Cocaine inhalational

Systemic effects of methamphetamine are similar to those of cocaine. Inhalation or IV injection results in an intense rush that lasts a few minutes. Methamphetamine has a longer duration of effect than cocaine. Pharmacologic effects include increased wakefulness, increased physical activity, decreased appetite, increased respiration, hyperthermia, euphoria, irritability, insomnia, confusion, tremors, anxiety, paranoia, aggressiveness, convulsions, increased heart rate and blood pressure, stroke, and death. 

In both cases, pneumothorax occurred with a delay after cocaine inhalation. The authors suggested that it was therefore unlikely that these cases of pneumothorax were due to direct traumatic effects of the drug powder inhaled, to barotrauma due to exaggerated inspiration, or to a Valsalva maneuver. Histological examination in both cases showed small foreign body granulomas with polarized material in the subpleural parenchyma. The authors proposed that the pleural damage could have been directly caused by a filler substance known as mannite (a fine white powder comprised of insoluble cellulose fibers). 

The authors concluded that intense pulmonary artery vasospasm secondary to cocaine inhalation may have caused this syndrome. 

A 30-year-old woman with a history of bronchial asthma and cocaine abuse had a cardiorespiratory arrest preceded by sudden dyspnea 1 hour after cocaine inhalation. Direct laryngoscopy showed edema of the glottis. After extended cardiopulmonary resuscitation, she went into a deep coma with dilated non-reactive pupils. Toxicological analysis showed cocaine and amphetamines in her urine. She was brain dead 11 hours later and her organs were used for transplantation. Her liver was given to a 14-year-... 

Chronic cocaine use, which is associated with immunosuppression, may be carcinogenic. The possible association between chronic cocaine exposure and pancreatic adenocarcinoma has been investigated (240,241). A study of hospital records in Brazil for the years 1986-1998 showed that of 198 patients with pancreatic adenocarcinoma, 13 (6.5%) were younger than 40 years of these, five had a history of chronic cocaine inhalation and one had abused marijuana. 

Tumlin JA, Sands JM, Someren A. Hemolytic uremic syndrome following "crack" cocaine inhalation. Am J Med Sci 1990 299 366-371. 

Note Any illicit drug use includes the nonmedical use of marijuana, cocaine, inhalants, hallucinogens, heroin, or psyd othera-peutic drugs at least one time. 

Glassification of Substance-Related Disorders. The DSM-IV classification system (1) divides substance-related disorders into two categories (/) substance use disorders, ie, abuse and dependence and (2) substance-induced disorders, intoxication, withdrawal, delirium, persisting dementia, persisting amnestic disorder, psychotic disorder, mood disorder, anxiety disorder, sexual dysfunction, and sleep disorder. The different classes of substances addressed herein are alcohol, amphetamines, caffeine, caimabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics or anxiolytics, polysubstance, and others. On the basis of their significant socioeconomic impact, alcohol, nicotine, cocaine, and opioids have been selected for discussion herein. 

Crack is the free base form of cocaine which in contrast to cocaine, the salt form, can be smoked. This inhalative application results in a very rapid, intense effect. 

Toluene, volatile nitrites, and anesthetics, like other substances of abuse such as cocaine, nicotine, and heroin, are characterized by rapid absorption, rapid entry into the brain, high bioavailability, a short half-life, and a rapid rate of metabolism and clearance (Gerasimov et al. 2002 Pontieri et al. 1996, 1998). Because these pharmacokinetic parameters are associated with the ability of addictive substances to induce positive reinforcing effects, it appears that the pharmacokinetic features of inhalants contribute to their high abuse liability among susceptible individuals. 

Bredt DS, Snyder SEl Nitric oxide, a novel neuronal messenger. Neuron 8 3—11, 1992 Brouette T, Anton R Clinical review of inhalants. Am J Addict 10 79-94, 2001 Brown ES, Nejtek VA, Perantie DC, et al Quetiapine in bipolar disorder and cocaine dependence. Bipolar Disord4 406 11, 2002 Bushnell PJ, Evans EIL, Palmes ED Effects of toluene inhalation on carbon dioxide production and locomotor activity in mice. Fundam Appl Toxicol 5 971-977, 1983... 

Sellers EM, Naranjo CA, Harrison M, et al Diazepam loading simplified treatment of alcohol withdrawal. Clin Pharmacol Ther 34 822-826, 1983 Sharp CW Introduction to inhalant Abuse, in Inhalant Abuse A Volatile Research Agenda (NIDA Research Monograph 129). Edited by Sharp CW, Beuvais F, Spence R. Rockville, MD, National Institute on Drug Abuse, 1992, pp 1-10 Smelson DA, Losonczy MF, Davis CW, et al Risperidone decreases craving and relapses in individuals with schizophrenia and cocaine dependence. Can J Psychiatry 47 671-675, 2002... 

Abuse of phencyclidine hydrochloride (PCP) is a national problem that has reached epidemic proportions in urban areas of the United States. The drug is inexpensive, readily obtainable, and is usually used in combination with other drugs such as marijuana, heroin, cocaine, and alcohol (Golden et al. 1982). The routes of PCP use include inhalation, ingestion and parenteral administration. 

Amphetamines Appetite suppressants Asthma inhalants Buspirone Carbamazepine Cocaine... 

The hydrochloride salt is inhaled or injected. It can be converted to cocaine base (crack or rock) and smoked to achieve almost instant absorption and intense euphoria. Tolerance to the high develops quickly. The high from snorting can last 15 to 30 minutes the high from smoking can last 5 to 10 minutes. 

Alcohol Abuse, Alcohol Dependence Amphetamine Abuse, Amphetamine Dependence Cannabis Abuse, Cannabis Dependence Cocaine Abuse, Cocaine Dependence Hallucinogen Abuse, Hallucinogen Dependence Inhalant Abuse, Inhalant Dependence Nicotine Dependence Opiate Abuse, Opiate Dependence Phencyclidine Abuse, Phencyclidine Dependence... 

---