Question 1: What effect does acute vs. chronic cocaine use have on heart disease? Cocaine is an addictive drug derived from the leaves of the coca plant. It is a strong stimulant mostly used as a recreational drug. Cocaine is commonly snorted, inhaled, or injected into the veins. It is one of the most widespread drugs in the United States. It is readily absorbed through the body’s mucous membranes. The onset of the action depends on the route of administration, which can take between three seconds to five minutes. Peak effects also depend on the route of administration which can take between one to twenty minutes or five to ninety minutes. Cocaine has a half-life of thirty to sixty minutes. Approximately 25-30 million Americans use cocaine …show more content…
and an average of six million people use the drug on a regular basis. Numerous case studies show the relationship between using cocaine and cardiac illness (8). An average of 10% of emergency department visits in the United States were due to cocaine use. Chest pain is the most common cocaine related medical problem, admitting more than 57% people to the hospital. Cardiotoxic effects due to cocaine are unpredictable in individuals. At times it is hard to determine the effects of cocaine in humans because of various impurities of cocaine used among people, different routes of administration, different doses, and underlying risk factors. There are many cardiovascular diseases associated with cocaine use such as: acute myocardial ischemia and infarction, arrhythmias and sudden death, contraction bands, myocarditis, cardiomyopathy, hypertension, cerebrovascular aneurysm, and accelerated atherosclerosis (9). There are two primary pharmacological properties of cocaine that affect the heart and vascular system. First it blocks the reuptake of catecholamines, including norepinephrine and dopamine at the presynaptic level in the central and peripheral nervous systems. It increases the release of catecholamines from antral and peripheral stores. Cocaine increases serum catecholamine levels in patients with cocaine cardiotoxicity. An excess catecholamine accumulation at the postsynaptic receptor sites results in sympathomimetic stimulation of the central nervous system and of the heart muscle and the vascular smooth muscle. Increased levels of norepinephrine in the vascular smooth muscle result in stimulation of postsynaptic alpha receptors. The second pharmacological property of cocaine the affects the heart is its local anesthetic effect. Cocaine blocks fast sodium channels in the myocardium, resulting in a depression of depolarization and a slowing of conduction velocity. Cocaine prolongs the refractoriness of atrial and ventricular muscle. Effects of cocaine cardiotoxicity can be related to an increase in the sympathetic output and reduction in sodium transport. Studies show acute administration of cocaine to human’s increase heart rate and/or blood pressure. Cocaine given intravenously causes a dose-related increase in heart rate and blood pressure. Single doses of cocaine, 4 mg, has no effect on heart rate. While 8 mg increases heart rate by 21%, 16 and 32 mg increases heart rate at 32% and 34% respectively. Controlled studies in humans showed that cocaine causes an increase in heart rate and blood pressure while reducing coronary caliber and coronary sinus flow and increasing coronary resistance. Studies examined effects of chronic cocaine administration in animals. Animals given cocaine, or its metabolite norcocaine, revealed addictive behaviors. Rabbits fed a high-cholesterol diet and cocaine developed accelerated atherosclerosis. Chronic cocaine use may damage the endothelium, which may lead to acceleration of atherosclerosis (1). Question 2: What is the purpose of endoscopic staining test? Endoscopy is a surgical procedure where surgeons use special instruments to view and operate on internal organs and vessels of the body.
