Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- tachycardia
- hypertension
- hyperthermia
- agitation
- mydriasis
- diaphoresis
Otros factores de diagnóstico
- seizures
Factores de riesgo
- high ambient temperature
- poverty
- cocaine body packing
- male sex
- plasma cholinesterase deficiency
- age 18-25 years
- history of cocaine use
- concomitant use of other sympathomimetics
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- ECG
- bedside serum glucose
- serum creatinine
- BUN
- serum creatine phosphokinase (CPK)
- serum troponin
- chest x-ray
- CT scan of brain
Pruebas diagnósticas que deben considerarse
- urine cocaine assay
- CT scan of abdomen and pelvis
Algoritmo de tratamiento
suspected/confirmed cocaine toxicity: nonbody packer/stuffer
suspected/confirmed cocaine toxicity: body packer/stuffer
Colaboradores
Autores
Andrew Stolbach, MD, MPH
Attending Physician
Johns Hopkins Hospital
Baltimore
MD
Divulgaciones
AS has been reimbursed by Peerview Education for delivering educational lectures unrelated to this topic; for expert testimony in unrelated toxicology topics; and by UpToDate for writing articles on other toxicology topics.
Revisores por pares
Janice Zimmerman, MD
Head
Critical Care Division
The Methodist Hospital
Houston
TX
Divulgaciones
JZ declares that she has no competing interests. JZ is the author of an article cited in this text, but the article was not included in the text at the time of her peer review.
Alison Jones, MD, FRCPE, FiBIOL, FRCP, FRACP
Dean
School of Medicine
Campbelltown Campus
University of Western Sydney
Australia
Раскрытие информации
AJ declares that she has no competing interests.
Andrew Parfitt, MBBS, FFAEM
Clinical Director
Acute Medicine
Associate Medical Director
Consultant Emergency Medicine
Guy's and St Thomas' NHS Foundation Trust
Clinical Lead and Consultant
Accident Emergency Medicine
St Thomas' Hospital
London
UK
Раскрытие информации
AP declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
Lavonas EJ, Akpunonu PD, Arens AM, et al. 2023 American Heart Association focused update on the management of patients with cardiac arrest or life-threatening toxicity due to poisoning: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2023 Oct 17;148(16):e149-84.Полный текст Аннотация
Royal College of Emergency Medicine. Management of suspected internal drug trafficker (SIDT). Dec 2020 [internet publication].Полный текст
Panchal AR, Bartos JA, Cabañas JG, et al. Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020 Oct 20;142(16_suppl_2):S366-468.Полный текст
Smollin CG, Hoffman RS. Chapter 75: Cocaine. In: Nelson LS, Howland MA, Lewin NA, et al, eds. Goldfrank's toxicologic emergencies, 11th ed. New York, NY: McGraw-Hill Education; 2019.
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Non-cocaine sympathomimetic overdose
- Alcohol, sedative or hypnotic withdrawal
- Anticholinergic syndrome
Больше ОтличияРекомендации
- 2023 American Heart Association focused update on the management of patients with cardiac arrest or life-threatening toxicity due to poisoning: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
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