title: Cocaine toxicity during dacryocystorhinostomy.
abstract: Toxic effects were observed in two healthy patients who received cocaine intranasally before dacryocystorhinostomy. One patient suffered an additional reaction to intranasally administered phenylephrine (Neo-Synephrine) hydrochloride. Because cocaine blocks uptake of catecholamines and has a sympathetic potentiating effect, its use is dangerous in patients with hypertensive cardiovascular disease or in conjunction with sympathomimetic or alpha-modifying drugs. Use of dilute solutions carefully measured for select patients is mandatory. The total dose of cocaine should not exceed 3 mg/kg.
mesh_terms: D000287:Administration, Topical; D000328:Adult; D002648:Child; D003042:Cocaine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D007765:Lacrimal Apparatus / Q000601:surgery*; D008297:Male; D009296:Nasal Cavity / Q000601:surgery*; D010656:Phenylephrine / Q000009:adverse effects; D013610:Tachycardia / Q000139:chemically induced
chemical_list: D010656:Phenylephrine; D003042:Cocaine