Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cocaine abuse is associated with a variety of severe acute neurologic complications typically occurring in the abusers themselves. These include ischemic stroke, subarachnoid and intraparenchymal hemorrhage, headaches, syncope, seizures, and death. Sixteen pediatric patients with presumed cocaine-related seizures secondary to maternal consumption are reported. They were evaluated only because of requests for neurologic consultation. All were seen during the 1987 calendar year at the King/Drew Medical Center and Urban Comprehensive Epilepsy Program of Los Angeles. The cohort had similar maternal pregnancy histories and uniformly presented with postdelivery tremulousness, irritability, and excessive startle responses. Shortly after birth, each patient began having stereotypic episodes with ictal electroencephalographic confirmation in seven. Eight of these neonates continued to have seizures after the initial month of life.
 ...
PMID:Neonatal cocaine-related seizures. 229 41

Deaths from cocaine abuse continue to increase, while the mechanism of lethality remains unclear. Previous investigations have focused on potential ventricular dysrhythmias and myocardial ischemic events from enhanced autonomic tone or seizure activity from central stimulation. However, cocaine is a local anesthetic and may impair cardiac conduction. To evaluate this, 16 conscious dogs received i.v. cocaine over 30 sec to mimic "recreational" use in doses of 3 mg/kg (n = 6), 5 mg/kg (n = 6) or 7 mg/kg (n = 4). Another group of anesthetized dogs (n = 6) received two infusions of cocaine (5 mg/kg) 1 hr apart. Plasma cocaine levels and His bundle electrograms were obtained at control and at 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0, 10 and 15 min after cocaine administration. At 0.5 min, plasma cocaine reached peak levels of 30.0, 45.0 and 59.6 micrograms/ml with increasing dose. Cocaine rapidly produced severe prolongation of His to ventricle interval and widening of the R wave. Slowing of conduction was dose-dependent, with maximal increases in His to venticle interval of 37 to 56% (P = .0299) and R wave duration of 34 to 77% (P less than .025). Furthermore, significant conduction impairment developed at cocaine levels that did not produce seizures. Conduction effects were equally pronounced during repeated administration of cocaine. These data indicate that cocaine causes marked conduction slowing, which could play an important role in cocaine death.
 ...
PMID:Cocaine-mediated impairment of cardiac conduction in the dog: a potential mechanism for sudden death after cocaine. 229 88

Severe acid-base disorders accompanying cocaine abuse have been reported but not emphasized in the literature. We report three cases of cocaine toxicity associated with profound acid-base derangements. Two cases demonstrated severe metabolic acidosis, one of which was not associated with known seizure activity. In addition, one case of profound alkalosis associated with cocaine use is presented. These cases are reported to emphasize the marked acid-base changes that can occur as a result of cocaine toxicity.
 ...
PMID:Severe acid-base abnormalities associated with cocaine abuse. 237 41

An increase in cocaine abuse by pregnant women has been associated with a range of maternal/fetal cardiovascular complications. Intracerebral hemorrhage has been reported as a cocaine-related complication, but has not previously been associated with pregnancy. We report a case of cocaine-associated intracerebral hemorrhage in the postpartum period which complicated the differential diagnosis and management of hypertension and seizures.
 ...
PMID:Cocaine, pregnancy, and postpartum intracerebral hemorrhage. 249 50

Drug abuse has become a social and medical problem. Amphetamine and cocaine have a potent sympathicomimetic action, so they have important effects on the Central Nervous and Cardiovascular Systems. Their neurological complications are principally: psychic alterations, seizures and stroke (hemorrhagic and ischemic). The latter are the most important in the clinical practice. Their capacity to produce transit arterial hypertension and cerebral vascular constriction could be the physiopathological substrate of such alterations. Angiographic studies have shown lesions suggesting vasculopathy. In the last ten years cocaine abuse has become an authentic epidemic. We have reviewed its neurological complications, particularly the vascular ones--42 hemorrhagic and 24 ischemic--and the following conclusions were drawn: it should be considered as a risk factor in the younger age group; a short period of time between the last drug dose and the clinical picture is frequently seen; clinical features may appear with the first drug administration; no characteristic lesion in relation to the way of administration or consumption time was elicited.
 ...
PMID:[Neurologic complications caused by use of cocaine, amphetamines and sympathomimetics]. 270 Feb 92

Over a 24-month period we evaluated 14 patients with neurologic disease associated with cocaine abuse. Five patients developed previously unreported complications: anterior spinal artery syndrome, lateral medullary syndrome, transient ischemic attacks in the middle cerebral artery and vertebrobasilar artery territories, and partial motor seizures. The recent availability of crack has led to a great increase in neurologic problems associated with the use of this drug.
 ...
PMID:Neurologic complications of cocaine abuse. 339 66

