Cocaethylene causes dose-dependent reductions in cardiac function in anesthetized dogs

Journal of Cardiovascular Pharmacology
L D WilsonS Earl

Abstract

Twelve million Americans abuse both cocaine and ethanol each year because this drug combination produces a pronounced and prolonged euphoria. However, these substances in combination are substantially more toxic than either drug alone. This toxicity may be due to cocaethylene, which has been detected in the serum of patients who have used cocaine and ethanol and two require emergency treatment. Cocaethylene is a pharmacologically active cocaine metabolite formed in the liver only in the presence of ethanol. To investigate the cardiovascular effects of cocaethylene, we randomized 15 mongrel dogs to receive 11.25 mg/kg (n = 4), 7.5 mg/kg (n = 6), or 3.75 mg/kg (n = 5) of cocaethylene as an intravenous (i.v.) bolus. These doses were chosen to achieve serum concentrations of cocaethylene consistent with those observed in patients with cocaine and ethanol toxicity. The ECG and the femoral arterial, left ventricular (LV), and pulmonary artery pressure were measured continuously, and cardiac output (CO) and serum levels of cocaethylene were monitored at specific intervals before and after drug administration. The maximal rate of increase and decrease in LV pressure (LVP), i.e., (dP/dt)max and (dP/dt)min, were determined as our indexes...Continue Reading

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