可卡因使用障碍

最后审阅: 29 八月 2022
最后更新: 01 二月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 家庭成员中存在可卡因或其他物质使用障碍
  • 高血压
  • 心动过速
  • 胸痛
  • 瞳孔散大
  • 发汗
  • 发抖
  • 躁动(轻度至重度)
  • 情绪变化(例如易激惹、欣快、焦虑)
更多 关键诊断因素

其他诊断因素

  • 焦虑(惊恐状态:轻度至重度)
  • 药物诱发的蚁走感
  • 既往因脱毒而住院
  • 可疑的烧伤(例如,唇部和拇指皲裂)
  • 鼻中隔溃疡,穿孔
  • 局灶性神经系统异常
  • 癫痫发作
  • 意识丧失/意识改变
  • 皮肤病变(例如皮下橙红色斑块、感染、糜烂、坏死)
  • 呼吸困难
其他诊断因素

危险因素

  • 酗酒/其他药物滥用史
  • 精神障碍史
  • 男性
更多 危险因素

诊断性检查

首要检查

  • 尿毒理学±针对左旋咪唑的气相色谱/质谱法
  • 心电图 (ECG)
  • 胸部 X 线检查
  • 头颅 CT
  • 脑电图检查
更多 首要检查

需考虑的检查

  • 全血细胞计数 (FBC)
  • 胸部 CT
  • 支气管肺泡灌洗
  • 经胸超声心动图
更多 需考虑的检查

治疗流程

急症处理

急性中毒

非妊娠成人和青少年:轻度可卡因使用障碍

非妊娠成人和青少年:中至重度可卡因使用障碍

妊娠

持续性治疗

持续缓解

继续使用或复吸

治疗抵抗性

撰稿人

作者

Steven B. Karch, MD, FFFLM, FCSFS

Consultant Cardiac Pathologist/Toxicologist (ret.)

Office of the Chief Medical Examiner

San Francisco

CA

利益声明

SBK is an author of a number of references cited in this topic. SBK declares that he has no other competing interests.

Kim Wolff, MBE, PhD

Professor of Analytical, Forensic, and Addiction Science, Director, King’s Forensics

Faculty Life Science and Medicine

King’s College London

London

UK

利益声明

KW declares that she provides expert opinion and reports as a panel member of the Secretary of State Medical Panel for Drink and Drug Driving and as a member of the World Health Organization Expert Panel on Drug Dependence.

同行评议者

Timothy Albertson, MD, PhD, MPH

Chief

Division of Pulmonary and Critical Care Medicine

University of California, Davis

Sacramento

CA

利益声明

TA declares that he has no competing interests.

Andrew Stolbach, MD

Assistant Professor

Department of Emergency Medicine

Johns Hopkins University Hospital

Baltimore

MD

利益声明

AS declares that he has no competing interests.

Russel Falck, MA

Assistant Professor of Community Health and Associate Director

Center for Interventions

Treatment and Addictions Research

Wright State University Boonshoft School of Medicine

Dayton

OH

利益声明

RF declares that he has no competing interests.

Christos Kouimtsidis, MBBS, MSc, MRCPsych, PhD

Consultant Psychiatrist and Honorary Senior Lecturer

Addictions, Alcohol Research

Institute of Psychiatry

King's College London

London

UK

利益声明

CK declares that he has no competing interests.

内容使用需遵循免责声明