This report reviewed 996 emergency room visits and 279 hospital admissions of patients with complications of cocaine abuse seen at the San Francisco General Hospital between 1979 and 1986. In 143 cases, acute neurologic or psychiatric symptoms were the primary complaint, and case-notes provided sufficient detail for analysis. The major neurologic complications included one or more seizures (n = 29), focal neurologic symptoms or signs (12), headache (10), and transient loss of consciousness (six). Psychiatric disturbances included agitation, anxiety, or depression (33), psychosis and paranoia (24), and suicidal ideation (18). The most serious consequences were found in patients with prolonged seizures or strokes, those who jumped out of buildings, and those who attempted suicide by overdosing with other drugs. There was no correlation between the appearance of complications and the reported route of administration, the amount of cocaine used, or prior experience with cocaine. The number of patients who are seeking hospital attention for these or related complaints appears to be rising substantially. Cocaine abuse, regardless of the use pattern, is associated with a variety of potentially severe neurologic and psychiatric complications.
 ...
PMID:Acute neurologic and psychiatric complications associated with cocaine abuse. 367 91

The increasingly widespread use of cocaine in the United States has been accompanied and perhaps exacerbated by the misconception that the drug is not associated with serious medical complications. In particular, the potential for cocaine to precipitate life-threatening cardiac events needs to be reemphasized. We report the clinical and pathological findings in seven people in whom nonintravenous "recreational" use of cocaine was temporally related to acute myocardial infarction, ventricular tachycardia and fibrillation, myocarditis, sudden death, or a combination of these events. We also review data on 19 previously reported cases of cocaine-related cardiovascular disorders. Analysis of all 26 patients indicated the following findings: the cardiac consequences of cocaine abuse are not unique to parenteral use of the drug, since nearly all the patients took the drug intranasally; underlying heart disease is not a prerequisite for cocaine-related cardiac disorders; seizure activity, a well-documented noncardiac complication of cocaine abuse, is neither a prerequisite for, nor an accompanying feature of, cardiac toxicity of cocaine; and the cardiac consequences of cocaine are not limited to massive doses of the drug. Although the pathogenesis of cardiac toxicity of cocaine remains incompletely defined, available circumstantial evidence suggests that cocaine has medical consequences that are equal in importance to its well-documented psychosocial consequences.
 ...
PMID:Acute cardiac events temporally related to cocaine abuse. 378 95

Specific consequences of cocaine abuse on health and psycho-social functioning were assessed in 55 cocaine-abusing subjects who called a telephone "helpline." REsults showed a high incidence and wide range of adverse consequences including: impairment of job functioning, interpersonal relationships, and financial status; disturbances of mood and cognitive functioning; psychiatric symptoms of depression, paranoia, and increased suicidal/violent tendencies; and physical symptoms of exhaustion, weight loss, sleep problems, and seizures. Cocaine-related automobile accidents, suicide attempts, and violent acts, including a cocaine-related homicide, were also reported. Intranasal users reported no fewer and no less severe adverse consequences than free-base smokers or intravenous users. Our findings challenge popular notions that cocaine is a benign "recreational" drug and that the intranasal route of administration guarantees protection against addictive patterns of use and adverse effects.
 ...
PMID:Adverse effects of cocaine abuse. 643 68

Cocaine is an extremely addictive local anesthetic which can produce stimulation of the sympathetic nervous system due to the inhibition of catecholamine reuptake at the synaptic junction. Because of the rapid metabolism of cocaine, the probability of a patient presenting to the operating room with acute intoxication is unlikely. However, the physiological effects of chronic cocaine abuse on various organ systems have an impact on anesthesia management. A preoperative review of major organ systems is essential. Selective beta 1 antagonists (i.e., esmolol) may need to be titrated with a direct vasodilator (i.e., nitroprusside) to manage hypertension and tachycardia. The nonselective beta antagonist effects of labetalol are much more potent than its alpha antagonist effects, which could result in unopposed alpha vasoconstriction. In addition, the equal affinity of the alpha adrenergic antagonist, phentolamine, for both alpha 1 and alpha 2 receptors may result in significant tachycardia. Nitroglycerin has also been used in management of hypertension associated with coronary vasoconstriction. There is controversy regarding management of ventricular dysrhythmias and asystole. Lidocaine is an amide local anesthetic that may have addictive effects, in the presence of cocaine, which may lower the seizure threshold. In addition, the use of epinephrine to treat asystole is controversial in the presence of a state of excess catecholamines induced by cocaine. General anesthesia may include barbiturates, nitrous oxide, and opioids. Inhalational agents may be used with caution due to their myocardial depressant effects. Regional anesthesia may be a good choice if coagulopathies and hypovolemia are corrected before the procedure.
 ...
PMID:Anesthetic management of the cocaine abuse patient. 750 43


<< Previous 1 2 3 4 5 Next >>