title: Pulmonary complications from cocaine and cocaine-based substances: imaging manifestations.
abstract: Cocaine is the illicit drug whose abuse most often results in cardiopulmonary symptoms and emergency treatment. Habitual smoking of alkaloidal cocaine ("freebase," "crack") has replaced nasal insufflation as the most common method of abuse. Smoking of cocaine exposes the lung directly to the volatilized drug as well as to the other combustion products of the smoked mixture, thereby increasing the risk of adverse pulmonary effects. A wide variety of pulmonary complications including interstitial pneumonitis, fibrosis, pulmonary hypertension, alveolar hemorrhage, asthma exacerbation, barotrauma, thermal airway injury, hilar lymphadenopathies, and bullous emphysema may be associated with the inhalation of crack cocaine or of associated substances such as talc, silica, and lactose. Cocaine abuse represents one of the most serious medical and social problems of our time. Radiologists should be familiar with the various pleuropulmonary complications associated with the abuse of illicit drugs in general and of cocaine in particular to ensure correct diagnosis and appropriate treatment planning in patients with respiratory manifestations associated with such abuse.
authors.affiliation: Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7800, San Antonio, TX 78229, USA. RestrepoC@UTHSCSA.edu
authors.forename: Carlos S
authors.initials: CS
authors.lastname: Restrepo
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Carrillo
authors.forename: Santiago
authors.initials: S
authors.lastname: Martínez
authors.forename: Paulina
authors.initials: P
authors.lastname: Ojeda
authors.forename: Aura L
authors.initials: AL
authors.lastname: Rivera
authors.forename: Ami
authors.initials: A
authors.lastname: Hatta
mesh_terms: D003042:Cocaine / Q000506:poisoning; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008168:Lung / Q000187:drug effects; D008171:Lung Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D008297:Male; D011859:Radiography; D012120:Respiration Disorders / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D015813:Substance Abuse Detection / Q000379:methods
chemical_list: D003042:Cocaine