Nonfatal Pulmonary Edema after “Freebase” Cocaine Smoking

Cucco, Robert A.; Yoo, Ok Hi; Cregler, Louis L.; Chang, Jui Cheng

doi:10.1164/ajrccm/136.1.179

Cited by 77 publications

(11 citation statements)

References 3 publications

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“…Pulmonary oedema is described in cocaine abusers and it may be cardiogenic with associated myocardial ischemia and infarction, myocardial dysfunction, arrhythmia, and dilated cardiomyopathy or noncardiogenic associated with damage to the pulmonary capillary endothelium with increased permeability [210]. About this, cocaine itself, and the cathecolamine excess that occurs in association with cocaine use, both decrease myocardial contractility [211].…”

Section: Pulmonary Toxicity and Cocainementioning

confidence: 99%

Side Effects of Cocaine Abuse: Multiorgan Toxicity and Pathological Consequences

Riezzo

Fiore²,

Carlo³

et al. 2012

CMC

168

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Cocaine is a powerful stimulant of the sympathetic nervous system by inhibiting catecholamine reuptake, stimulating central sympathetic outflow, and increasing the sensitivity of adrenergic nerve endings to norepinephrine (NE). It is known, from numerous studies, that cocaine causes irreversible structural changes on the brain, heart, lung and other organs such as liver and kidney and there are many mechanisms involved in the genesis of these damages. Some effects are determined by the overstimulation of the adrenergic system. Most of the direct toxic effects are mediated by oxidative stress and by mitochondrial dysfunction produced during the metabolism of noradrenaline or during the metabolism of norcocaina, as in cocaine-induced hepathotoxicity. Cocaine is responsible for the coronary arteries vasoconstriction, atherosclerotic phenomena and thrombus formation. In this way, cocaine favors the myocardial infarction. While the arrhythmogenic effect of cocaine is mediated by the action on potassium channel (blocking), calcium channels (enhances the function) and inhibiting the flow of sodium during depolarization. Moreover chronic cocaine use is associated with myocarditis, ventricular hypertrophy, dilated cardiomyopathy and heart failure. A variety of respiratory problems temporally associated with crack inhalation have been reported. Cocaine may cause changes in the respiratory tract as a result of its pharmacologic effects exerted either locally or systemically, its method of administration (smoking, sniffing, injecting), or its alteration of central nervous system neuroregulation of pulmonary function. Renal failure resulting from cocaine abuse has been also well documented. A lot of studies demonstrated a high incidence of congenital cardiovascular and brain malformations in offspring born to mothers with a history of cocaine abuse.

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Section: Pulmonary Toxicity and Cocainementioning

confidence: 99%

Side Effects of Cocaine Abuse: Multiorgan Toxicity and Pathological Consequences

Riezzo

Fiore²,

Carlo³

et al. 2012

CMC

168

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show abstract

“…Myocardial ischemia and infarction, myocardial dysfunction, arrhythmia, and dilated cardiomyopathy may be contributing factors in cardiogenic edema. Damage to the pulmonary capillary endothelium with increased permeability may play a role in noncardiogenic edema (36). It has been postulated that the mechanism may be similar to that of heroin toxicity, with increased endothelial permeability of capillaries and an elevated protein content in BAL fluid.…”

Section: Pulmonary Edemamentioning

confidence: 99%

Pulmonary Complications from Cocaine and Cocaine-based Substances: Imaging Manifestations

Carrillo²,

et al. 2007

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Cocaine is the illicit drug whose abuse most often results in cardiopulmonary symptoms and emergency treatment. Habitual smoking of alkaloidal cocaine ("freebase," "crack") has replaced nasal insufflation as the most common method of abuse. Smoking of cocaine exposes the lung directly to the volatilized drug as well as to the other combustion products of the smoked mixture, thereby increasing the risk of adverse pulmonary effects. A wide variety of pulmonary complications including interstitial pneumonitis, fibrosis, pulmonary hypertension, alveolar hemorrhage, asthma exacerbation, barotrauma, thermal airway injury, hilar lymphadenopathies, and bullous emphysema may be associated with the inhalation of crack cocaine or of associated substances such as talc, silica, and lactose. Cocaine abuse represents one of the most serious medical and social problems of our time. Radiologists should be familiar with the various pleuropulmonary complications associated with the abuse of illicit drugs in general and of cocaine in particular to ensure correct diagnosis and appropriate treatment planning in patients with respiratory manifestations associated with such abuse.

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“…In fact, pulmonary edema has been demonstrated in 77%-85% of cocaine-related deaths in autopsy series [33,34]. Pulmonary edema in cocaine users may be due to damaged pulmonary capillary endothelium with increased permeability or it may be cardiogenic in nature [35]. Cocaine use cause myocardial infarction, arrhythmias, congestive heart failure and endocarditis.…”

Section: Pulmonary Edemamentioning

confidence: 99%

Pulmonary Effects of Cocaine Use

Akwe¹

2017

JLPRR

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Cocaine is a powerful central nervous system stimulant extracted from the leaves of Erythroxylon coca, a native plant of the Andean and Amazon regions in South America. Cocaine has multiple effects on the lungs, both acute and chronic. Effects of cocaine to the lungs depend on the route of administration (oral, nasal, intravenous), dose size, frequency of exposure, and presence of associated substances like heroin, talc or marijuana. These effects include barotrauma; airway injury; asthma; pulmonary edema; pulmonary hemorrhage; "crack lung", eosinophilic lung disease; bronchiolitis obliterans, organized pneumonia, interstitial lung disease; pulmonary hypertension; emphysema; both infectious and aspiration pneumonias; and tumors. The most commonly encountered respiratory symptoms include cough productive of dark sputum (carbonaceous material), chest pain, dyspnea, hemoptysis, wheezing, and exacerbation of asthma. Keywords:

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Nonfatal Pulmonary Edema after “Freebase” Cocaine Smoking

Cited by 77 publications

References 3 publications

Side Effects of Cocaine Abuse: Multiorgan Toxicity and Pathological Consequences

Side Effects of Cocaine Abuse: Multiorgan Toxicity and Pathological Consequences

Pulmonary Complications from Cocaine and Cocaine-based Substances: Imaging Manifestations

Pulmonary Effects of Cocaine Use

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