It allows surgeons to view problems within the body without making large incisions. An endoscope is inserted through a small cut, or opening. An endoscope is a flexible tube with a camera attached to it to allow the surgeon to see internal organs. Scissors or tongs can be added to the endoscope to operate or remove tissue. Endoscopy has a lower risk of bleeding and infection than open surgery. It can come with rare complications such as: fever, damage to internal organs, and chest pain. The risks depend on the location of the procedure and the overall condition of the patient. Endoscopies fall into categories based on where they are located on the body (5). Upper gastrointestinal endoscopy, UGI, is a procedure that allows surgeons to look at the inside lining of the esophagus, stomach, and duodenum. The tip of the endoscope is inserted through the mouth and moved down the throat into the esophagus, stomach, and duodenum. An UGI may be performed to find: inflammation of the esophagus, ulcers, cancer, hiatal hernia, or a narrowing of the esophagus. It may be done in a doctor’s office, clinic, or hospital …show more content…
(6). UGI can be performed in all types of patients, including pediatrics. Often infants born prematurely undergo UGI endoscopy procedures with smaller endoscopes. Though endoscopy can be performed on children, it is contraindicated in children with unstable airways, cardiovascular collapse, intestinal perforation, or peritonitis. Flexible fiber optic endoscopy was introduced to pediatrics in the 1970s. Endoscopy was initially used only for diagnostic study in children. Dyspepsia, UGI bleeding, and abdominal pain are the most common indications for diagnostic UGI endoscopy in pediatric surgical practices. It is not necessary for all children with dyspeptic symptoms to receive endoscopic treatment. UGI strictures are generally located at the esophageal level in children. Esophageal strictures in children may be caused by congenital anomaly, foreign body ingestion, or be secondary to gastroesophageal reflux, or esophageal surgery. Endoscopy is performed under general anesthesia with tracheal intubation. During this time focus is on the narrowed esophagus or pylorus. Sedation and general anesthesia facilitate endoscopic procedures and decrease the emotional stress from separation from parents, analgesia, and amnesia. Detailed examination is recommended to choose the right anesthetic modality and to reduce complications, the endoscopist and anesthesiologist should make this decision together. Moderate sedation is preferred for children. UGI endoscopy are generally safe interventions in experienced hands. The complication rates are usually less than 3% and decrease as a person gets older. Most complications related to the procedure are minor, they are divided into two groups. The first group is associated to anesthesia such as delayed extubation, bronchospasm, and fever. The second group are complications associated with endoscopy and related procedures. Following the procedure some patients may encounter UGI hemorrhage and duodenal hermatoma. Overall complications in upper gastrointestinal endoscopy procedure is minimal and can be prevented (10). Question 3: What are the benefits of using lidocaine plus adrenaline on patients during surgery? Sedation during surgery is the most important factor in surgical operations. For the past two decades’ anesthesiologists have been trying to identify combinations of medicines to improve the quality and level of anesthesia and sedation during and after an operation. They have also been trying to identify ways to reduce dosage of administered medicines and lowering adverse side effects (4). Anesthesiologists often add epinephrine, also known as adrenaline, to lidocaine to reduce the local anesthesia, LA, plasma concentration, which minimizes the possibility of systemic toxicity. Secondly it enhances the quality and prolongs the duration of peripheral nerve block. This makes it possible for the surgeon to work without interruptions, as well as perform the surgery with lower doses of sedatives, and facilitates certain surgical procedures. Lidocaine, commonly referred to as xylocaine and lignocaine, is used to cause numbness or loss of feeling in an area of a person’s body. It is usually given before and during surgery, childbirth, or dental work. Adrenaline is a medication, hormone, and neurotransmitter that can be used for cardiac arrest, anaphylaxis, and superficial bleeding. Lidocaine is available in various forms such as: injection, cream, gel, and spray. It also comes in numerous concentrations. Adrenaline mediates contraction of the vascular smooth muscle, reduces blood flow, and slows clearance of lidocaine from the nerve by stimulating alpha adrenergic receptors on the neural vasculature (2). Epinephrine and lidocaine are considered connected because they are often combined in an injection form to treat pain that might occur during local medical procedures including stitching a wound or removing a growth. Medical professionals often use the combination of the drugs because they are effective together. Though they are combined, come people may react negatively to one or both of the drugs used in this injection. There are some disadvantages of combining epinephrine and lidocaine; some patients have allergic reactions to lidocaine. Lidocaine and epinephrine are not usually used in patients with thyroid disease, or disease of the kidneys or liver (9). Lidocaine and adrenaline is commonly used in dentistry.
