How is hypotension treated in cocaine toxicity?

How is aortic dissection treated in cocaine toxicity?

How is pulmonary edema treated in cocaine toxicity?

How is hypoxia treated in cocaine toxicity?

What is the role of naloxone in the treatment of cocaine toxicity?

What is the role of flumazenil in the treatment of cocaine toxicity?

How are seizures treated in cocaine toxicity?

How are dystonic reactions treated in cocaine toxicity?

How is hypoglycemia treated in cocaine toxicity?

How is acidosis treated in cocaine toxicity?

How is hyperthermia treated in cocaine toxicity?

How is rhabdomyolysis treated in cocaine toxicity?

What are GI concerns in the treatment of cocaine toxicity?

How is body packing managed in cocaine toxicity?

How are the psychiatric manifestations of cocaine toxicity treated?

When should cerebral malaria be considered in the differential diagnosis of cocaine toxicity?

Which patients with cocaine toxicity should be screened for HIV and hepatitis?

What are the risks of organ donation following treatment for cocaine toxicity?

What is the role of topiramate in the treatment of cocaine toxicity?

Which specialist consultations are beneficial in the treatment of cocaine toxicity?

Medications

What is the role of pharmacotherapeutic intervention in cocaine toxicity?

Which medications in the drug class Nutrients are used in the treatment of Cocaine Toxicity?

Which medications in the drug class GI agents are used in the treatment of Cocaine Toxicity?

Which medications in the drug class Cardiovascular agents are used in the treatment of Cocaine Toxicity?

Which medications in the drug class Benzodiazepines are used in the treatment of Cocaine Toxicity?

Follow-up

What is included in the long-term care following treatment for cocaine toxicity?

When is inpatient care for cocaine toxicity indicated?

When should patient transfer be considered in the treatment of cocaine toxicity?

How is cocaine toxicity prevented?

What are the possible complications of cocaine toxicity?

What is the prevalence of suicide among cocaine users?

What is the prevalence of domestic violence in patients affected with cocaine toxicity?

What are the health risks of cocaine toxicity?

What is included in patient education about cocaine toxicity?