Presentation
Despite the seemingly rare and random nature that this scenario presents, this patient's care serves to reinforce what should be done to successfully manage a patient with an ingested foreign body, as well as the important issues related to crack cocaine [ncbi.nlm.nih.gov]
A 34-year-old female presented 7 h after drinking beer and smoking crack. She was concerned that she might have inhaled the “screen” from her crack pipe, a piece of Brillo® pad the size of her fingertip. [deepdyve.com]
In addition to publishing papers presented at the annual meetings of the associated organizations, the journal publishes selected unsolicited manuscripts. [ingentaconnect.com]
Entire Body System
- Fever
Hospital emergency rooms here and elsewhere now do a urine test for drugs if children are brought in with seizures but have no fever and no history of seizures. [tampabay.com]
Low-grade fever. Being excessively talkative. Being easily startled or nervous. [projectknow.com]
The most common signs and symptoms of crack overdose include: agitation cold sweats coma confusion coughing that produces black mucus excessive tremors fainting fever hallucinations insomnia itching narrowed pupils problems breathing seizures severe headache [drug.addictionblog.org]
[…] charcoal, 1g/kg (up to 50g) PO q4hours for several doses Consider whole bowel irrigation if develop toxicity Consider discharge if do not develop toxicity after 4hr obs Complications Acute Cocaine-associated chest pain Sympathomimetic qualities Tachycardia Fever [wikem.org]
- Anorexia
Chronic intoxication and overdose with crack can lead to anorexia, causing weight loss, physical exhaustion, behavioral problems and chronic depression. [drug.addictionblog.org]
Respiratoric
- Cough
Signs of crack use include: Secretive behavior Unexplained spending of cash Weight loss Burns on the hands or mouth, cracked or blistered lips Breathing problems, coughing up black phlegm, tuberculosis Track marks Lack of interest in previously pleasurable [healthyplace.com]
More than half of people who smoke crack will develop a wheeze, cough or shortness of breath. Many crack users will also experience chest pain and cough up black mucus or blood. [drugrehab.com]
खांसना Coughed Coughed 191.Counsel सलाह देना Counselled Counselled 192.Count गिनना, गिनती गिनना Counted Counted 193.Course बहना, पार करना Coursed Coursed 194.Cover ढंकना, छुपाना Covered Covered 195.Cower झुकना या पीछे हटना Cowered Cowered 196.Crack टूटना [rps00945.blogspot.com]
Breathing and respiratory problems, including damage to lungs, extreme coughing, and shortness of breath. Over time, long-term effects can include kidney, liver and heart damage. Becoming addicted to either form of cocaine is a serious dependency. [palmerlakerecovery.com]
- Tachypnea
“constellation of signs and symptoms that can suggest a class of toxin exposure” Toxidrome Bottom line Details Causes Treatment Sympathomimetic “Fight or flight” “Pedal to the metal” “Crazy, amped” Excess catecholamines: hypertension, tachycardia, tachypnea [canadiem.org]
Her vital signs revealed tachycardia and tachypnea without fever (her heart rate was 148 beats per minute, her respiratory rate, 60 breaths per minute and temperature 36°C). [jmedicalcasereports.biomedcentral.com]
Gastrointestinal
- Nausea
It can cause abdominal pain, headaches, gastrointestinal complications, and nausea as well. Binge use of the drug can cause adverse effects, such as anxiety, irritability, and restlessness. [hiredpower.com]
After use of crack cocaine, crack cocaine symptoms include the following: 2 Crack cocaine craving Depression Agitation, anxiety, anger, irritability Fatigue, lack of motivation Nausea, vomiting Shaking, muscle pain Disturbed sleep Crack Cocaine Use: Signs [healthyplace.com]
When smoking too much of the drug in a crack pipe, a person may experience a quickened or irregular heart beat, hyperventilation, seizures and nausea. [alcoholrehab.com]
Restlessness Anxiety Nervousness or paranoia Heightened alertness Increased heart rate and blood pressure Seizures Pressured speech Dilated eyes Loss of appetite Disturbed sleep patterns Contracted blood vessels Increased body temperature Hyperexcitability Nausea [addictioncenter.com]
- Vomiting
Some people believe that inducing vomiting will reduce the drug affects but this is dangerous and may lead to choking. [alcoholrehab.com]