Dentist believe the use of epinephrine is contraindicated in cardiovascular patients because it raises the blood pressure and heart rate. Studies show that the amount of epinephrine in dental cartridges is relatively low, therefore the use of one to three cartridges of lidocaine and epinephrine is safe, though it slightly raises blood pressure and heart rate. The slight rise in heart rate and blood pressure is not clinically or medically important. The wrong volume or concentration of anesthetic solution may produce systemic complications. A study given at Khorasgen Dental School determined that injection of lidocaine without epinephrine caused a reduction of blood pressure and heart rate due to the vasodilative effect of lidocaine. An increase in blood pressure and heart rate after injection of lidocaine with epinephrine was a result as well. Researchers have proved that an increase in cardiovascular parameters after injection of local anesthetics can be due to epinephrine
(8).
The Cocaine Kids and Dorm Room Dealers are two very different, but yet similar books. Cocaine Kids are about a group of kids, primarily of Hispanic race, with one kid of the Black race. The kids were raised in the inner city of New York. Dorm Room Dealers are about White, middle to upper-middle class college students, who was selling drugs for their status. The purpose of this paper is to prove that there are racial disparities among drug users. There will be examples from the texts that show the different takes on the drug markets and how race plays a factor. There also will be how these experiences shape the kids drug dealing and using. The paper will conclude how all the kids either remained in the drug career or left the drug career.
In Less Than Zero, cocaine addiction tests a group of three friends against the backdrop of glamorous, 1980’s Los Angeles. I chose this film because I’ve read the novel by Bret Easton Ellis. While the movie differs quite a bit from the book, it still touches on some key points about drug use that Ellis speaks to in the novel. At the beginning of the film, Clay, Julian, and Blair have graduated high school in Beverly Hills. Clay chooses to leave and attend a prestigious university. Blair (Clay’s girlfriend) stays in Los Angeles because she is too afraid to go to school. Julian’s father gives him a large sum of money to start his own recording studio. By Thanksgiving, Clay returns to Los Angeles to find Julian and Blair sleeping together. At
Cocaine is a classified ‘Schedule II’ drug, also known as “crack”, and “coke” it is a powerful drug, and addictive stimulant well known as a psychoactive substance. That comes from a plant called coca leaf that has been around since the mid-1800s and throughout the 20th century. “In the mid-1980s, addiction to the drug was seen as exaggerated or dismissed as psychological and not addiction” (Miller, Gold, Smith, 1997, p.62). In the past, cocaine’s original use was for medical purposes as local anesthetic for surgeries. Now its usage is illegal and this drug is immersed into the body through various ways. However,...
“The first time cocaine is used it may make the heart beat faster leading to a feeling of excitement and fear” (qtd. in Carroll, 1994, p.24). Followed by euphoria, these feelings can peak within five seconds. The user then begins to feel more energetic and becomes more sociable (Carroll, 1994). One inhalation will produce a high usually lasting 10-15 minutes. After this zenith of intense sensation, “…the drug wears off, these temporary sensations of mastery are replaced by an intense depression, and the drug abuser will then "crash", becoming lethargic and typically sleeping for several days” (qtd. in Narconon, 2001). There are several different ways to use crack. It can be snorted, smoked, or taken intravenously. It can also be taken orally (chewed), but this method is not preferred because of the low intensity of the high. The two most popular ways of using crack are smoking and IV usage. These two methods are most favored because they give the most intense sensations.
Krishnakumar, S., & Tambe, P. (2009). Entry complications in laparoscopic surgery. Journal of Gynecological Endoscopy and Surgery, 1(1). http://dx.doi.org/10.4103/0974-1216.51900
Clayton, R. R. (1996). Cocaine use in the United States: In a blizzard or just being snowed. Cocaine Use in America: Epidemiologic and Clinical Perspectives. National Institute on Drug Abuse Research Monograph, 61, 8-34.
...imply as a stimulant. Therefore, although cocaine is a stronger stimulant than regular coca, native Andean people prefer to use coca because of its cultural associations, history of use before European interactions and its various other medicinal purposes. In addition, native Andeans are more likely to use coca than cocaine because it is grown close to home and requires less processing. Although European influence existed in the development of cocaine, the people of Latin America were able to maintain the identity of the coca leaf in face of this external influence.
