cocaine hydrochloride

cocaine hydrochloride,

a white crystalline powder used as a local anesthetic. It was originally derived from coca leaves but can also be prepared synthetically. Cocaine is a Schedule I drug under the Controlled Substances Act of 1970.

indications In solution it is sometimes used as a topical anesthetic applied to mucous membranes. Its vasoconstrictive action slows bleeding and limits absorption. Prolonged or frequent use may damage the mucous membranes.

contraindications It is incompatible with all alkaloid precipitants, mercurials, and silver nitrate. Central nervous system overstimulation may result from use with monoamine oxidase inhibitors, amphetamines, or guanethidine. Combination with epinephrine or norepinephrine can lead to cardiac arrhythmias or ventricular fibrillation. Persons with severe cardiovascular disease, thyrotoxicosis, hypotension, or hypertension should not take this drug.

adverse reactions Among the most serious adverse reactions are excitement, depression, euphoria, restlessness, tremors, vertigo, nausea, vomiting, hypotension, hypertension, abdominal cramps, exophthalmia, mydriasis, peripheral vascular collapse, tachypnea, tachycardia, chills, fever, coma, and death from respiratory failure.

note Cocaine hydrochloride solution should be freshly made; it deteriorates rapidly on standing and cannot be heat-sterilized.