Withdrawal symptoms can include: Headaches Anxiety Aggression Restlessness Cramps Vomiting. KEY SOURCES Australian Drug Foundation. (2016). Amphetamines. Melbourne: State Government Victoria. Australian Institute of Health and Welfare. (2018). [cracksintheice.org.au]
Signs to look out for include the following: Weak pulse or blood pressure A marked decrease in respiration rate Clammy or sweat-covered skin Vomiting in excess, or the action of vomiting without bile coming out Hyperactivity Confusion Clumsiness Trembling [therecoveryvillage.com]
After use of crack cocaine, crack cocaine symptoms include the following: 2 Crack cocaine craving Depression Agitation, anxiety, anger, irritability Fatigue, lack of motivation Nausea, vomiting Shaking, muscle pain Disturbed sleep Crack Cocaine Use: Signs [healthyplace.com]
If spontaneous vomiting occurs, watch for signs of pulmonary aspiration. Consider appropriate management of chemically contaminated children at the exposure site. [atsdr.cdc.gov]
- Loss of Appetite
Psychological effects may include euphoria, excitation, general arousal, dizziness, increased alertness and focus, mental clarity, increased talkativeness, loss of appetite, among others. [hiredpower.com]
[…] of appetite Vertigo Muscle twitches Anxious, irritable or aggressive Severe mental distress including paranoia and psychosis After use of crack cocaine the user experiences what is known as a "crash." [healthyplace.com]
Some immediate side effects of crack abuse include: Irritability Aggression Restlessness Anxiety Nervousness or paranoia Heightened alertness Increased heart rate and blood pressure Seizures Pressured speech Dilated eyes Loss of appetite Disturbed sleep [addictioncenter.com]
Extreme weight loss; loss of appetite. Periods of very high energy. Prolonged periods of sleeplessness followed by periods of depression and apathy. Physical shaking. Bloodshot eyes or dilated pupils. Sweating. Low-grade fever. [projectknow.com]
Cardiovascular
- Chest Pain
Management of Cocaine-associated chest pain and myocardial infarction. Circulation. 2008; 117: 1897-1907. ↑ McCord, J., Jneid, H., Hollander, J. E., de Lemos, J. A., Cercek, B., Hsue, P., Gibler, W. B., Ohman, E. [wikem.org]
Nitroglycerin is an important intervention for treatment of angina and chest pain from possible MI. Observe cocaine-induced chest pain; follow up based on patient’s signs and symptoms. [calsprogram.org]
pain Journal articles Afonso L. [lifeinthefastlane.com]
Crack overdose can also cause the development of hemoptysis, pleuritic chest pain, pulmonary infiltrates, asthma, and reactive airway disease. [drug.addictionblog.org]
Specific signs of calcium-channel blocker poisoning include: feeling agitated low blood pressure, which can cause symptoms such as lightheadedness and fainting chest pain a slow heartbeat (below 60 beats per minute) Benzodiazepines Benzodiazepines are [nhs.uk]
- Hypertension
Signs of intoxication were hypertension, tachycardia, hyperthermia, agitation, and generalized seizure activity. Treatment included therapeutic sedation with lorazepam and adrenolysis with esmolol infusion. [ncbi.nlm.nih.gov]
[…] emergency Benzos Phentolamine 2.5-5mg IV (direct α-adrenergic antagonist, anti-hypertensive of choice) [3] OR nitroprusside 0.3mcg/kg/min Beta-blockers contraindicated May cause paradoxical hypertension IV crystalloid replacement (most patients have [wikem.org]
Hypertension The use of beta blockers, including labetalol, should be avoided in the treatment of cocaine-related cardiovascular complications due to the potential of creating unopposed alpha-adrenergic stimulation resulting in worsening hypertension, [calsprogram.org]
seizures, intracerebral haemorrhage or aortic dissection Hypertension and tachycardia IV benzodiazepines if agitated if refractory to sedation: Phentolamine 1 mg IV q5min titrated SNP or GTN infusion Avoid beta-blockers SVT IV benzodiazepines if agitated [lifeinthefastlane.com]
These include tachycardia and hypertension, but may also be responsible for the development of hyperthermia and rhabdomyolysis. [academic.oup.com]
- Tachycardia
Signs of intoxication were hypertension, tachycardia, hyperthermia, agitation, and generalized seizure activity. Treatment included therapeutic sedation with lorazepam and adrenolysis with esmolol infusion. [ncbi.nlm.nih.gov]
Both a legitimate medical drug and a drug of abuse Forms of Abuse Cocaine can be smoked, snorted, injected or ingested Smoked form is often in a free-base or crack form Clinical Features Side effects of chronic cocaine use Sympathomimetic toxidrome: Tachycardia [wikem.org]
