Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- taquicardia
- hipertensão
- hipertermia
- agitação
- midríase
- diaforese
Other diagnostic factors
- convulsões
Risk factors
- temperatura ambiente elevada
- pobreza
- body packing de cocaína
- sexo masculino
- deficiência de colinesterase plasmática
- idade entre 18-25 anos
- história de uso de cocaína
- uso concomitante de outros simpatomiméticos
Diagnostic tests
1st tests to order
- eletrocardiograma (ECG)
- glicose sérica à beira do leito
- creatinina sérica
- ureia
- creatina fosfoquinase sérica (CPK)
- troponina sérica
- radiografia torácica
- tomografia computadorizada (TC) cranioencefálica
Tests to consider
- teste de cocaína na urina
- tomografia computadorizada (TC) de abdome e pelve
Treatment algorithm
toxicidade por cocaína suspeitada/confirmada: exceto "mula" de tráfico/body stuffer
toxicidade por cocaína suspeitada/confirmada: "mula" de tráfico/body stuffer
Contributors
Authors
Andrew Stolbach, MD, MPH
Attending Physician
Johns Hopkins Hospital
Baltimore
MD
Disclosures
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.
Peer reviewers
Janice Zimmerman, MD
Head
Critical Care Division
The Methodist Hospital
Houston
TX
Disclosures
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
Disclosures
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
Disclosures
AP declares that he has no competing interests.
References
Key articles
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.Full text Abstract
Royal College of Emergency Medicine. Management of suspected internal drug trafficker (SIDT). Dec 2020 [internet publication].Full text
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.Full text
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.
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Overdose de simpatomiméticos diferentes da cocaína
- Abstinência alcoólica, de sedativos ou de hipnóticos
- Síndrome anticolinérgica
More DifferentialsGuidelines
- Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders
- 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
More GuidelinesPatient information
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