Despite the seemingly rare and random nature that this scenario presents, this patient's care serves to reinforce what should be done to successfully manage a patient with an ingested foreign body, as well as the important issues related to crack cocaine [ncbi.nlm.nih.gov]

A 34-year-old female presented 7 h after drinking beer and smoking crack. She was concerned that she might have inhaled the “screen” from her crack pipe, a piece of Brillo® pad the size of her fingertip. [deepdyve.com]

In addition to publishing papers presented at the annual meetings of the associated organizations, the journal publishes selected unsolicited manuscripts. [ingentaconnect.com]

• Fever

  Hospital emergency rooms here and elsewhere now do a urine test for drugs if children are brought in with seizures but have no fever and no history of seizures. [tampabay.com]

  Low-grade fever. Being excessively talkative. Being easily startled or nervous. [projectknow.com]

  The most common signs and symptoms of crack overdose include: agitation cold sweats coma confusion coughing that produces black mucus excessive tremors fainting fever hallucinations insomnia itching narrowed pupils problems breathing seizures severe headache [drug.addictionblog.org]

  […] charcoal, 1g/kg (up to 50g) PO q4hours for several doses Consider whole bowel irrigation if develop toxicity Consider discharge if do not develop toxicity after 4hr obs Complications Acute Cocaine-associated chest pain Sympathomimetic qualities Tachycardia Fever [wikem.org]

• Cough

  Signs of crack use include: Secretive behavior Unexplained spending of cash Weight loss Burns on the hands or mouth, cracked or blistered lips Breathing problems, coughing up black phlegm, tuberculosis Track marks Lack of interest in previously pleasurable [healthyplace.com]

  More than half of people who smoke crack will develop a wheeze, cough or shortness of breath. Many crack users will also experience chest pain and cough up black mucus or blood. [drugrehab.com]

  खांसना Coughed Coughed 191.Counsel सलाह देना Counselled Counselled 192.Count गिनना, गिनती गिनना Counted Counted 193.Course बहना, पार करना Coursed Coursed 194.Cover ढंकना, छुपाना Covered Covered 195.Cower झुकना या पीछे हटना Cowered Cowered 196.Crack टूटना [rps00945.blogspot.com]

  Breathing and respiratory problems, including damage to lungs, extreme coughing, and shortness of breath. Over time, long-term effects can include kidney, liver and heart damage. Becoming addicted to either form of cocaine is a serious dependency. [palmerlakerecovery.com]

• Hoarseness

  Listen for sounds of hoarseness or difficulty talking. Smoking or snorting crack may damage mucous linings of the nose and throat, making it difficult to swallow and speak. Look for signs of excessively red and bloodshot eyes. [livestrong.com]

  Constant sore throat and hoarse voice. Burns or blisters on the lips. Burns or blisters on the fingers. Coughing up dark phlegm. Incoherent or disorganized speech. Poor oral hygiene (sudden weakness in the teeth, broken teeth). [projectknow.com]

  Regular intranasal use (snorting) of cocaine, for example, can lead to loss of the sense of smell; nosebleeds; problems with swallowing; hoarseness; and a chronically runny nose. [thebody.com]

  Some crack users can be identified by their hoarse voices and chronic sore throat. Different drugs have different effects on the pupils of the eyes, and crack is no exception. [americanaddictioncenters.org]

• Tachypnea

  “constellation of signs and symptoms that can suggest a class of toxin exposure” Toxidrome Bottom line Details Causes Treatment Sympathomimetic “Fight or flight” “Pedal to the metal” “Crazy, amped” Excess catecholamines: hypertension, tachycardia, tachypnea [canadiem.org]

  Her vital signs revealed tachycardia and tachypnea without fever (her heart rate was 148 beats per minute, her respiratory rate, 60 breaths per minute and temperature 36°C). [jmedicalcasereports.biomedcentral.com]

• Loss of Appetite

  Psychological effects may include euphoria, excitation, general arousal, dizziness, increased alertness and focus, mental clarity, increased talkativeness, loss of appetite, among others. [hiredpower.com]

  […] of appetite Vertigo Muscle twitches Anxious, irritable or aggressive Severe mental distress including paranoia and psychosis After use of crack cocaine the user experiences what is known as a "crash." [healthyplace.com]

  Some immediate side effects of crack abuse include: Irritability Aggression Restlessness Anxiety Nervousness or paranoia Heightened alertness Increased heart rate and blood pressure Seizures Pressured speech Dilated eyes Loss of appetite Disturbed sleep [addictioncenter.com]

