The price of cocaine has fallen sharply in the past decade resulting in cocaine toxicity becoming a much more frequent clinical problem. This increase has made cocaine a favourite topic of question writers.

• Source: Cocaine is an alkaloid derived from the coca plant. It is widely used as a recreational stimulant.
• Forms: Sniffed, chewed, IV

Cocaine

• Heat sensitive
• Cannot be smoked

Crack-cocaine

• Cocaine is 'washed' with a strong alkali (sodium bicarbonate or ammonia)
• (makes a cracking sound)

Epidemiology

• 2.4% of the population use cocaine
• responsible for 200-300 deaths per year

Physiology

• cocaine blocks the reuptake of dopamine, noradrenaline and serotonin = enhancing peripheral effect of somatic nervous system and producing psychomotor effect

PC

• mood changes - irritability, euphoria, dysphoria
• Chronic high dose dependancy - perforated septum, psychiatric and medical complications