12th March 2024

Cocaine poisoning

Cocaine is a recreational drug which can cause chest pain, agitation, hypertension, sinus tachycardia, narrow complex tachycardia and QT prolongation. Other neurological effects include mydriasis, hyperreflexia and convulsions. Treatment involves benzodiazepines which work by decreasing sympathetic nerve activity. When managing cocaine-induced hypertension, benzodiazepines are first line followed by agents such as sodium nitroprusside and GTN which act as vasodilators to control hypertension. Sodium bicarbonate also has a role to treat those with widened QRS >100ms.