Effects of cocaine and levamisole (as adulterant) on the isolated perfused Langendorff heart

Abstract

Cocaine-related deaths occur regularly in forensic routine work. In cases in which the detected concentration of cocaine is rather low and other causes of death apart from intoxication can be ruled out, the question arises if adulterants of cocaine might have played a crucial role. In the present study, cardiac effects of cocaine, of the adulterant levamisole and of mixtures of both were evaluated using the isolated perfused Langendorff heart. While exposed to the substances, functional parameters heart rate, left ventricular pressure and coronary flow were documented. Relevant alterations of these parameters were found for cocaine as well as for levamisole. Exposing the hearts to a mixture of both resulted in a combination of these effects; the emergence of new alterations or an obvious aggravation were not detected. Nevertheless, the results imply that the consumption of cocaine adulterated with levamisole bares an increased risk for cardiac complications, especially in the presence of preexisting cardiac pathologies.

New Thiazole Acetic Acid Derivatives: A Study to Screen Cardiovascular Activity Using Isolated Rat Hearts and Blood Vessels

“…The accumulated calcium then acts on the myofibrils, induces a sliding action, and produces ‘forceful’ contractions of the myocardium [ 16 , 17 ]. The greater increase in the developed tension when the derivatives of the thiazole were combined with Adr suggests that the combination potentiated the myocardial contraction [ 18 ].…”

Cardiac effects of 5F-Cumyl-PEGACLONE

“…In general, the experimental setup was realized as described before [ 19 , 20 ]: male Wistar rats aged 2 to 3 months with a weight between 250 g and 350 g were used for the experiment. They were sedated with an intraperitoneal injection of pentobarbital (80 mg/kg body weight; Narcoren, Merial, Germany) in a final volume of 2 ml NaCl (0.9%) containing 0.2 ml heparin (25,000 IU/5 ml; B. Braun, Melsungen, Germany), placed latero-proximal to the hind legs.…”

Adverse reactions with levamisole vary according to its indications and misuse: A systematic pharmacovigilance study

“…Severe somatic complications widely reported in users of levamisole‐adulterated cocaine include leucopenia, agranulocytosis, leucoencephalopathy, arthritis, thrombotic vasculopathy and vasculitis 48 . Cardiac complications, cognitive impairments and cerebral toxicities were also recently described 49–51 . As the percentage of levamisole in cocaine powder and the amount of cocaine consumed is never known at the time of consumption, it is very difficult to estimate the level of levamisole exposure in the cases.…”

“… 48 Cardiac complications, cognitive impairments and cerebral toxicities were also recently described. 49 , 50 , 51 As the percentage of levamisole in cocaine powder and the amount of cocaine consumed is never known at the time of consumption, it is very difficult to estimate the level of levamisole exposure in the cases.…”