Anastopoulos K. Kantor |  |
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Cocaine is presently the most abused major stimulant used in the United States. Drug addict has spread among yougsters and cocaine has become the drug most frequently involved in emergency department visits. It is not a new drug of abuse, however it is now considered the top of the line of "recreational" substances. Very often cocaine is part of mixture with alcohol, heroin and other dangerous cocktails.
There is a common myth that cocaine is not addictive because it lacks the physical withdrawal symptoms seen in alcohol or heroin addicted individuals. However, the substance has powerful psychological addictive properties.
Among several complications, cocaine includes the strong stimulation of the sympathetic nervous response. Arterial hypertension, angina and myocardial infarction and failure have all been minutiously describe in cocaine users.
An episode of severe heart failure produced by cocaine can be very difficult to manage with medical resources and will not unusually ends as a fatal complication.
The following abstract relates what is possibly the first use of ECMO to rescue a patient presenting with an episode of severe heart failure resistant to conventional medical management:
Cocaine is an increasing cause of admission in the emergency room. The widespread abuse of this drug during the last decade in the USA is now widely emerging in Europe. Because of its various cardio-vascular complications, cocaine is one of the most death-related drugs known at this time. The following report describes the dramatic case of a young man polydrug addict presenting at our institution with life-threatening acute heart failure that developed shortly after his very first cocaine intake. Because of the lack of response to intensive medical treatment, we decided to perform a percutaneous extracorporeal circulation membranous oxygenation (ECMO) that allowed survival and rapid left ventricular function recovery. This report highlights cocaine as a rising trigger of acute heart failure in young people and is, to the best of our knowledge, the first report that illustrates ECMO as an effective hemodynamic support in the course of fulminant cocaine-induced cardiomyopathy.
De Vroey F, Plein D, Vercauteren S, Castadot M, Bettendorf P. Rescue extracorporeal circulation as bridge to recovery in fulminant cocaine-induced heart failure.
Int J Cardiol. 2008 Mar 10 [Epub ahead of print]
April 9, 2008 11:21 am - Greece |
Evelyn Shonne | |
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ECMO has been used in the emergency room or in emergency medical situations for a few years. Digitalis intentional intoxication, cardiac arrest unresponsive to conventional resuscitation maneuvers, and cold exposure constitute a few non all inclusive exemples of ECMO being used out of usual set of indications.
The case described is very important because emergency personnel has to deal with cocaine intoxication even more frequently and in a growing scale.
It is quite possible that ECMO will contribute to save many individuals after abusing of such a potent drug.
April 18, 2008 10:00 am - Germany |
Charles Bender | |
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Crack addiction is one of society's biggest problem today. persons addicted to crack cocaine will do almost anything to get the drug. It has reached all levels of our society; rich, poor, and everyone in between. Family members connected to addicts with a crack cocaine dependency live in chaos and confusion, they do not understande the underlying mechanism of crack addiction.
The chemical cocaine hydrochloride is usually known as crack. Users chemically process the coke to get rid of the hydrochloride. This process is called "freebasing" and makes it more potent. "Crack" is a solid form of freebased cocaine. It is named "crack" as it snaps and cracks when heated and used.
One gram of pure powder cocaine will convert to approximately 0.89 grams of crack. The Drug Enforcement Administration estimates that crack rocks are between 75 and 90 percent pure cocaine.
Crack Cocaine is inhaled and rapidly absorbed through the lungs, into the blood, and carried swiftly to the brain. The risks of doing an overdose and poisoning leading to coma, convulsions, and even death are highly increased. Crack's rapid rush -5 to 7 mins of intense pleasure- rapidly subsides, leading to the feeling of depression that needs to be taken care by using more crack cocaine. This cycle makes higher the chances of addiction and dependency. Because of the quick high, abusers are always thinking of, and devising ways to get more crack cocaine. Psychologically, the drug decreases the concentration, ambition, drive, and increases confusion and irritability, wreaking havoc on abusers' professional and personal lives. Habitual use may lead to coke psychosis causing, paranoia, hallucinations, and a condition also known as fornication, in which insects or snakes are perceived to be crawling under the skin. The paranoia and depression can lead to violent and suicidal behavior. The side effects of adulterants increase cocaine's risks. The drug is often mixed with one or more of any number of substances, such as cheaper drugs procaine, lidocaine, and benzocaine, and substances that pose no serious danger, such as sugars (mannitol and sucrose), or starches. However, when quinine or amphetamines are mixed with it, the potential danger for serious side effects increases enormously.
From: Crack Addition Treatment June 2, 2008 10:57 am - Greece |
Jonathan Boyle | |
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From September 1983 through November 1986, autopsies were performed on 6810 patients at the Office of the Maryland Medical Examiners; of these 40 had detectable cocaine, its metabolites, or both in body fluids. Results of histologic examination showed myocarditis (mononuclear infiltrate) in 8 of 40 (20%) patients dying with detectable cocaine in body fluids We conclude that myocarditis occurs frequently in patients dying of cocaine abuse and may represent microvascular injury.
Virmani R et cols. Am Heart J. 1989 Jun;117(6):1398-9. June 12, 2008 10:30 am - England |
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