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Cocaine

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  1. See Also
    1. Amphetamine
    2. MDMA
    3. Methamphetamine
    4. Chemical Dependency
    5. Substance Abuse Evaluation
  2. Background
    1. Naturally derived from Coca plant
      1. South American shrub
      2. Not the same as the cocoa plant
    2. Class
      1. Stimulant
      2. Local anesthetic
      3. Schedule I
  3. Street Names
    1. Coke
    2. Snow Flake
    3. Toot
    4. Star Dust
    5. Happy Dust
    6. Bernice
  4. Pharmacokinetics
    1. Cocaine (20-300 mg)
      1. Duration: 2-4 hours
      2. Half life: 90 minutes
    2. Metabolized by serum and hepatic cholinesterases
    3. Excreted by kidneys
    4. Crosses the placenta by simple diffusion
    5. Affects Neurotransmitters
      1. Norepinephrine
      2. Dopamine - arousal
      3. Serotonin - awakening
    6. Prolonged Duration and toxicity
      1. Excessive intake
        1. "body packers" with ruptured bag
      2. Concurrent Alcohol ingestion
  5. Forms
    1. Swallowed
    2. Snorted
    3. Intravenous
    4. Freebase residue,
    5. Smoked (solid crack)
  6. Peak Toxicity
    1. Swallowing: 60-90 minutes
    2. Snorting: 30-60 minutes
    3. Intravenous or Smoked: Minutes
  7. Toxicity: Systemic Sympathomimetic Effect
    1. See Sympathomimetic Toxicity
  8. Management: Toxicity
    1. See Sympathomimetic Toxicity
  9. Management: Withdrawal
    1. Ativan until adequate Sedation
      1. May require significant dosages
    2. Propranolol 20 mg qid (indicated for chills)
  10. Management: Abstinence
    1. Study of effective options for therapy
      1. Cognitive behavior therapy
      2. Disulfiram (effective even if no Alcohol Abuse)
      3. Caroll (2004) Arch Gen Psychiatry 61:264
  11. References
    1. Shih (1996) Hosp Physician p :

Cocaine (C0009170)

Definition (MSH)An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake.
Definition (CSP)alkaloid ester extracted from the leaves of plants including coca; has powerful central nervous system effects similar to the amphetamines and is a drug of abuse; acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake; it is also a local anesthetic and vasoconstrictor and is clinically used for that purpose.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121) , Hazardous or Poisonous Substance (T131)
MSHD003042
EnglishCocaine, cocaine in any form, COCAINE PREPARATION, cocaine product
Spanishcocaina
Parent ConceptsCocaine (C0009170), AOD substance or product (C0678374), Alkaloids (C0002062), Central Nervous System Stimulants (C0002763), Local Anesthetics (C0002934), Tropanes (C0041177), Dopamine Agonists (C0178601), [NT300] ANESTHETICS, MUCOSAL (C0973582), Psychostimulant (C0304403), Ester type local anesthetic (C0360098), Ophthalmic topical anesthetic (C0973601), Dermatological Anesthetics (C1579272)
SourcesAOD, CSP, LCH, LNC, MSH, MTH, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)



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