Cocaine-related emergency department presentations

K. S. Schrank

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations


Cocaine use is related to a vast array of emergency medical conditions, and emergency physicians throughout the United States are likely to be confronted with these patients. Although catastrophic complications are well recognized, they fortunately represent a very small fraction of cocaine sequelae. However, a high index of clinical suspicion should be maintained to avoid misdiagnosis of complications such as myocardial ischemia, significant rhabdomyolysis, or small subarachnoid hemorrhage. Rapid intervention is crucial in patients presenting with seizures, hyperthermia, lethal arrhythmias, or toxic delirium. Most patients do well with ED evaluation and nonspecific supportive care, but an understanding of this drug's mechanisms of action and its interactions with therapeutic interventions is vital in situations such as acute hypertension, cardiac arrhythmias, or agitated states. Reliable animal models that closely simulate human responses are not yet available. At this time, knowledge remains limited, particularly as to optimal pharmacologic management of specific cocaine effects. Further investigations into potentially adverse consequences of commonly used medical regimens, such as β-receptor antagonist, will be essential in guiding management of these cases.

Original languageEnglish (US)
Pages (from-to)110-128
Number of pages19
JournalNIDA Research Monograph Series
Issue number123
StatePublished - Dec 1 1992

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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