Cocaine Toxicity

Cocaine Toxicity

Remember Cocaine is a sympathomimetic, hence would cause Agitation, Tachycardia, Hypetension, Hyperthermia, and myocardial ischemia

Cocaine induced Myocardial Ischemia/Chest Pain:

IV Benzodiazepines (diazepam/lorazepam): Controls agitation, hypertension, seizures, and chest pain

IV nitrates (1^st line to manage angina/hypertension), Ca+2 Blockers as second line agents

(Do not use beta blockers as it may cause paradoxical hypertension, and vasoconstriction due to unopposed alpha effects, Phentolamine could be used but it may cause a drastic fall in BP and should be avoided in patients with history of myocardial ischemia)

Aspirin PO

If chest pain still persists, and EKG shows myocardial injury: reperfusion therapy (rTPAs or PCI)