Document Detail

Acute effects of intravenous cocaine on pulmonary artery pressure and cardiac index in habitual crack smokers.
MedLine Citation:
PMID:  8995989     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Some habitual crack cocaine smokers who deny IV drug abuse show decreased pulmonary transfer of carbon monoxide (DCO). We speculated that repeated elevations in pulmonary artery pressure (PAP) might cause pulmonary capillary damage and result in a lowered DCO, or that the reduction could be due to anoxic lung injury secondary to repeated episodes of cocaine-induced pulmonary vascular constriction.
STUDY OBJECTIVE: Compare the acute effects of i.v. cocaine HCl and placebo on PAP, cardiac stroke volume, and cardiac output estimated indirectly by continuous Doppler echocardiography.
DESIGN: A single-blind crossover study in which placebo always preceded the active drug.
SUBJECTS: Ten current crack-smoking subjects, 32 to 47 years of age, with a history of limited previous i.v. cocaine use.
METHODS: PAP, cardiac stroke volume, heart rate, and BP were measured continuously after injection of placebo followed by cocaine HCl (0.5 mg/kg).
RESULTS: i.v. cocaine resulted in no significant change in PAP (-0.14 +/- 3.3[SD] mm Hg, 95% confidence interval [CI] for difference -2.48, +2.21). Stroke volume index showed no significant change after cocaine (-0.1 +/- 2.0 mL; 95% CI, -1.5, +1.3). Heart rate showed a significant increase (10.0 +/- 7.2 min-1; p = 0.0017, 95% CI, +4.9, +15.1). Cardiac index showed a significant increase (0.48 +/- 0.32 L/min; p = 0.0012, 95% CI, +0.25, +0.71). Pulmonary vascular resistance showed no significant change (-44 +/- 101, 95% CI, -116, +29).
CONCLUSIONS: i.v. cocaine HCl does not cause short-term increases in PAP or stroke volume index, but causes an increase in cardiac index due to its chronotropic effect.
E C Kleerup; M Wong; J A Marques-Magallanes; M D Goldman; D P Tashkin
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Chest     Volume:  111     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-02-06     Completed Date:  1997-02-06     Revised Date:  2012-11-30    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  30-5     Citation Subset:  AIM; IM    
Division of Pulmonary and Critical Care Medicine, UCLA School of Medicine 90095-1690, USA.
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MeSH Terms
Cardiac Output / drug effects*
Cocaine / administration & dosage,  pharmacology*
Crack Cocaine*
Cross-Over Studies
Echocardiography, Doppler
Injections, Intravenous
Middle Aged
Opioid-Related Disorders / physiopathology*
Pulmonary Artery / drug effects,  physiology*
Single-Blind Method
Stroke Volume / drug effects
Vascular Resistance / drug effects
Grant Support
Reg. No./Substance:
0/Crack Cocaine; 50-36-2/Cocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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