Cocaine

• Why are beta-blockers not given in cocaine-induced HTN?

  Cocaine → increased release of adrenaline → increase action of alpha-1 (→ vasoconstriction), beta-1 (→ increase HR) and beta-2 (→ vasodilation) So, if you give a beta blocker, you will remove the action of adrenaline on beta receptors (unopposed alpha receptor agonism) → removes effects of beta-2 receptors (vasodilation)
• What are the cognitive risks associated with cocaine use?

  Long term cocaine use can cause shrinkage of grey matter
• Why do people feel more confident after taking cocaine?

  Cocaine increases dopamine in brain's reward centre -> become more erratic
• What are the physical risks associated with cocaine use?

  Fits, MI, strokes

  Overdose & death

  Damage to nasal cartilage (if sniffed)

  Breathing problem

  Damage veins (of injected) - risk of HIV
• How does cocaine affect cortisol secretion?

  Cocaine leads to HPA activation -> cortisol secretion
• What is the antidote for cocaine toxicity/overdose?

  Treat symptoms

  Give benzodiazepines (for HTN, hyperthermia, seizures & agitation)
• What is cocaine?

  Local anaesthetic
• How does cocaine lead to HTN?

  Blocks the reuptake of dopamine, serotonin & noradrenaline in ANS → more adrenaline in synaptic cleft → binds to adrenergic receptors → vasoconstriction
• What are the signs & symptoms of a cocaine overdose?

  Cardiac

  • Chest pain
  • Tachycardia
  • Hypertension
  • Stroke

  Neurological

  • Seizures
  • Neurological impairments
• MOA - cocaine

  Reversibly binds to & inactivates Na+ channels -> no Na+ influx -> no depolarization of nerves -> no AP

  Blocks noradrenaline reuptake in ANS -> vasoconstrictive properties