Anestesia no paciente usuário de cocaína

Luft, Ana Paula; Mendes, Florentino Fernandes

doi:10.1590/s0034-70942007000300009

Cited by 16 publications

(6 citation statements)

References 35 publications

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“…A benzocaína é um AL do tipo éster, com efeito de curta duração. Assim como outros ALs, a benzocaína exerce seu efeito ligando-se ao domínio intracelular do canal NaV, inibindo, assim, a transferência e despolarização por íons prevenindo a transmissão neuronal (El-Boghdadly, 2018;Melo, 2010;Luft, 2007). A toxicidade dos ALs é dose dependente.…”

Section: Resultsunclassified

Adulterantes identificados na cocaína comercializada no Piauí - PI: uma análise qualitativa do seu potencial toxicológico

Silva

Lima

Oliveira

et al. 2020

RSD

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Na produção da cocaína de rua para o comércio de varejo, além do princípio ativo, outras substâncias são comumente adicionadas. A presença de outras substâncias, conhecidas como adulterantes, torna-se um agravante a mais à saúde dos usuários. Este trabalho teve o objetivo de avaliar qualitativamente a cocaína apreendida pela polícia civil do estado do PI. Para isso, foram utilizadas 100 amostras de cocaína apreendidas entre os anos de 2017 e 2018. As análises por CG-EM identificaram, principalmente, cafeína, fenacetina e levamisol em 58%, 48% e 30% das amostras, respectivamente. Somente 9% das amostras não possuíam adulterantes. Esses adulterantes podem alterar os sinais e sintomas de uma intoxicação por cocaína causando desde um aumento do seu poder adictivo a distúrbios hematológicos. Por fim, é possível concluir que a cocaína apreendida no PI não possui um grau elevado de pureza e que devido ao perfil toxicológico dos seus principais adulterantes a identificação dessas substâncias é um dado de grande relevância já que auxilia na compreensão do seu mercado e do real risco à saúde de seus usuários.

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Section: Resultsunclassified

Adulterantes identificados na cocaína comercializada no Piauí - PI: uma análise qualitativa do seu potencial toxicológico

Silva

Lima

Oliveira

et al. 2020

RSD

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“…Due to its diversity of compounds, cocaine can be used in many routes, such as oral, nasal, pulmonary, or intravenous route (Corrêa et al, 2014). As for its pharmacokinetics, cocaine is a benzoylmethylenoin, with a plasma half-life of about 30-60 min, suffering hydrolysis by plasma and hepatic esterases, producing inactive metabolites (Ball and Westhorpe, 2003), such as ecgonine methyl ester, which by degrading forms benzoylgonin, a urinary metabolite and Norcaide, a metabolite produced through demethylation (Luft and Mendes, 2007).…”

Section: Mechanism Of Actionmentioning

confidence: 99%

Awareness during anesthesia in cocaine addicters: concerning about chemical interactions

Moreira¹,

Barbosa²,

Gonçalves³

et al. 2023

Development and Its Applications in Scientific Knowledge

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The interaction between cocaine and anesthetic drugs has been known since 1884 when it was first used for the treatment of morphine addiction and as a local anesthetic. Due to a large number of users of the substance, the interaction with anesthetic drugs has been frequent and it has been seen that many drugs have their effects altered in the presence of cocaine. Through a bibliographical survey in PubMed and CrossRef, aiming to highlight the risks of this interaction and conduct in cases of elective surgeries in these patients, we conducted this study and verified that so many drugs have to be avoided due to their interaction effects, but in the absence of clinical signs of intoxication, screening becomes ineffective.

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“…These sympathomimetic effects can present as profound hemodynamic lability during anesthesia, particularly for patients acutely intoxicated with cocaine. Extreme elevation in blood pressure as a result of cocaine combined with surgical stimulation can have devastating effects including malignant arrythmias, subarachnoid hemorrhage and rupture of pre-existing aortic aneurysm [ 34 , 35 ].…”

Section: Additional Anesthetic Considerationsmentioning

confidence: 99%

Illicit Drug Use and Endoscopy: When Do We Say No?

et al. 2022

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Background Illicit drug use (IDU) is often encountered in patients undergoing elective ambulatory surgical procedures such as endoscopy. Given the variety of systemic effects of these drugs, sedation and anesthetics are believed to increase the risk of cardiopulmonary complications during procedures. Procedural cancelations are common, regardless of the drug type, recency of use, and total dosage consumed. There is a lack of institutional and society recommendations regarding the optimal approach to performing outpatient endoscopy on patients with IDU. Aim To review the literature for current recommendations regarding the optimal management of outpatient elective endoscopic procedures in patients with IDU. Secondary aim is to provide guidance for clinicians who encounter IDU in endoscopic practice. Methods Systematic review of PubMed, CINAHL, Embase, and Google Scholar for articles presenting data on outcomes of elective procedures in patients using illicit drugs. Results There are no clinically relevant differences in periprocedural complications or mortality in cannabis users compared to non-users. Endoscopy in patients with remote cocaine use was also found to have similar outcomes to recent use. Conclusions Canceling endoscopic procedures in patients with recent IDU without consideration of the type of drug, dosage, and chronicity may lead to unnecessary delays in care and increased patient morbidity. Healthcare systems would benefit from additional guidelines for evaluating the patient with recent illicit drug use for acute intoxication and consider proceeding with procedures in the non-toxic population.

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Anestesia no paciente usuário de cocaína

Cited by 16 publications

References 35 publications

Adulterantes identificados na cocaína comercializada no Piauí - PI: uma análise qualitativa do seu potencial toxicológico

Adulterantes identificados na cocaína comercializada no Piauí - PI: uma análise qualitativa do seu potencial toxicológico

Awareness during anesthesia in cocaine addicters: concerning about chemical interactions

Illicit Drug Use and Endoscopy: When Do We Say No?

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