E-Pearl of the Week

October 10, 2011


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October 10, 2011

Cocaine and beta blockers

Cocaine abuse is an important cause of neurological disease in some populations. Seizures, psychiatric disorders and cerebrovascular disease are among the most commons clinical presentations. It is important to remember that in patients with hypertension and documented or suspected use of cocaine, beta blockers are not usually recommended due to the unopposed alpha agonist effect in the heart that can lead to coronary vasoconstriction and cardiac ischemia. When indicated, other drugs should be used to treat hypertension.


  1. Buttner, A. Review: The neuropathology of drug abuse. Neuropathol Appl Neurobiol 2011;37:118-134.
  2. Lange RA, Cigarroa RG, Flores ED, et al. Potentiation of cocaine-induced coronary vasoconstriction by beta-adrenergic blockade. Ann Intern Med 1990;112:897-903.

Submitted by: Jose Gutierrez, MD, MPH
Dr. Gutierrez reports no disclosures.

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