  Extreme weight loss; loss of appetite. Periods of very high energy. Prolonged periods of sleeplessness followed by periods of depression and apathy. Physical shaking. Bloodshot eyes or dilated pupils. Sweating. Low-grade fever. [projectknow.com]

• Abdominal Pain

  She complained of "burning" in her throat, a foreign body sensation, and change in her voice, but no dyspnea, dysphagia, or abdominal pain. [ncbi.nlm.nih.gov]

  She complained of “burning” in her throat, a foreign body sensation, and change in her voice, but no dyspnea, dysphagia, or abdominal pain. [deepdyve.com]

  It can cause abdominal pain, headaches, gastrointestinal complications, and nausea as well. Binge use of the drug can cause adverse effects, such as anxiety, irritability, and restlessness. [hiredpower.com]

• Chest Pain

  Management of Cocaine-associated chest pain and myocardial infarction. Circulation. 2008; 117: 1897-1907. ↑ McCord, J., Jneid, H., Hollander, J. E., de Lemos, J. A., Cercek, B., Hsue, P., Gibler, W. B., Ohman, E. [wikem.org]

  Nitroglycerin is an important intervention for treatment of angina and chest pain from possible MI. Observe cocaine-induced chest pain; follow up based on patient’s signs and symptoms. [calsprogram.org]

  pain Journal articles Afonso L. [lifeinthefastlane.com]

  Crack overdose can also cause the development of hemoptysis, pleuritic chest pain, pulmonary infiltrates, asthma, and reactive airway disease. [drug.addictionblog.org]

  Specific signs of calcium-channel blocker poisoning include: feeling agitated low blood pressure, which can cause symptoms such as lightheadedness and fainting chest pain a slow heartbeat (below 60 beats per minute) Benzodiazepines Benzodiazepines are [nhs.uk]

• Hypertension

  Signs of intoxication were hypertension, tachycardia, hyperthermia, agitation, and generalized seizure activity. Treatment included therapeutic sedation with lorazepam and adrenolysis with esmolol infusion. [ncbi.nlm.nih.gov]

  […] emergency Benzos Phentolamine 2.5-5mg IV (direct α-adrenergic antagonist, anti-hypertensive of choice) [3] OR nitroprusside 0.3mcg/kg/min Beta-blockers contraindicated May cause paradoxical hypertension IV crystalloid replacement (most patients have [wikem.org]

  Hypertension The use of beta blockers, including labetalol, should be avoided in the treatment of cocaine-related cardiovascular complications due to the potential of creating unopposed alpha-adrenergic stimulation resulting in worsening hypertension, [calsprogram.org]

  seizures, intracerebral haemorrhage or aortic dissection Hypertension and tachycardia IV benzodiazepines if agitated if refractory to sedation: Phentolamine 1 mg IV q5min titrated SNP or GTN infusion Avoid beta-blockers SVT IV benzodiazepines if agitated [lifeinthefastlane.com]

  These include tachycardia and hypertension, but may also be responsible for the development of hyperthermia and rhabdomyolysis. [academic.oup.com]

• Tachycardia

  Signs of intoxication were hypertension, tachycardia, hyperthermia, agitation, and generalized seizure activity. Treatment included therapeutic sedation with lorazepam and adrenolysis with esmolol infusion. [ncbi.nlm.nih.gov]

  Both a legitimate medical drug and a drug of abuse Forms of Abuse Cocaine can be smoked, snorted, injected or ingested Smoked form is often in a free-base or crack form Clinical Features Side effects of chronic cocaine use Sympathomimetic toxidrome: Tachycardia [wikem.org]

  hyperthermia (41°C), tachycardia, hypertension, DIC Liver transplant after 4 days; death from graft rejection after 18 days 6 20 M Found collapsed in street after party; haemophiliac Convulsions, hyperthermia (40°C), tachycardia, hypertension, DIC, [academic.oup.com]

  Ventricular arrhythmias as ventricular tachycardia and ventricular fibrillation induced by the cocaine may be responsible for it; in our case ventricular fibrillation was observed which was promptly reversed by defibrillation. [hindawi.com]

• Muscle Spasm

  They can experience greatly increased heart rate, muscle spasms and convulsions. The drug can make people feel paranoid, angry, hostile and anxious, even when they aren’t high. [drugfreeworld.org]

  They can experience increased heart rate, muscle spasms, and convulsions. Cocaine can permanently damage their nasal tissue. Cocaine affects your emotions. [recoverythroughsupport.com]

