Substance Abuse: Cocaine Abuse

Cocaine is a crystalline alkaloid obtained from the leaves of Erythroxylon coca (family Erythroxylaceae) and other species of Erythroxylon, or by synthesis from ecgonine or its derivatives.

Cocaine is a potent central nervous system stimulant, vasoconstrictor, and topical anesthetic, widely abused as a euphoriant and associated with the risk of severe adverse physical and mental effects.



Cocaine: cocaine hydrochlororide (sniffed) free-base cocaine (smoked), crack cocaine (small rocks that are smoked), cocaine that may be injected intravenously

Effect of Substance:

Euphoria, risk taking behavior, feeling of confidence, anorexia, inappropriate sexual behavior, tachycardia, tachypnea, nervousness, hypertension, dilated pupil, agitation, fever, inability to concentrate.

Effect of Withdrawal:
Psychosis, delusion, hallucinations, paranoia, depression, ideas of persecution, aggressiveness, tremor, hypervigilance, insomnia, fatigue, muscle pain, nausea, vomiting, general malaise, suicidal ideation

Treatment:
Detoxification
Drugs: antidepressant, antipsychotic
Charcoal to treat ingested cocaine
Behavior therapy
Psychotherapy
Halfway houses
Day or night hospitalization
Twelve-step support groups

Nursing Intervention:
Maintain and ensure the airway and ventilation
Maintain safety
Monitor and assess patient for using of alcohol and benzodiazepine
Control seizure
Treat hyperthermia
Monitor cardiovascular status
Quiet environment
Encourage patient to express fears and anxiety

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