From the Guidelines
Hypotension is not an effect of cocaine intoxication.
Effects of Cocaine Intoxication
- Arrhythmia: Cocaine can cause arrhythmias, including wide-complex tachycardia, due to its effects on cardiac sodium and potassium channels 1.
- Seizures: Cocaine can cause seizures due to its stimulant effects on the central nervous system 1.
- Depression: While not directly mentioned in the provided evidence, cocaine use can lead to depression, especially during withdrawal or as a result of long-term use.
- Psychosis: Cocaine can cause psychosis, especially in large doses or with prolonged use, due to its effects on dopamine and serotonin reuptake 1.
Pathophysiology of Cocaine Intoxication
Cocaine blocks the reuptake of norepinephrine, dopamine, and serotonin, leading to an accumulation of these neurotransmitters and causing a sympathomimetic toxidrome, which includes hypertension, tachycardia, and hyperthermia 1.
Treatment of Cocaine-Associated Cardiovascular Complications
Benzodiazepines, such as lorazepam or diazepam, are commonly used to manage hypertension, tachycardia, and agitation in patients with cocaine intoxication 1. Calcium channel blockers, such as verapamil, and nitrates may also be used to control hypertension and chest pain 1.
From the Research
Effects of Cocaine Intoxication
The effects of cocaine intoxication are varied and can include:
- Arrhythmia, as cocaine is known to induce pro-arrhythmia due to its class I antiarrhythmic property 2
- Seizures, which can occur due to central nervous system stimulation caused by cocaine 3, 2
- Depression, which can manifest as respiratory and cardiovascular failure in cases of massive overdose 3
- Psychosis, characterized by paranoid delusions, hallucinations, and other cocaine-related behaviors 4, 5, 6
Hypotension
Hypotension is not typically associated with cocaine intoxication. In fact, cocaine is known to cause hypertensive effects due to its potent pharmacological effects as an indirect-acting sympathomimetic agent 2. Therefore, hypotension is not an expected effect of cocaine intoxication, making it the correct answer to the question.