Drug reference

cocaine

DAT Inhibitor · Local anesthetic

DAT InhibitorLocal anesthetic

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

1 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 3 →

AdrenalineSevereTextbookKDT 7e · p57

Mechanism

Acts as an antagonist to block dopamine (DA) reuptake, thereby potentiating DA signaling and increasing extracellular DA.

Indications

Topical anesthetic in eye and nasal surgeries (limited clinical utility)Topical anesthesia of the upper respiratory tractTopical use as local anesthetic in otolaryngology and tear duct surgeryHorner syndrome (diagnosis)intranasal in combination with topical anesthesia for cannulating the nasolacrimal systemOcular anaesthesia (but use not warranted due to side effects)

Pharmacokinetics

Onset

Fast

Half-life

about 50 min (in plasma)

Metabolism

Degraded by esterases in the liver.

Contraindications

Never injected (protoplasmic poison, causes tissue necrosis).

Side effects

Common

addictionstrong reinforcementpsychological dependence (leading to continuous or occasional use)EuphoriaExcitementMental confusionRestlessnessTremor and twitching of musclesConvulsionsUnconsciousnessRespiratory depressionDeath (dose-dependent)Sense of wellbeingDelays fatigueIncreases power of enduranceBradycardia (due to vagal centre stimulation)Rise in BP (due to vasomotor centre stimulation)NauseaVomiting (due to vomiting centre stimulation)Pyrexia (due to temperature regulating centre stimulation and increased muscular activity)Local vasoconstrictionTachycardiaMydriasisConstriction of conjunctival vesselsClouding of corneaSloughing of cornea

Serious

Can worsen psychosis
High toxicity due to reduced catecholamine uptake in both the central and peripheral nervous systems and resulting prolongation of transmitter dwell time in the synaptic cleft
Abuse potential
Strokes
Heart attacks
Cardiac arrhythmias
Myocardial ischemia
Myocarditis
Aortic dissection
Cerebral vasoconstriction
Seizures
Death from traumatic injuries
Premature labor
Abruptio placentae
Psychiatric disorders (anxiety, depression, psychosis)
Tissue necrosis (if injected)