  The journal of Neuropsychopharmacology explains that baclofen, a muscle relaxant, can be administered to treat the muscle spasms that are normally part of detoxing from drug addiction. [americanaddictioncenters.org]

  Chronic, excessive exposure such as occurs in intentional gasoline abuse (sniffing) can cause irritability, tremor, nausea, insomnia, loss of memory, drowsiness, mental dullness, confusion, seizures, muscle spasms, altered vision, hallucinations, impaired [atsdr.cdc.gov]

• Blurred Vision

  The physical effects of ice can include: SHORT TERM Headaches and dizziness Dilated (enlarged) pupils and blurred vision Dry mouth Jaw clenching, teeth grinding Insomnia Increased attention, alertness and talkativeness Trembling Sweaty, cold and clammy [cracksintheice.org.au]

  […] or blurred vision mental confusion seizures (fits) loss of consciousness coma, in severe cases Signs of a medication or drug overdose Medication overdoses are the most common type of poisoning in the UK. [nhs.uk]

  Confusion, giddiness, nausea, headache, blurred vision, dizziness, and weakness can occur. In massive exposures, rapid CNS depression, respiratory depression, seizures, loss of consciousness, coma, and death have been reported. [atsdr.cdc.gov]

• Lacrimation

  Chapter First Online: 22 January 2015 Abstract In small quantities, cocaine has been used for local anesthesia, predominantly used for nasal and lacrimal duct surgery. [link.springer.com]

  Muscarinic effects: Diarrhea, diaphoresis Urination Miosis Bradycardia Bronchorrhea Emesis Lacrimation Lethargic Salivation Nicotinic effects: Mydriasis Tachycardia Weakness Tremors Fasciculations Seizures Somnolent Organophosphate and carbamate insecticides [canadiem.org]

• Euphoria

  Psychological effects may include euphoria, excitation, general arousal, dizziness, increased alertness and focus, mental clarity, increased talkativeness, loss of appetite, among others. [hiredpower.com]

  FIBF has been sold online as a party drug as it causes a sense of euphoria in users. It has the potential to be life-threatening as it can depress the respiratory system. [yorkshireeveningpost.co.uk]

  The continual activation of the dopaminergic system, on the other hand, may lead to euphoria (especially experienced following acute ingestion). [nature.com]

  During use of crack cocaine, crack cocaine symptoms include the following: 1 Energy, restlessness, insomnia Heightened sense of sight, smell and touch Euphoria Increased heart rate Dilated pupils Increase in blood pressure Increase in body temperature [healthyplace.com]

• Delusion

  Taking a higher dose could lead to confused and disoriented behavior, antisocial behavior, delusions, hallucinations, irritability, fear, paranoia, and even aggressiveness. [hiredpower.com]

  People who use crack cocaine may initially feel exhilarated and alert, but this can quickly be replaced by feelings of anxiety, depression and even delusions. [addiction.lovetoknow.com]

  Unexplained spending of cash Weight loss Burns on the hands or mouth, cracked or blistered lips Breathing problems, coughing up black phlegm, tuberculosis Track marks Lack of interest in previously pleasurable activities Legal problems Hyper-alert behavior Delusions [healthyplace.com]

  COCAINE-INDUCED PSYCHOTIC DISORDER, WITH DELUSIONS. [minddisorders.com]

• Mood Swings

  He may also suffer attacks of paranoia, hallucinations or mood swings while driving. Lack of concentration may result in a loss of control of the vehicle. [narconon.org]

  Mood swings, irritability, frequent trips to the bathroom, secretive behavior, and changes in friends often signify drug abuse. [newportacademy.com]

  Patients may experience intense psychological effects such as mood swings, agitation, depression, and anxiety during the withdrawal period. 5 This period varies in duration based on the amount of use and the time the substance was abused. [drugabuse.com]

  The superhuman stimulation and unfathomable fatigue also cause violent and unpredictable mood swings, causing users to be argumentative and perhaps violent and dangerous to those around them, especially toward people who try and stop the drug use. [americanaddictioncenters.org]

• Aggressive Behavior

  The Pennsylvania Attorney General says that some mental and emotional effects of using the drug include: Irritability Intense anxiety Restlessness Aggressive behavior Paranoia When the drug wears off or the user attempts to stop smoking crack for good [luxury.rehabs.com]

  These rebound signs of crack use can cause users to become agitated, withdrawn, or excessively sleepy and lead to severe depression, and suicidal, harmful, or aggressive behaviors. 5. Paranoia A common sign of crack use isparanoia. [addictions.com]

