Cite this post as:
Scott Weingart, MD FCCM. EMCrit Wee – The Great Beta-Blocker for Cocaine Toxicity Slugfest. EMCrit Blog. Published on July 22, 2018. Accessed on March 28th 2024. Available at [https://emcrit.org/emcrit/beta-blocker-for-cocaine-toxicity/ ].
Financial Disclosures:
Dr. Scott Weingart, Course Director, reports no relevant financial relationships with ineligible companies.
This episode’s speaker(s), (listed above), report no relevant financial relationships with ineligible companies.
CME Review
Original Release: July 22, 2018
Date of Most Recent Review: Jan 1, 2022
Termination Date: Jan 1, 2025
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I am seeking clarification on the basic physiologic processes that hopefully are what underpin the cocaine vs beta blocker debate. Personally I have never understood the rationale behind the fear of “unopposed alpha”. I would like to think this is due to my own lack of understanding about the endogenous adrengergic system. The linchpin question that needs to be clarified is: Does beta agonism yield alpha antagonism? If yes, might someone please expound on this for me. If no, then I see no logical connection between beta blockade and a harm potential with alpha agonism. As an example: if a… Read more »
Gabriel, your phrasing leads to more problems then it solves and may lead some to not want to answer. The linchpin ? within your comment is not the one you listed–the linchpin ? is simply if a patient is on beta-blockers, why is ok to give phenylephrine and not ok to give cocaine. Now that is a great ? that gets at the heart of the issue. The answer is that we believe that phenylephrine doesn’t cause coronary vasoconstriction, while we believe that cocaine does. If this is true that cocaine does indeed cause coronary vasoconstriction the next ? is… Read more »