Vascular Toxicity of Cocaine

Bansal, Sudeep; Morgan, James P.

doi:10.2174/1567270000906010030

Cited by 3 publications

(4 citation statements)

References 84 publications

(54 reference statements)

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“…Cocaine crosses the blood–brain-barrier perhaps better than other psychoactive chemicals and may even induce its breakdown [17,18]. In addition, cocaine blocks reuptake of catecholamines in the presynaptic neurons in the central and peripheral nervous systems, resulting in increased catecholamines, sympathetic output and stimulation [2,19]. There is also evidence that the cardiovascular actions of cocaine are mediated in part by dopamine [20], via central and peripheral mechanisms [21].…”

Section: Pharmacodynamics Of Cocainementioning

confidence: 99%

“…1, upper box) [10,23,24] consist of repeated endothelial damage leading to premature and severe atherosclerosis in various organs [10,19]. …”

Section: Chronic Effects Of Cocainementioning

confidence: 99%

“…Cocaine-induced chronic neurotoxicity consists of monoamine re-uptake inhibition, anti-cholinergic activity, and alpha-adrenergic stimulation [19]. Advanced atherosclerosis of intracranial vessels [32] is noted as the cause of cocaine-induced stroke in numerous studies [4,29].…”

Section: Chronic Effects Of Cocainementioning

confidence: 99%

“…Heart mechanisms adapted from Ref. [13]; figure based on following references [2,5,6,10,13,15–19,23–44]. …”

Section: Figmentioning

confidence: 99%

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Vascular disease in cocaine addiction

et al. 2017

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Cocaine, a powerful vasoconstrictor, induces immune responses including cytokine elevations. Chronic cocaine use is associated with functional brain impairments potentially mediated by vascular pathology. Although the Crack-Cocaine epidemic has declined, its vascular consequences are increasingly becoming evident among individuals with cocaine use disorder of that period, now aging. Paradoxically, during the period when prevention efforts could make a difference, this population receives psychosocial treatment at best. We review major postmortem and in vitro studies documenting cocaine-induced vascular toxicity. PubMed and Academic Search Complete were used with relevant terms. Findings consist of the major mechanisms of cocaine-induced vasoconstriction, endothelial dysfunction, and accelerated atherosclerosis, emphasizing acute, chronic, and secondary effects of cocaine. The etiology underlying cocaine's acute and chronic vascular effects is multifactorial, spanning hypertension, impaired homeostasis and platelet function, thrombosis, thromboembolism, and alterations in blood flow. Early detection of vascular disease in cocaine addiction by multimodality imaging is discussed. Treatment may be similar to indications in patients with traditional risk-factors, with few exceptions such as enhanced supportive care and use of benzodiazepines and phentolamine for sedation, and avoiding β-blockers. Given the vascular toxicity cocaine induces, further compounded by smoking and alcohol comorbidity, and interacting with aging of the crack generation, there is a public health imperative to identify pre-symptomatic markers of vascular impairments in cocaine addiction and employ preventive treatment to reduce silent disease progression.

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Section: Pharmacodynamics Of Cocainementioning

confidence: 99%

“…1, upper box) [10,23,24] consist of repeated endothelial damage leading to premature and severe atherosclerosis in various organs [10,19]. …”

Section: Chronic Effects Of Cocainementioning

confidence: 99%

Section: Chronic Effects Of Cocainementioning

confidence: 99%

“…Heart mechanisms adapted from Ref. [13]; figure based on following references [2,5,6,10,13,15–19,23–44]. …”

Section: Figmentioning

confidence: 99%

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Vascular disease in cocaine addiction

et al. 2017

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Isolated fibromuscular dysplasia of the coronary ostium: a rare cause of sudden death. Case report and review of the literature

García

deRoux

Axiotis

2015

Cardiovascular Pathology

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Are We Witnessing a New Wave of Substance Use Disorders?: A Spotlight on Stimulant Use Disorders

Mumba¹,

Davis²

2023

J Psychosoc Nurs Ment Health Serv

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Stimulant use disorders are emerging as a serious global threat to health. Although research, clinical, and policy efforts have largely concentrated on opioid use disorders over the past decade, exponential rises in prevalence and overdose deaths attributable to stimulant use disorders warrant renewed attention. To date, no approved medications are available to treat stimulant use disorders; however, behavioral interventions have been effective and should be proactively promoted. Similarly, complementary and integrative therapies and harm reduction services have emerging evidence for effectiveness in treating these conditions. Research, practice, and policy interventions should address stigma for medications for stimulant use disorders when available, vaccine hesitancy if vaccines are approved and safe, environmental surveillance to reduce population exposure to toxic effects of methamphetamines, and educational interventions for health providers to increase competency to reduce the long-term effects on various body systems. [ Journal of Psychosocial Nursing and Mental Health Services, 61 (3), 13–18.]

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Vascular Toxicity of Cocaine

Cited by 3 publications

References 84 publications

Vascular disease in cocaine addiction

Vascular disease in cocaine addiction

Isolated fibromuscular dysplasia of the coronary ostium: a rare cause of sudden death. Case report and review of the literature

Are We Witnessing a New Wave of Substance Use Disorders?: A Spotlight on Stimulant Use Disorders

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