CHEST SEEK® Author Commentary (7 New Flashcards! June 2026)-Cocaine Intoxication - Commentary From Alexander S. Niven, MD, FCC{

Cocaine Intoxication - Commentary From Alexander S. Niven, MD, FCC{

Video Transcription

Video Summary

A 54-year-old man with alcohol abuse presented after a self-limited seizure and showed signs of a sympathomimetic toxidrome: tachycardia, hypertension, dilated pupils, and ST elevation on ECG. The key concern was cocaine toxicity. Management should focus on systematic overdose evaluation, then treatment with lorazepam as first-line therapy. Benzodiazepines help prevent further seizures, reduce sympathetic overactivity, and improve chest pain and vasoconstriction. Nitroglycerin or calcium channel blockers may be added if needed. Beta blockers are traditionally avoided due to concern for unopposed alpha effects, though this is debated.

Asset Caption

This question is found in the Pharmacology and Toxicology module in the Critical Care Medicine Collection.

Keywords

cocaine toxicity

sympathomimetic toxidrome

lorazepam

benzodiazepines

ST elevation