Cocaine Toxicity


Natural alkaloid derived from the coca shrub; occasionally still used medicinally as an ester-type topical anesthetic and local vasoconstrictor.
Timing and duration of symptoms vary with preparation.
 
Route of Exposure Onset of Action Peak Action Duration of Action
IV <1 min 3-5 min 30-60 min
Nasal insufflation (snorting) 1-5 min 20-30 min 60-120 min
Inhalation (smoking) <1 min 3-5 min 30-60 min
GI 30-60 min 60-90 min Unknown


Cocaine alkaloid (“crack, free base”) is heat stable and is usually smoked.
Cocaine hydrochloride cannot be smoked, but is water soluble and may be snorted or injected.

Mechanism/Toxicity

Pathophysiology

Symptoms

Physical Exam

Diagnostic testing

Treatment

Complications

Disposition