Vascular Toxicity of Cocaine

Abstract

Cocaine acts on the vascular system by a number of mechanisms including monoamine re-uptake inhibition, local anesthesia, anti-cholinergic activity, alpha-adrenergic stimulation, regulation of various vasoconstrictor and vasodilator agents and promotion of prothrombotic state. These effects lead to a number of clinical syndromes via vasoconstriction, platelet activation, thrombus formation and early atherosclerosis in almost every organ of the body. Many of these effects may be under appreciated. Furthermore, cocaine is commonly associated with the use of tobacco and alcohol which can lead to superadditive effects and/or prolonged toxicity.