Cocaethylene—ethanol adding fuel to cocaine’s fire

Alexandra Rapp; Anthony Okorodudu

doi:10.1016/B978-0-12-815846-3.00061-2

Cocaethylene—ethanol adding fuel to cocaine’s fire

Alexandra Rapp, Anthony Okorodudu

Pathology

Research output: Chapter in Book/Report/Conference proceeding › Chapter

Abstract

Cocaethylene is formed by the transesterification of cocaine by liver carboxylesterase in the presence of ethanol and produces a stronger subjective euphoria compared to cocaine. However, animal and human studies have shown a much greater risk of toxicity associated with cocaethylene. Adverse effects of cocaethylene include increased hypertension and systemic vascular resistance, decreased myocardial function, slowed cardiac conduction, arrhythmias, and immunologic compromise. Herein, we present a case of a middle-aged female suffering from severe congestive heart failure and cocaine abuse who was suspected to have cocaethylene as a contributing factor to an acute heart failure exacerbation with pneumonia.

Original language	English (US)
Title of host publication	Toxicology Cases for the Clinical and Forensic Laboratory
Publisher	Elsevier
Pages	265-266
Number of pages	2
ISBN (Electronic)	9780128158463
ISBN (Print)	9780128163733
DOIs	https://doi.org/10.1016/B978-0-12-815846-3.00061-2
State	Published - Jan 1 2020

Keywords

Cocaethylene
arrhythmias
carboxylesterase
cocaine
congestive heart failure
hypertension
transesterification

ASJC Scopus subject areas

General Medicine

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10.1016/B978-0-12-815846-3.00061-2

Cite this

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AB - Cocaethylene is formed by the transesterification of cocaine by liver carboxylesterase in the presence of ethanol and produces a stronger subjective euphoria compared to cocaine. However, animal and human studies have shown a much greater risk of toxicity associated with cocaethylene. Adverse effects of cocaethylene include increased hypertension and systemic vascular resistance, decreased myocardial function, slowed cardiac conduction, arrhythmias, and immunologic compromise. Herein, we present a case of a middle-aged female suffering from severe congestive heart failure and cocaine abuse who was suspected to have cocaethylene as a contributing factor to an acute heart failure exacerbation with pneumonia.

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KW - arrhythmias

KW - carboxylesterase

KW - cocaine

KW - congestive heart failure

KW - hypertension

KW - transesterification

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BT - Toxicology Cases for the Clinical and Forensic Laboratory

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ER -

Cocaethylene—ethanol adding fuel to cocaine’s fire

Abstract

Keywords

ASJC Scopus subject areas

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