hyperthermia (41°C), tachycardia, hypertension, DIC Liver transplant after 4 days; death from graft rejection after 18 days 6 20 M Found collapsed in street after party; haemophiliac Convulsions, hyperthermia (40°C), tachycardia, hypertension, DIC, [academic.oup.com]
Ventricular arrhythmias as ventricular tachycardia and ventricular fibrillation induced by the cocaine may be responsible for it; in our case ventricular fibrillation was observed which was promptly reversed by defibrillation. [hindawi.com]
Eyes
- Blurred Vision
The physical effects of ice can include: SHORT TERM Headaches and dizziness Dilated (enlarged) pupils and blurred vision Dry mouth Jaw clenching, teeth grinding Insomnia Increased attention, alertness and talkativeness Trembling Sweaty, cold and clammy [cracksintheice.org.au]
[…] or blurred vision mental confusion seizures (fits) loss of consciousness coma, in severe cases Signs of a medication or drug overdose Medication overdoses are the most common type of poisoning in the UK. [nhs.uk]
Confusion, giddiness, nausea, headache, blurred vision, dizziness, and weakness can occur. In massive exposures, rapid CNS depression, respiratory depression, seizures, loss of consciousness, coma, and death have been reported. [atsdr.cdc.gov]
Psychiatrical
- Euphoria
Psychological effects may include euphoria, excitation, general arousal, dizziness, increased alertness and focus, mental clarity, increased talkativeness, loss of appetite, among others. [hiredpower.com]
FIBF has been sold online as a party drug as it causes a sense of euphoria in users. It has the potential to be life-threatening as it can depress the respiratory system. [yorkshireeveningpost.co.uk]
The continual activation of the dopaminergic system, on the other hand, may lead to euphoria (especially experienced following acute ingestion). [nature.com]
During use of crack cocaine, crack cocaine symptoms include the following: 1 Energy, restlessness, insomnia Heightened sense of sight, smell and touch Euphoria Increased heart rate Dilated pupils Increase in blood pressure Increase in body temperature [healthyplace.com]
- Suggestibility
These cases suggest that, in certain cases of pediatric caustic ingestion, caregivers should be questioned regarding possible drug abuse. Larger warning labels and further public education might help prevent many cases of pediatric caustic ingestion. [ncbi.nlm.nih.gov]
As far as getting your question on the board I suggest you try from 5 am till 8 am and see if you get lucky. The board only seems to accept one question per calendar day but I have not figured out what the hour lapse time actually is. [medhelp.org]
Craig Harvey, the coroner's operations chief, said the toxicology findings "suggested chronic usage." [chicagotribune.com]
For instance, your doctor may suggest you cut stress to help you swallow less often. Or you may need to avoid chewing gum or sucking on hard candy, which can lower the amount of air you swallow. [webmd.com]
- Delusion
Taking a higher dose could lead to confused and disoriented behavior, antisocial behavior, delusions, hallucinations, irritability, fear, paranoia, and even aggressiveness. [hiredpower.com]
People who use crack cocaine may initially feel exhilarated and alert, but this can quickly be replaced by feelings of anxiety, depression and even delusions. [addiction.lovetoknow.com]
Unexplained spending of cash Weight loss Burns on the hands or mouth, cracked or blistered lips Breathing problems, coughing up black phlegm, tuberculosis Track marks Lack of interest in previously pleasurable activities Legal problems Hyper-alert behavior Delusions [healthyplace.com]
COCAINE-INDUCED PSYCHOTIC DISORDER, WITH DELUSIONS. [minddisorders.com]
- Anxiety Disorder
The role of anxiety sensitivity and difficulties in emotion regulation in posttraumatic stress disorder among crack/cocaine dependent patients in residential substance abuse treatment. Journal of Anxiety Disorders, 23(5), 591-599. [mentalhelp.net]
- Addictive Behavior
behaviors when you go back to your old life and routines. [meridiantreatment.com]
It can cause a cycle of chemical dependency and addictive behavior. The skilled group of counselors and medical practitioners at The Recovery Village at Ridgefield can help substance abusers get sober. [ridgefieldrecovery.com]
