General Principles

  • Cocaine was historically used as a topical vasoconstrictor and local anesthetic.
  • Cocaine is used recreationally by a variety of routes—it may be insufflated, smoked, injected, or taken orally.


  • Cocaine inhibits the reuptake of serotonin, norepinephrine, and dopamine, producing an excitatory or sympathomimetic state.
  • Cocaine is also a local anesthetic with sodium channel antagonist properties and may produce cardiac conduction abnormalities.
  • Cocaine is vasculotoxic, enhances platelet aggregation, and accelerates the development of atherosclerotic disease.1

There's more to see -- the rest of this topic is available only to subscribers.