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Cocaine Toxicity During Dacryocystorhinostomy

Cocaine Toxicity During Dacryocystorhinostomy Abstract • Toxic effects were observed in two healthy patients who received cocaine intranasally before dacryocystorhinostomy. One patient suffered an additional reaction to intranasally administered phenylephrine (Neo-Synephrine) hydrochloride. Because cocaine blocks uptake of catecholamines and has a sympathetic potentiating effect, its use is dangerous in patients with hypertensive cardiovascular disease or in conjunction with sympathomimetic or α-modifying drugs. Use of dilute solutions carefully measured for select patients is mandatory. The total dose of cocaine should not exceed 3 mg/kg. References 1. Schenck NL: Cocaine: Its use and misuse in otolaryngology . Trans Am Acad Ophthalmol Otolaryngol 80:343-351, 1975. 2. Wetli CV, Wright RK: Death caused by recreational cocaine use . JAMA 241:2519-2522, 1979.Crossref 3. Ritchie JM, Cohen PJ: Cocaine: Procaine and other synthetic local anesthetics , in Goodman LS, Gillman A (eds): The Pharmacological Basis of Therapeutics , ed 5. New York, Macmillan Publishing Co Inc, 1975, pp 386-388. 4. Chung B, Naraghi M, Adriani J: Sympathomimetic effects of cocaine and their influence on halothane and enflurane anesthesia . Anesth Rev 5:16-19, (January) 1978. 5. Kochntop DE, Liao J, Van Bergen FH: Effects of pharmacologic alterations of adrenergic mechanisms by cocaine, tropolone, aminophylline, and ketamine on epinephrine-induced arrhythmias during halothane-nitrous oxide anesthesia . Anesthesiology 46:83-93, 1977.Crossref 6. Rappolt RT, Gay GR, Inaba DS: Propranolol: A specific antagonist to cocaine . Clin Toxicol 10:265-271, 1977.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Cocaine Toxicity During Dacryocystorhinostomy

Archives of Ophthalmology , Volume 98 (5) – May 1, 1980

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References (8)

Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1980.01020030836006
Publisher site
See Article on Publisher Site

Abstract

Abstract • Toxic effects were observed in two healthy patients who received cocaine intranasally before dacryocystorhinostomy. One patient suffered an additional reaction to intranasally administered phenylephrine (Neo-Synephrine) hydrochloride. Because cocaine blocks uptake of catecholamines and has a sympathetic potentiating effect, its use is dangerous in patients with hypertensive cardiovascular disease or in conjunction with sympathomimetic or α-modifying drugs. Use of dilute solutions carefully measured for select patients is mandatory. The total dose of cocaine should not exceed 3 mg/kg. References 1. Schenck NL: Cocaine: Its use and misuse in otolaryngology . Trans Am Acad Ophthalmol Otolaryngol 80:343-351, 1975. 2. Wetli CV, Wright RK: Death caused by recreational cocaine use . JAMA 241:2519-2522, 1979.Crossref 3. Ritchie JM, Cohen PJ: Cocaine: Procaine and other synthetic local anesthetics , in Goodman LS, Gillman A (eds): The Pharmacological Basis of Therapeutics , ed 5. New York, Macmillan Publishing Co Inc, 1975, pp 386-388. 4. Chung B, Naraghi M, Adriani J: Sympathomimetic effects of cocaine and their influence on halothane and enflurane anesthesia . Anesth Rev 5:16-19, (January) 1978. 5. Kochntop DE, Liao J, Van Bergen FH: Effects of pharmacologic alterations of adrenergic mechanisms by cocaine, tropolone, aminophylline, and ketamine on epinephrine-induced arrhythmias during halothane-nitrous oxide anesthesia . Anesthesiology 46:83-93, 1977.Crossref 6. Rappolt RT, Gay GR, Inaba DS: Propranolol: A specific antagonist to cocaine . Clin Toxicol 10:265-271, 1977.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: May 1, 1980

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