Highlights & Basics
- Cocaine toxicity occurs within minutes to hours of excessive cocaine use.
- Some patients may die suddenly before treatment is given.
- Presentation includes tachycardia, hypertension, hyperthermia, diaphoresis, mydriasis, and agitation.
- Urine cocaine screen confirms recent cocaine use, but treatment should not be delayed pending results of the test as these will not affect acute management.
- Treatment may involve supportive care and benzodiazepines; hyperthermia requires rapid cooling to prevent death. When cocaine is taken in the presence of an opioid, the patient should be treated based on the prevailing toxidrome.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
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Panchal AR, Bartos JA, Cabañas JG, et al. Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020 Oct 20;142(16_suppl_2):S366-468.[Full Text]
Smollin CG, Hoffman RS. Chapter 75: Cocaine. In: Nelson LS, Howland MA, Lewin NA, et al, eds. Goldfrank's toxicologic emergencies, 11th ed. New York, NY: McGraw-Hill Education; 2019.
Lavonas EJ, Akpunonu PD, Arens AM, et al. 2023 American Heart Association focused update on the management of patients with cardiac arrest or life-threatening toxicity due to poisoning: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2023 Oct 17;148(16):e149-84.[Abstract][Full Text]
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