Journal article
beta-Blockers, Cocaine, and the Unopposed -Stimulation Phenomenon
Journal of cardiovascular pharmacology and therapeutics, v 22(3), pp 239-249
01 May 2017
PMID: 28399647
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Cocaine abuse remains a significant worldwide health problem. Patients with cardiovascular toxicity from cocaine abuse frequently present to the emergency department for treatment. These patients may be tachycardic, hypertensive, agitated, and have chest pain. Several pharmacological options exist for treatment of cocaine-induced cardiovascular toxicity. For the past 3 decades, the phenomenon of unopposed -stimulation after -blocker use in cocaine-positive patients has been cited as an absolute contraindication, despite limited and inconsistent clinical evidence. In this review, the authors of the original studies, case reports, and systematic review in which unopposed -stimulation was believed to be a factor investigate the pathophysiology, pharmacology, and published evidence behind the unopposed -stimulation phenomenon. We also investigate other potential explanations for unopposed -stimulation, including the unique and deleterious pharmacologic properties of cocaine in the absence of -blockers. The safety and efficacy of the mixed -/-blockers labetalol and carvedilol are also discussed in relation to unopposed -stimulation.
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Details
- Title
- beta-Blockers, Cocaine, and the Unopposed -Stimulation Phenomenon
- Creators
- John R. Richards - University of California Davis Medical CenterJudd E. Hollander - University of PennsylvaniaEdward A. Ramoska - Drexel UniversityFareed N. Fareed - College Station Medical CenterI. Charles Sand - Medical Research AssociatesMaria Manuela Izquierdo Gomez - Hosp Univ Canarias, Dept Cardiol, Tenerife, SpainRichard A. Lange - Texas Tech University Health Sciences Center
- Publication Details
- Journal of cardiovascular pharmacology and therapeutics, v 22(3), pp 239-249
- Publisher
- Sage
- Number of pages
- 11
- Resource Type
- Journal article
- Language
- English
- Web of Science ID
- WOS:000398836500005
- Scopus ID
- 2-s2.0-85018726377
- Other Identifier
- 991021892107504721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Pharmacology & Pharmacy