What is the focus of medication and drug use history in the evaluation of suspected cocaine toxicity?

Updated: Sep 01, 2018
  • Author: Lynn Barkley Burnett, MD, EdD, LLB(c); Chief Editor: Sage W Wiener, MD  more...
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Answer

Medication and drug use history can be determined as follows:

  • What is the patient's average daily use? What is his or her history of cocaine and other drug use? (The mechanism of fatality differs for long-term cocaine users.)

  • Does the patient use tobacco (ie, does he or she have increased risk for atherosclerosis and coronary vasospasm)? How many packs does the patient smoke per day?

  • Does the patient use alcohol (ie, is cocaethylene formation possible)? If so, did the patient drink before or during cocaine uses? How much alcohol was consumed?

  • What other substances were used? How much was consumed? What route of intake was used?

  • Does the patient have any other drug addictions? Were any drug combinations taken or were drugs taken to increase, prolong, or decrease the effects of cocaine?

  • Could medications taken by the patient potentiate the effects of cocaine? Is the patient in withdrawal?

  • What prompted the visit to the ED? Possible reasons for cocaine-related ED visits include unexpected reactions, overdose, chronic effects, accidental injury, and withdrawal [28]

  • Does the patient want help in coping with cocaine use?


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