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Cocaine toxicity

Última revisión: 20 Aug 2025
Última actualización: 25 Mar 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • tachycardia
  • hypertension
  • hyperthermia
  • agitation
  • mydriasis
  • diaphoresis
Todos los datos

Otros factores de diagnóstico

  • seizures
Todos los datos

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
Todos los datos

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
Todos los datos

Pruebas diagnósticas que deben considerarse

  • urine cocaine assay
  • CT scan of abdomen and pelvis
Todos los datos

Algoritmo de tratamiento

Inicial

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
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