Withdrawal symptoms include: depression fatigue increased appetite unpleasant dreams and insomnia slowed thinking How can people get treatment for cocaine addiction? Behavioral therapy may be used to treat cocaine addiction. [drugabuse.gov]
Strategies are needed to address the neurobiological, social and medical aspects of addiction. Behavioral, supportive, and pharmacologic strategies are required. As of 2018, there were no FDA-approved medications to treat cocaine addiction. [drugs.com]
It is also referred to as chemical dependency and addictive behavior. Drug-use disorders spare no one and are spread throughout society. They are not limited by age, profession, race, religion, or physical attributes. [emedicinehealth.com]
Neurologic
- Seizure
Signs of intoxication were hypertension, tachycardia, hyperthermia, agitation, and generalized seizure activity. Treatment included therapeutic sedation with lorazepam and adrenolysis with esmolol infusion. [ncbi.nlm.nih.gov]
The usual symptom is uncontrolled seizures. Hospital emergency rooms here and elsewhere now do a urine test for drugs if children are brought in with seizures but have no fever and no history of seizures. [tampabay.com]
Repeated seizures were observed, and benzodiazepines were administered. [hindawi.com]
Seizures or convulsions. Unconsciousness. Heart attack. Stroke. [projectknow.com]
- Agitation
Signs of intoxication were hypertension, tachycardia, hyperthermia, agitation, and generalized seizure activity. Treatment included therapeutic sedation with lorazepam and adrenolysis with esmolol infusion. [ncbi.nlm.nih.gov]
Cocaine can be smoked, snorted, injected or ingested Smoked form is often in a free-base or crack form Clinical Features Side effects of chronic cocaine use Sympathomimetic toxidrome: Tachycardia, diaphoresis, mydriasis, hypertension, hyperthermia, agitation [wikem.org]
[…] and agitated delirium 5 mg diazepam IV q2-5min until seizures stop or gentle sedation consider NaHCO3 if evidence of sodium channel blockade Hyperthermia T > 38.5°C continuous core-temperature monitoring benzodiazepine sedation fluid resuscitation T> [lifeinthefastlane.com]
Specific signs of SSRI poisoning include: feeling agitated tremor (shaking) uncontrolled movement of the eyes (nystagmus) severe muscle tension Beta-blockers Beta-blockers are used to treat a number of conditions that affect the heart or blood, such as [nhs.uk]
Irritability or agitation. Extreme anxiousness. Difficulty urinating. Seizures or convulsions. Unconsciousness. Heart attack. Stroke. [projectknow.com]
- Irritability
First-wave physical effects may include anxiety, elevated heart rate, and blood pressure, increased body temperature, irritability, dilated pupils, and restlessness. [hiredpower.com]
After use of crack cocaine, crack cocaine symptoms include the following: 2 Crack cocaine craving Depression Agitation, anxiety, anger, irritability Fatigue, lack of motivation Nausea, vomiting Shaking, muscle pain Disturbed sleep Crack Cocaine Use: Signs [healthyplace.com]
Prolonged contact with liquid gasoline causes significant irritation (i.e., irritant contact dermatitis), degreasing, and burns. Redness and blisters may occur. Ocular Eye irritation from gasoline vapors begins at about 200 ppm. [atsdr.cdc.gov]
Pay attention to signs of nosebleeds or irritated nasal passages, a common sign of snorted cocaine. Irritation to the nasal linings and passages due to snorting may also be noted by constant sniffling and a runny nose, according to Narconon. [livestrong.com]
- Stroke
Neurovascular complications of cocaine use at a tertiary stroke center. J Stroke Cerebrovasc Dis. 2010;19(4):273–8. CrossRef PubMed Google Scholar Wu V, Huang J, Lien H, et al. [link.springer.com]
Crack overdose can result in serious and chronic damage to the body such as stroke, heart attack and kidney failure. [mentalhelp.net]
Any route of administration can potentially lead to absorption of toxic amounts of cocaine, causing heart attacks, strokes, or seizures—all of which can result in sudden death.2,7 [drugabuse.gov]
[…] heart rate and blood pressure Seizures Pressured speech Dilated eyes Loss of appetite Disturbed sleep patterns Contracted blood vessels Increased body temperature Hyperexcitability Nausea Intense euphoria Intense cravings to use more Bizarre behavior Stroke [addictioncenter.com]
- Confusion
There may be hallucinations and confusion. The person may think there are bugs crawling on his skin. They may pick and scratch at their skin. They will probably have trouble concentrating. [narconon.org]
