Topical anesthesia abuse

Its euphoric properties are due primarily to inhibition of catecholamine uptake, particularly dopamine, in the CNS. Other local anesthetics do not block the uptake of norepinephrine and do not produce the sensitization to catecholamines, vasoconstriction, or mydriasis characteristic of cocaine. Currently, cocaine is used primarily for topical anesthesia of the upper respiratory tract, where its combination of both vasoconstrictor and local anesthetic properties provide anesthesia and shrinking of the mucosa. Because of its abuse potential, cocaine is listed as a schedule II drug by the U.S. Drug Enforcement Agency. 

Sensory systems Topical ocular anesthesia abuse is often misdiagnosed as acanthamoeba keratitis (a parasitic disease) and early identification to prevent ocular complications including superficial pxmctate keratitis, persistent epithelial defects, stromal/ring infiltrates, comeal oedema, endothelial damage and ocular inflammation is important. Local anesthetics may cause direct toxicity to the comeal epithelium, stroma and endothelium. Preservatives in the anesthetics may also contribute to toxicity. Patient demographics may include a health care association and/or psychiatric illness [25 ]. Evisceration of the eye after persistent topical anesthetic use has been described [26 ]. 

DOT CLASSIFICATION Forbidden SAFETY PROFILE A human poison by ingestion and possibly other routes. Poison experimentally by ingestion, intraperitoneal, intravenous, subcutaneous, and parenteral routes. Human central nervous system effects by ingestion and possibly other routes general anesthesia, hallucinations or distorted perceptions, and convulsions. An eye irritant. A widely abused, controlled substance. Abuse leads to habituation or addiction. In medicine, it is used as a local narcotic anesthetic applied topically to mucous membranes. The free base is soluble... 

Cocaine is used for topical local anesthesia of mucous membranes. It is also a drug of abuse. 

Local anesthetics are widely used to provide anesthesia via local subcutaneous Injection topical application to skin and mucous membranes and epidural, spinal, and regional nerve blocks. In addition, lidocaine (see p 462) is used intravenously as an antiarrhythmic agent and cocaine (see p 171) is a popular drug of abuse. Gommonly used agents are divided into two chemical groups ester-linked and amide-linked (Table 11-2). 

---

See also in sourсe #XX -- [ ]

---