Cocaine toxicity after laryngoscopy in an infant.
Iatrogenic cocaine toxicity was observed in a 5.5-month-old male who received intranasal cocaine as a topical anesthetic for laryngoscopy. He became agitated, diaphoretic, tachycardic, and hypertensive shortly following the procedure. To control his signs and symptoms, he required 3 doses of IV lorazepam. Systemic absorption and toxicity can vary amongst individuals, making it difficult to determine appropriate dosing. The maximum dose of 1 mg/kg in children has not been validated and toxicity may appear at a much lower dose in certain individuals. Pediatric patients receiving topical cocaine as an anesthetic must be given the lowest possible dose, and then carefully monitored for signs of systemic absorption.
Rezvani
Massoud
M
The Hospital for Sick Children, Department of Clinical Pharmacology & Toxicology, Toronto, Canada. massoudrezvani@hotmail.com
Hartfield
Dawn
D
D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D003042:Cocaine / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000188:drug therapy; D007223:Infant; D007828:Laryngoscopy / Q000379:methods; D008140:Lorazepam / Q000627:therapeutic use; D008297:Male; D013610:Tachycardia / Q000139:chemically induced / Q000188:drug therapy
D000779:Anesthetics, Local; D003042:Cocaine; D008140:Lorazepam