  Other signs of crack abuse to look for include: Frequent disappearances (to get high) Dilated pupils Aggressive behavior Restlessness Increased breathing rate Uncharacteristic irresponsibility Burns on fingers Cracked or blistered lips from smoking out [addictioncenter.com]

• Visual Hallucination

  Some users have also reported auditory and visual hallucinations during this time, with periods of severe paranoia occurring in the first 24 hours. [futuresrecoveryhealthcare.com]

  hallucinations of insects.) [14] People experiencing these hallucinations might scratch themselves to the extent of serious skin damage and bleeding, especially when they are delirious. [5] [14] Pregnancy and nursing "Crack baby" is a term for a child [ipfs.io]

• Seizure

  Signs of intoxication were hypertension, tachycardia, hyperthermia, agitation, and generalized seizure activity. Treatment included therapeutic sedation with lorazepam and adrenolysis with esmolol infusion. [ncbi.nlm.nih.gov]

  The usual symptom is uncontrolled seizures. Hospital emergency rooms here and elsewhere now do a urine test for drugs if children are brought in with seizures but have no fever and no history of seizures. [tampabay.com]

  Repeated seizures were observed, and benzodiazepines were administered. [hindawi.com]

  Seizures or convulsions. Unconsciousness. Heart attack. Stroke. [projectknow.com]

• Agitation

  Signs of intoxication were hypertension, tachycardia, hyperthermia, agitation, and generalized seizure activity. Treatment included therapeutic sedation with lorazepam and adrenolysis with esmolol infusion. [ncbi.nlm.nih.gov]

  Cocaine can be smoked, snorted, injected or ingested Smoked form is often in a free-base or crack form Clinical Features Side effects of chronic cocaine use Sympathomimetic toxidrome: Tachycardia, diaphoresis, mydriasis, hypertension, hyperthermia, agitation [wikem.org]

  […] and agitated delirium 5 mg diazepam IV q2-5min until seizures stop or gentle sedation consider NaHCO3 if evidence of sodium channel blockade Hyperthermia T > 38.5°C continuous core-temperature monitoring benzodiazepine sedation fluid resuscitation T> [lifeinthefastlane.com]

  Specific signs of SSRI poisoning include: feeling agitated tremor (shaking) uncontrolled movement of the eyes (nystagmus) severe muscle tension Beta-blockers Beta-blockers are used to treat a number of conditions that affect the heart or blood, such as [nhs.uk]

  Irritability or agitation. Extreme anxiousness. Difficulty urinating. Seizures or convulsions. Unconsciousness. Heart attack. Stroke. [projectknow.com]

• Irritability

  First-wave physical effects may include anxiety, elevated heart rate, and blood pressure, increased body temperature, irritability, dilated pupils, and restlessness. [hiredpower.com]

  After use of crack cocaine, crack cocaine symptoms include the following: 2 Crack cocaine craving Depression Agitation, anxiety, anger, irritability Fatigue, lack of motivation Nausea, vomiting Shaking, muscle pain Disturbed sleep Crack Cocaine Use: Signs [healthyplace.com]

  Prolonged contact with liquid gasoline causes significant irritation (i.e., irritant contact dermatitis), degreasing, and burns. Redness and blisters may occur. Ocular Eye irritation from gasoline vapors begins at about 200 ppm. [atsdr.cdc.gov]

  Pay attention to signs of nosebleeds or irritated nasal passages, a common sign of snorted cocaine. Irritation to the nasal linings and passages due to snorting may also be noted by constant sniffling and a runny nose, according to Narconon. [livestrong.com]

• Stroke

  Neurovascular complications of cocaine use at a tertiary stroke center. J Stroke Cerebrovasc Dis. 2010;19(4):273–8. CrossRef PubMed Google Scholar Wu V, Huang J, Lien H, et al. [link.springer.com]

  Crack overdose can result in serious and chronic damage to the body such as stroke, heart attack and kidney failure. [mentalhelp.net]

  Any route of administration can potentially lead to absorption of toxic amounts of cocaine, causing heart attacks, strokes, or seizures—all of which can result in sudden death.2,7 [drugabuse.gov]

  […] heart rate and blood pressure Seizures Pressured speech Dilated eyes Loss of appetite Disturbed sleep patterns Contracted blood vessels Increased body temperature Hyperexcitability Nausea Intense euphoria Intense cravings to use more Bizarre behavior Stroke [addictioncenter.com]

• Confusion

  There may be hallucinations and confusion. The person may think there are bugs crawling on his skin. They may pick and scratch at their skin. They will probably have trouble concentrating. [narconon.org]

