RT Book, Section A1 Hoffman, Robert S. A1 Howland, Mary Ann A1 Lewin, Neal A. A1 Nelson, Lewis S. A1 Goldfrank, Lewis R. SR Print(0) ID 1103621962 T1 Epigraph T2 Goldfrank's Toxicologic Emergencies, 10e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071801843 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1103621962 RD 2024/03/29 AB Erythroxylum coca, the source of cocaine, is renowned in toxicology and medicine for its ritual use by ancient cultures, traditional use by modern indigenous peoples, role as the first pharmaceutical local anesthetic, and notorious use as an illicit drug of abuse. The molecule benzoylmethylecgonine (cocaine) highlights the complex structure of a plant alkaloid. At the cellular level, cocaine is a remarkable drug that blocks the reuptake of neurotransmitters (dopamine, norepinephrine, epinephrine, and serotonin), blocks neuronal and cardiac sodium channels, and causes vasoconstriction. The cardiotoxic effects are demonstrated on the electrocardiogram, which shows a classic ST segment anterior wall myocardial infarction in a young person who recently used cocaine. Although a true antidote to cocaine toxicity has yet to be developed, the vial represents the benzodiazepines, which have become the mainstay of therapy for psychomotor agitation that results from typical cocaine overdose.