Cocaine-associated cardiotoxicity: a systematic review yields no answers

Christopher Siesarchik/shutterstock.com 3 out of 5 stars Treatment of cocaine cardiovascular toxicity: a systematic review. Richards JR et al. Clin Toxicol 2016 Feb 26 [Epub ahead of print] Abstract This paper is the most frustrating thing I’ve read since I force marched my way through the “Oxen of the Sun” chapter of James Joyce’s Ulysses. I must say that, despite its difficulties, the Joyce selection — with its obstetric setting and drunken medical students — was much more fun. There is considerable controversy among toxicologists, emergency physicians, and cardiologists as to the best agents to use for treating cocaine-associated cardiotoxicity. Benzodiazepines? Beta-blockers? Calcium-channel blockers? Nitroglycerine? An important factor to consider is what manifestation(s) are present — tachycardia? hypertension? chest pain? dysrhythmia> To attempt to address these questions, the authors conducted a systematic review “to determine the current best evidence for treatment of the most commonly encountered adverse cardiovascular effects caused by cocaine toxicity . . .” Unfortunately, few detailed methods are described. It is difficult to make out exactly how the articles were chosen and how they were rated as to level of evidence.  In addition, the authors make virtually no actionable suggestions. After surveying and cataloging 149 papers, their conclusion is unhelpfully vague: Cocaine toxicity can result in tachycardia, dysrhy...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical cardiotoxicity cocaine systematic review Source Type: news