Neuropsychiatric Effects of Cocaine Use Disorders: COCAINE OVERDOSE

21 Nov
2009

COCAINE OVERDOSE

Fatal and near-fatal cases of cocaine overdose are not uncommon. The dose of cocaine that might result in fatal outcomes depends on an individual’s weight, height and general health status. Also, fatal outcomes may occur irrespective of the frequency of use or route of administration.

Cocaine induces a multisystem response characterized by vasoconstriction, tachycardia and tachyp­nea. As a result, clinicians need a high index of suspicion to manage cocaine overdoses effectively. For instance, severe hemodynamic compromise can lead to target organ damage in the heart, bowels, skeletal muscles, liver, kidneys and the brain. levitra plus

Also, cocaine has a direct deleterious effect on cardiac repolarization. Massive doses can produce angina pectoris, myocardial necrosis and/or sudden death even among individuals with no cardiac risk factors, such as young adults. Low doses may result in malignant arrhythmias in individuals with cardiac risk factors. Apparently, the growing awareness of the cardiac effects of cocaine is persuading active users to report chest complaints immediately to the ambulance service or the emergency departments.

Cocaine overdose is associated with seizures, status epilepticus, headaches and strokes. Typically, there might be a new-onset seizure or an exacerbation of an existing seizure disorder. Cocaine-related, new-onset focal seizures in humans should prompt a search for cerebral hemorrhage. Cocaine should be considered in the diagnostic work up of strokes in young adults. viagra plus

Acute renal failure is a serious complication of cocaine overdose. The kidney shutdown might be secondary to massive muscle necrosis and myoglo-binemia. The patient might exhibit mental status alterations. In long-term cocaine users, this acute failure may be superimposed on chronic renal arteri-opathy and hypertension.

Acute agitation in cocaine overdose can manifest as garrulousness, excitement, restlessness and confusion. Patients with suspected overdose of cocaine should be transported urgently to the nearest emergency department using an advanced life-support ambulance, when possible. The patients’ family, ambulance service personnel, law enforcement officers and physicians need to be aware that attempts to control cocaine agitation with physical restraints and neck hold can result in lethal complications. cialis professional online

An overdose of alcohol and cocaine frequently needs more intense care in the emergency department than cocaine-only overdose. Worse episodes of violent acts, cardiotoxicity and sudden death occur with coalcohol overdose as compared to cocaine overdose alone. In the presence of alcohol, cocaine forms a highly toxic metabolite, cocaethylene.

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