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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