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wikitox:2.1.11.4.8.1_cocaine [2018/09/01 09:00] – created - external edit 127.0.0.1wikitox:2.1.11.4.8.1_cocaine [2025/04/13 05:32] (current) – ↷ Links adapted because of a move operation 45.184.128.82
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 Cardiac ischaemia should be treated along conventional lines with aspirin and nitrates in addition to benzodiazepines. \\ Alpha-adrenergic receptor antagonist (e.g. phentolamine) should be considered in patients who do not respond to aspirin, nitrates and benzodiazepines. \\ Patients with evidence of myocardial infarction should receive conventional treatment. Unselective [[:wikitox:3.4.3.4.2_beta_blockers|beta-blockers]] are considered contraindicated as successful beta-blockade may expose the patient to unopposed alpha mediated vasoconstriction worsening cardiac ischaemia and hypertension. Evidence does not support the use of selective beta-blockers or mixed alpha/beta-blockers such as labetalol. Cardiac ischaemia should be treated along conventional lines with aspirin and nitrates in addition to benzodiazepines. \\ Alpha-adrenergic receptor antagonist (e.g. phentolamine) should be considered in patients who do not respond to aspirin, nitrates and benzodiazepines. \\ Patients with evidence of myocardial infarction should receive conventional treatment. Unselective [[:wikitox:3.4.3.4.2_beta_blockers|beta-blockers]] are considered contraindicated as successful beta-blockade may expose the patient to unopposed alpha mediated vasoconstriction worsening cardiac ischaemia and hypertension. Evidence does not support the use of selective beta-blockers or mixed alpha/beta-blockers such as labetalol.
  
-**Arrhythmias** \\ Patients with broad complex tachyarrhythmia associated with acute cocaine use should be treated in a similar manner to patients with [[:wikitox:2.1.11.9.2.1_tricyclic_antidepressants|tricyclic antidepressant poisonings]]. Initial treatment should be aimed at [[:wikitox:alkalinisation|alkalinising]] the patient with the administration of sodium bicarbonate. Patients refractory to alkalinisation should receive [[:wikitox:lignocaine|]].+**Arrhythmias** \\ Patients with broad complex tachyarrhythmia associated with acute cocaine use should be treated in a similar manner to patients with [[:wikitox:2.1.11.9.2.1_tricyclic_antidepressants|tricyclic antidepressant poisonings]]. Initial treatment should be aimed at [[:concept_serum_alkalinization|alkalinising]] the patient with the administration of sodium bicarbonate. Patients refractory to alkalinisation should receive [[:wikitox:lignocaine|]].
  
 **Hypertension** \\ Patients whose hypertension does not respond to adequate sedation should be considered for intravenous nitroprusside infusion. **Hypertension** \\ Patients whose hypertension does not respond to adequate sedation should be considered for intravenous nitroprusside infusion.