Electrocardiographic and hemodynamic effects of intravenous cocaine in awake and anesthetized dogs

Schwartz, A. B.; Janzén, David; Rt, Jones; Boyle, W.

doi:10.1016/0022-0736(89)90086-1

Cited by 68 publications

(27 citation statements)

References 20 publications

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“…38 Cocaine prolongs the PR, QRS, and QT intervals. 39,40 Cocaine is associated with coronary atherosclerosis even in young users with relatively few cardiac risk factors. 41,42 …”

Section: Clinicalmentioning

confidence: 99%

Cardiovascular Effects of Cocaine

2010

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“…38 Cocaine prolongs the PR, QRS, and QT intervals. 39,40 Cocaine is associated with coronary atherosclerosis even in young users with relatively few cardiac risk factors. 41,42 …”

Section: Clinicalmentioning

confidence: 99%

Cardiovascular Effects of Cocaine

2010

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“…Several examples best illustrate this point. First, in anaesthetized animals the heart rate remains largely unchanged and the arrhythmic effects of small (sub-lethal) doses of cocaine are minimized [18]. In contrast massive doses of cocaine in humans occasionally result from rupture of smuggled drug packets.…”

Section: Sodium Channel Blockadementioning

confidence: 99%

Treatment of patients with cocaine‐induced arrhythmias: bringing the bench to the bedside

Hoffman

2010

Brit J Clinical Pharma

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Widespread use of cocaine and its attendant toxicity has produced a wealth of benchwork studies and small animal investigations that evaluated the effects of cocaine on the cardiovascular system. Despite this wealth of knowledge, very little is known about the frequency or types of arrhythmias in patients with significant cocaine toxicity. The likely aetiologies; catecholamine excess, sodium channel blockade, potassium channel blockade, calcium channel effects, or ischaemia may act alone or in concert to produce a vast array of clinical findings that are modulated by hyperthermia, acidosis, hypoxia and electrolyte abnormalities. The initial paper in the series by Wood & Dargan providing the epidemiological framework of cocaine use and abuse is followed by a detailed review of the electrophysiological effects of cocaine by O'Leary & Hancox. This review is designed to complement the previous papers and focuses on the diagnosis and treatment of patients with cocaine‐associated arrhythmias.

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“…However, it has also been proposed that cocaine-related deaths of cardiac origin may occur in the absence of myocardial infarction, presumably because of direct adverse effects on cardiac electrophysiology. [11][12][13][14][15] Cocaine is a local anesthetic, and its blockade of Na+ channels1617 may produce conduction disturbances in the heart. Such conduction disturbances could contribute to the generation of reentrant arrhythmias, and previous investigators have emphasized this concept of cocaine arrhythmogenesis"~- 15; however, it has also been shown that cocaine prolongs repolarization.…”

mentioning

confidence: 99%

Early afterdepolarizations and triggered activity induced by cocaine. A possible mechanism of cocaine arrhythmogenesis.

Kimura

Bassett

et al. 1992

Circulation

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Background. Cocaine may produce life-threatening cardiac arrhythmias, but it is not clear whether this is an indirect effect of coronary vasoconstriction and ischemia or a direct myocardial effect of the substance. Except for its effects on the Na+ current as a local anesthetic, little is known about the direct electrophysiological actions on cardiac cells. Therefore, we studied the effects of cocaine on action potentials and membrane currents in isolated feline ventricular myocytes to test the hypothesis that cocaine-induced arrhythmogenesis may be based on cellular and ionic mechanisms.Methods and Results. Action potentials and membrane currents were recorded using the patch clamp technique. Single cells were isolated from feline left ventricles by enzymatic digestion. Exposure to cocaine (10 or 50 atM) depressed the plateau phase of the action potential and prolonged action potential

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Electrocardiographic and hemodynamic effects of intravenous cocaine in awake and anesthetized dogs

Cited by 68 publications

References 20 publications

Cardiovascular Effects of Cocaine

Cardiovascular Effects of Cocaine

Treatment of patients with cocaine‐induced arrhythmias: bringing the bench to the bedside

Early afterdepolarizations and triggered activity induced by cocaine. A possible mechanism of cocaine arrhythmogenesis.

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