Pulmonary Effects of Cocaine Use

Abstract

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:

Journey of the Nasal Septum Into the Lungs: A Unique Complication of Cocaine Abuse

“…Rigid or flexible bronchoscopy should subsequently be performed to retrieve or biopsy the FB or mass respectively. As in our case, initial event can go unnoticed with persistent coughing being the most common symptom which can mimic COPD, asthma, or even obstructive pneumonia [4]. The patient did benefit from a course of glucocorticoids which is reported to reduce granulation tissue secondary to FB aspiration [6][7].…”

“…Pulmonary effects depend on the route of administration (oral, nasal, intravenous) and concomitant abuse of other substances. Effects include airway injury, infectious and aspiration pneumonia, with the most common being productive cough of dark sputum (carbonaceous material), chest pain, dyspnea, hemoptysis, wheezing, and exacerbation of asthma [4]. Here, we report a case of nasal septal aspiration as a complication of intranasal cocaine inhalation with concurrent alcohol abuse.…”

Cocaine-Induced Ventilation/Perfusion Mismatch Mimicking Pulmonary Embolism

“…They are thought to be secondary to the cocaine-induced vasoconstriction or vasospasm, granulomatous process, and endothelial dysfunction. 4,6,12,13 Furthermore, intravenously administered cocaine can lead to foreign body (needle fragments) emboli causing PE or aseptic pulmonary granuloma. 14,15 In our case, we believe that the filling defect initially detected on the V/Q scan was related to cocaine abuse.…”

“…4 It can range from severe bronchospasm when inhaled to bronchiectasis from chronic usage. 4 In fact, cocaine is responsible for up to 30% emergency department visits related to asthma attacks in young adults. 5 While its effects on the pulmonary vasculature are poorly understood, chronic usage has been linked to pulmonary hypertension, and severe vasospasm can lead to pulmonary infarction.…”

“…3 Pulmonary complications are varied depending on the route, dose, and frequency of administration. 4 It can range from severe bronchospasm when inhaled to bronchiectasis from chronic usage. 4 In fact, cocaine is responsible for up to 30% emergency department visits related to asthma attacks in young adults.…”