- Paste (1-4%)
- As a part of Moffatt's solution:
- 2ml 8% cocaine
- 2ml 1% sodium bicarbonate
- 1ml 1:1,000 adrenaline
Cocaine
Cocaine
- Cocaine is an ester-linked local anaesthetic derived from Erythroxylon coca
- It is used for topical anaesthesia and local vasoconstriction, but also as a drug of abuse
- Blocks Uptake 1 and MAO
- This stimulates the sympathetic nervous system, leading to hypertension, tachycardia and hyperthermia
- Side-effects include:
- Tachyarrhythmia
- Coronary artery vasospasm, increasing risk of myocardial infarction
- Confusion
- Seizures
- Hallucinations
Absorption
- pKa 8.6
- 5% unionised at physiological pH
- Well absorbed from mucous membranes
Distribution
- 95% protein bound
- Is the archetypal LA off which all other LA potencies and lipid solubilites are based
Metabolism
- Exclusively hepatic by hydrolysis to inactive metabolites that are excreted in the urine
Excretion
- Elimination half-life 80mins