  Taking a higher dose could lead to confused and disoriented behavior, antisocial behavior, delusions, hallucinations, irritability, fear, paranoia, and even aggressiveness. [hiredpower.com]

  उलझाना, भ्रमित होना Confused Confused 143.Congratulate बधाई देना Congratulated Congratulated 145.Connect जोड़ना, मिलाना Connected Connected 145.Connote जताना, भाव बतलाना, अर्थ सूचित करना Connoted Connoted 146.Conquer जितना, विजयी होना, Conquered Conquered [rps00945.blogspot.com]

In general, a solid toxic workup includes these labs: CBC, serum chemistry Renal function Liver function tests (INR/Bili/Alb) w/ Liver Enzymes (AST/ALT/ALP/GGT) Urinalysis (with HCG) Serum ETOH Serum lactate Bedside glucose Serum osmolality EKG With the [canadiem.org]

Benefits of Seeking Inpatient Treatment If you’ve become addicted, the only way to rid yourself of this crack cocaine and cocaine addiction is through treatment. There are a number of treatment options that are available to you. [crehab.org]

Crack Addiction Treatment Getting treatment for a crack cocaine addiction is very important. If left unchecked, a crack habit can eventually kill a user or cause permanent psychological damage. [americanaddictioncenters.org]

Treating Yourself When you choose to clean up your life and become a former addict, a treatment center such as Meridian Treatment Solutions can help and will probably be one of your most valuable assets on your road to recovery. [meridiantreatment.com]

Hope Without Commitment Find the best treatment options. [addictionresource.com]

Providing the optimal combination of treatment services for each individual is critical to successful treatment outcome. [recoverythroughsupport.com]

Prognosis Not all cocaine abusers become dependent on the drug. [minddisorders.com]

Long Term Prognosis of Cocaine Addiction Rehabitation The prognosis for minor complications of cocaine use is good if further drug use can be stopped completely. [emedicinehealth.com]

While she had been hemodynamically stable before induction of general anesthesia, her BP was quite labile (BP 145/90–70/30 mmHg, HR 85–110 beats/min) for the next 40 min with no obvious surgical or anesthetic etiology for the instability. [anesthesiology.pubs.asahq.org]

Medical Complications of Drug Use 840 Acute and Chronic Pain 863 Substance Use Disorders in Individuals with CoOccurring Psychiatric Disorders 904 Epidemiology and Emerging Public Health Perspectives 913 HIVRelated Medical Complications and Treatment [books.google.com]

Adams (eds.), Cocaine Use in America: Epidemiologic and Clinical Perspectives (PDF), NIDA Research Monograph, vol. 61, U.S. [en.wikipedia.org]

Risk of Becoming Cocaine Dependent: Epidemiological Estimates for the United States, 2000-2001. Neuropsychopharmacology, 1006-1018. Last updated on January 28, 2020 2020-01-28T13:36:25+00:00 Finding the perfect treatment is only one phone call away! [drugabuse.com]

Longmore W, Abadir A, Berman S, Chaudhry K, Gintautiene K, Gintautas J: Epidemiology and pharmacology of chronic "crack" use: The growing problem of an inner-city hospital. Proc West Pharmacol Soc 1989; 32:211-6. [anesthesiology.pubs.asahq.org]

CNS complications of cocaine abuse: prevalance, pathophysiology, and neuroradiology. AJR Am J Roentgenol. 1992;159:137–47. CrossRef PubMed Google Scholar Buchanan JA, Heard K, Burbach C, et al. [link.springer.com]

Brown E, Prager J, Lee H, Ramsey R: CNS complications of cocaine abuse: Prevalence, pathophysiology, and neuroradiology. Am J Roentgen 1992; 159:137-47. [anesthesiology.pubs.asahq.org]

[…] and Treatment of Addiction Among African Americans 1250 The Public Health Approach to the Prevention of Substance Abuse 1255 Medical Education in Substance Abuse The Acquisition of Knowledge Attitudes and Skills 1269 Education and Training of Clinical [books.google.com]

Though multiple medications have been tried, none have proved effective in treating cocaine abuse in randomized controlled trials Cocaine vaccine is currently being investigated as a tool to prevent relapse among prior cocaine users. [amjmed.org]

Larger warning labels and further public education might help prevent many cases of pediatric caustic ingestion. [ncbi.nlm.nih.gov]

Behavioral interventions -- particularly, cognitive-behavioral therapy -- have been shown to be effective for decreasing cocaine use and preventing relapse. [thebody.com]