Cocaine Cardiovascular Toxicity

Karch, Steven B.

doi:10.1097/01.smj.0000168701.08879.3f

Cited by 89 publications

(73 citation statements)

References 43 publications

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“…Cocaine can be a cardiac depressant as well, with either direct or barorefl ex-mediated inhibition of sympathetic neural tonus from the CNS and sympathetic ganglia [14]. Although chronic use of cocaine can produce cardiac alterations that favor sudden death such as myocardial hypertrophy, fi brosis, and microvascular disease [15], these were not prominent in our cohort of decedents. With the enhanced cardiac risk caused by cocaine, capsaicin can exert synergistic untoward cardiac effects [16].…”

Section: Discussionmentioning

confidence: 95%

Capsaicin, an active ingredient in pepper sprays, increases the lethality of cocaine

et al. 2009

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Section: Discussionmentioning

confidence: 95%

Capsaicin, an active ingredient in pepper sprays, increases the lethality of cocaine

et al. 2009

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“…Symptoms and signs of cocaine intoxication include anxiety, diaphoresis, tachycardia, hypertension, hyperthermia, mydriasis, hallucinations, convulsions, and cardiovascular collapse. ED staff should be aware of the clinical signs of cocaine toxicity during follow-up (12).…”

Section: Discussionmentioning

confidence: 99%

International Smuggling of Cocaine by Body Concealment: A Case Report

Kaplan¹,

Söğüt²,

Yigit³

2016

Iran Red Crescent Med J

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Introduction: We present a case report of a healthy man who ingested a large number of well-manufactured cocaine packages to smuggle them across international borders. Case Presentation: A 36-year-old man ingested cocaine packages worth approximately US $900,000 to transport it from Dubai to Madrid. He was arrested by police at Istanbul Ataturk Airport for suspected body packing of drugs. On arrival to the emergency department of our tertiary-care university hospital in Istanbul, Turkey, he confessed that he had attempted to smuggle 76 packages of cocaine in his gastrointestinal tract. The patient complained of nausea, but did not have abdominal pain. The physical examination was unremarkable. Radiological screening showed many small packages in the abdomen. There were no signs of intestinal obstruction. In this case, repeat computed tomography of the abdomen confirmed complete evacuation. The patient was discharged into police custody six hours later, after passing the number of packets that he had reported to have swallowed. Conclusions: Abdominal radiography and computed tomography are useful tools for in the evaluation of suspected body packers. Improved packaging material used by smugglers and a more conservative treatment approach have reduced the mortality and morbidity.

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“…The association of chronic cocaine use with heart pathology was elucidated previously (e.g., by Tazelaar et al, 56 Karch and Billingham, 57 and Karch and Stephens 58 ), and was recently reviewed by Karch. 59 Karch et al 60 found that long-term cocaine use was necessary for the development of cardiac alterations, and that isolated postmortem measurements of blood cocaine concentrations (which may be high in occasional recreational users) should not be used to assess toxicity. In addition, Karch and Wetli 61 stressed that myocardial fibrosis and hypertrophy are common in general; both may promote arrhythmic sudden death.…”

Section: Effects On the Cardiovascular Systemmentioning

confidence: 99%

Deaths in custody: Are some due to electronic control devices (including TASER® devices) or excited delirium?

Jauchem

2010

Journal of Forensic and Legal Medicine

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a b s t r a c tDeaths have occurred after law-enforcement incidents involving applications of electronic control devices (ECDs) (including TASER Ò devices). An ''excited delirium" syndrome (reported in the literature prior to the development of ECDs currently in use), however, includes several factors that may be related to such deaths in custody. In this review, potential detrimental effects of ECDs are compared with possible changes due to excited delirium. Although extreme (i.e., long-duration or repeated) exposures to ECDs can result in significant hyperkalaemia, acidaemia, and myoglobinemia in animal models, limited applications (such as those normally used in law-enforcement situations) would appear to have only transient effects. In addition, the hyperthermia observed in patients with excited delirium does not seem to be directly exacerbated by ECD applications. ECD use is unlikely to be a common cause of ventricular fibrillation, but other events that are generally associated with excited delirium (e.g., drug use) may be related to subsequent ventricular fibrillation or asystole. Metabolic or respiratory acidosis may only be serious consequences of long-duration or repeated ECD applications. On the basis of current available information, factors other than ECDs themselves may be more important when death occurs after the use of ECDs.

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Cocaine Cardiovascular Toxicity

Cited by 89 publications

References 43 publications

Capsaicin, an active ingredient in pepper sprays, increases the lethality of cocaine

Capsaicin, an active ingredient in pepper sprays, increases the lethality of cocaine

International Smuggling of Cocaine by Body Concealment: A Case Report

Deaths in custody: Are some due to electronic control devices (including TASER® devices) or excited delirium?

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