Cocaine Intoxication / Withdrawal - Diagnosis and Management ...
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Cocaine Intoxication / Withdrawal - Diagnosis and Management Summary

Intoxication: Grandiosity, euphoria, hyperactivity, anorexia, anxiety, psychotic sx (formication, paranoia, AH/VH), fever, mydriasis. Vasospasm can cause HTN emergency, stroke, MI and seizures. 

 • Tx: labetalol, phentolamine (AVOID unopposed alpha stimulation)

Withdrawal: Depression, fatigue, nightmares, cravings,↑ sleep/appetite. 

 • Tx: Acute: propranolol, quetiapine for severe sx; Chronic: consider topiramate and/or baclofen for cravings/dependence (consult ACT)



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Account created for the MGH Internal Medicine Housestaff Manual "White Book" - https://stk10.github.io/MGH-Docs/WhiteBook-2019-2020.pdf
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