Cocaine

Acute cocaine toxicity presents with:

• Sympathomimetic effects
  Similar to amphetamines.
• Vasospasm
  • Cardiac
  • Cerebral
• Myocardial ischaemia
  Combination of:
  • ↑ Myocardial oxygen demand
  • Coronary vasospasm
  • ↑ Platelet aggregation

Epidemiology and Risk Factors

Pathophysiology

Aetiology

Clinical Manifestations

Diagnostic Approach and DDx

Investigations

Bedside:

Laboratory:

Imaging:

Other:

Management

Resuscitation:

Specific therapy:

• Pharmacological
  • Benzodiazepines
  • Aspirin
  • Calcium channel blockade
  • α-blockade
• Procedural
  • Angioplasty
• Physical

Supportive care:

Disposition:

Preventative:

Marginal and Ineffective Therapies

• β-blocker
  Relative contraindicated due to risk of unopposed α stimulation.
• DAPT
  Not recommended due to ↑ ICH risk with systemic hypertension.
• Heparin

Anaesthetic Considerations

Complications

• C
  • MI
• D
  • ICH

Prognosis

Key Studies

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References

1. Bersten, A. D., & Handy, J. M. (2018). Oh’s Intensive Care Manual. Elsevier Gezondheidszorg.