Patients feel fear not so much from the actual pain but from the lack of control that they feel lying in a dental chair. That creates a lot of anxiousness in some patients, as they don’t feel helpless. Most dentists continue treating all patients in a similarly assuming that they all have similar pain level and will handle the procedure in the same way. Dentists should be mindful of their patient’s level of tolerance and make them aware of the entire procedure ahead of time so that they are able to handle the unexpected situations. They should take time to ensure that the patient feels comfortable at every step. Use of medications and wide array of techniques can help patients eliminate pain and anxiety and making dental visits a pleasant experi...
When a person takes cocaine, it causes a rush. There is between one or two minutes of intense pleasure. This is followed by five to 8 minutes of euphoria, then as the high comes down, an overwhelming urge for more, which may last for a day. (3) When a user is between cocaine doses or halts usage, the opposite effects occur. The user is depressed and tired (2).
In the 1970s, cocaine was expensive and considered a "status" drug. The introduction of inexpensive crack increased the accessibility of this substance, and crack has become the drug of choice for many users, especially for inner...
Pure cocaine is the product of the Erythroxylon coca bush, which is mostly found in South America (NIDA, 2014). In South America the consumption of the coca leaf have been recorded as far back as 3000 B.C. (Warner EA, 1993). The coca leafs only contain about two percent of cocaine and in this form there is few instances of abuse. The rate at which it is absorbed is slow in the digestive system and very little cocaine reaches the bloodstream. When the Spaniards came to the Inca civilization in 1532 the drug allowed the locals to endure a harsh and physically demanding life in the Andes. It was seen as a gift from the god Inti (Inciardi, 2002, pg. 49). Even today those natives of the region chew the coca leaves.
cocaine is by far one of the most addicting drugs out there, it's been engulfing
The use of cocaine in the United States has declined over the last twenty years while the use of crack has increased. Many people avoided the use of crack because of the harmful chemicals used in creating the drug. One of the reasons why crack became popular is because of not needing to inject the drug hence less risks of being infected by the AIDS virus. Carroll (2000) states cocaine is the most powerful stimulant of natural origin. Most users snort or inject the drug to enable a quicker “high.” Cocaine use brings on many health problems. Fatal complications occur from regular use, for example, liver damage, seizures, elevated blood pressure causing stroke, heart failure, or heart attack.
Upper endoscopy, also termed as the EGD, is the examination of the person’s upper gastrointestinal tract with the use of a flexible, long, and thin scope. The thin scope contains a camera at its tip that allows the doctor to look inside the esophagus, stomach, and the duodenum of the patient. With little or no discomfort to the person undergoing the examination, this medical procedure allows the physician to clearly see the parts of the patient’s upper gastrointestinal tract. Why Upper endoscopy is Done If you are wondering why Upper endoscopy is done, the reason is that it will help the doctor to diagnose and even treat conditions affecting the upper part of the digestive system, such as the stomach, duodenum or the beginning of the small intestine, and the esophagus.
Cocaine is a dangerous drug that acts as a stimulant on the brain (National Institute on Drug Abuse, 2013). It is derived from the leaves of the South American coca plant and can be found as a powder, or be produced as a rock crystal, also known as crack. Cocaine is injected or snorted and produces a high that is euphoric, and the individual has increased energy and becomes very talkative (NIDA, 2013). Because cocaine is a stimulant, it increases blood pressure, heart rate, and body temperature (NIDA, 2013). In the brain, cocaine causes dopamine to build up between synapses (NIDA, 2013). Therefore, there is not reuptake and the dopamine increases, creating this intense euphoria (NIDA, 2013). Cocaine carries a high risk of addiction, since tolerance continually increases. Heart attack, stroke, and malnourishment are other side effects (Ackerman, 2014). The emotional effects include paranoia, anxiety, and irritability (Ackerman, 2014). Cocaine is potent substance, and the effects on a pregnancy can be devastating. It is not known what amount creates the danger or birth defects, but cocaine has an effect on weight, length, premature labor, miscarriage in utero, and more effects are common after the birth and throughout the child's growth (Ackerman, 2014).