Taking a higher dose could lead to confused and disoriented behavior, antisocial behavior, delusions, hallucinations, irritability, fear, paranoia, and even aggressiveness. [hiredpower.com]
उलझाना, भ्रमित होना Confused Confused 143.Congratulate बधाई देना Congratulated Congratulated 145.Connect जोड़ना, मिलाना Connected Connected 145.Connote जताना, भाव बतलाना, अर्थ सूचित करना Connoted Connoted 146.Conquer जितना, विजयी होना, Conquered Conquered [rps00945.blogspot.com]
Workup
In general, a solid toxic workup includes these labs: CBC, serum chemistry Renal function Liver function tests (INR/Bili/Alb) w/ Liver Enzymes (AST/ALT/ALP/GGT) Urinalysis (with HCG) Serum ETOH Serum lactate Bedside glucose Serum osmolality EKG With the [canadiem.org]
Treatment
Benefits of Seeking Inpatient Treatment If you’ve become addicted, the only way to rid yourself of this crack cocaine and cocaine addiction is through treatment. There are a number of treatment options that are available to you. [crehab.org]
Crack Addiction Treatment Getting treatment for a crack cocaine addiction is very important. If left unchecked, a crack habit can eventually kill a user or cause permanent psychological damage. [americanaddictioncenters.org]
Treating Yourself When you choose to clean up your life and become a former addict, a treatment center such as Meridian Treatment Solutions can help and will probably be one of your most valuable assets on your road to recovery. [meridiantreatment.com]
Hope Without Commitment Find the best treatment options. [addictionresource.com]
Providing the optimal combination of treatment services for each individual is critical to successful treatment outcome. [recoverythroughsupport.com]
Prognosis
Prognosis Not all cocaine abusers become dependent on the drug. [minddisorders.com]
Long Term Prognosis of Cocaine Addiction Rehabitation The prognosis for minor complications of cocaine use is good if further drug use can be stopped completely. [emedicinehealth.com]
Etiology
While she had been hemodynamically stable before induction of general anesthesia, her BP was quite labile (BP 145/90–70/30 mmHg, HR 85–110 beats/min) for the next 40 min with no obvious surgical or anesthetic etiology for the instability. [anesthesiology.pubs.asahq.org]
Epidemiology
Medical Complications of Drug Use 840 Acute and Chronic Pain 863 Substance Use Disorders in Individuals with CoOccurring Psychiatric Disorders 904 Epidemiology and Emerging Public Health Perspectives 913 HIVRelated Medical Complications and Treatment [books.google.com]
Adams (eds.), Cocaine Use in America: Epidemiologic and Clinical Perspectives (PDF), NIDA Research Monograph, vol. 61, U.S. [en.wikipedia.org]
Risk of Becoming Cocaine Dependent: Epidemiological Estimates for the United States, 2000-2001. Neuropsychopharmacology, 1006-1018. Last updated on January 28, 2020 2020-01-28T13:36:25+00:00 Finding the perfect treatment is only one phone call away! [drugabuse.com]
Longmore W, Abadir A, Berman S, Chaudhry K, Gintautiene K, Gintautas J: Epidemiology and pharmacology of chronic "crack" use: The growing problem of an inner-city hospital. Proc West Pharmacol Soc 1989; 32:211-6. [anesthesiology.pubs.asahq.org]
Pathophysiology
CNS complications of cocaine abuse: prevalance, pathophysiology, and neuroradiology. AJR Am J Roentgenol. 1992;159:137–47. CrossRef PubMed Google Scholar Buchanan JA, Heard K, Burbach C, et al. [link.springer.com]
Brown E, Prager J, Lee H, Ramsey R: CNS complications of cocaine abuse: Prevalence, pathophysiology, and neuroradiology. Am J Roentgen 1992; 159:137-47. [anesthesiology.pubs.asahq.org]
Prevention
[…] and Treatment of Addiction Among African Americans 1250 The Public Health Approach to the Prevention of Substance Abuse 1255 Medical Education in Substance Abuse The Acquisition of Knowledge Attitudes and Skills 1269 Education and Training of Clinical [books.google.com]
Though multiple medications have been tried, none have proved effective in treating cocaine abuse in randomized controlled trials Cocaine vaccine is currently being investigated as a tool to prevent relapse among prior cocaine users. [amjmed.org]
Larger warning labels and further public education might help prevent many cases of pediatric caustic ingestion. [ncbi.nlm.nih.gov]
Behavioral interventions -- particularly, cognitive-behavioral therapy -- have been shown to be effective for decreasing cocaine use and preventing relapse. [thebody.com]