: The most potent stimulant of natural origin, a bitter addictive anesthetic (pain blocker) which is extracted from the leaves of the coca scrub (Erythroxylon coca) indigenous to the Andean highlands of South America. From the name of the plant came the name cocaine and its street name coke (and Coke as in Coca Cola, which once contained it). Once the American surgeon William S. Halstead (1852-1922) had injected cocaine into nerve trunks and showed it numbed feeling, cocaine came into use as an anesthetic agent. It was first employed as a spinal anesthetic in 1898 by the German surgeon August Bier. Soon thereafter the addictiveness of cocaine was discovered. Safer anesthetics were developed in the 20th century and cocaine fell into disuse in medicine as a pain blocker. Tragically, cocaine continues in use as a highly addictive and destructive street drug, an inadvertent contribution by medicine to the contemporary drug culture. Illicit cocaine is usually distributed as a white crystalline powder or as an off-white chunky material. Cocaine base is converted into the powder form, which is usually cocaine hydrochloride, by diluting it with other substances. The substances most commonly used in this process are sugars, such as lactose, inositol, and mannitol, and local anesthetics, such as lidocaine. The adulteration of cocaine increases its volume and thus multiplies profits. The major routes of administration of cocaine are snorting, injecting, and smoking (including freebase and crack cocaine). Snorting is inhaling cocaine powder through the nose where it is absorbed into the bloodstream through the nasal tissues. Injecting is using a needle to release the drug directly into the bloodstream. Smoking involves inhaling cocaine vapor or smoke into the lungs, where it is absorbed into the bloodstream as quickly as when it is injected. "Crack" is the street name given to cocaine that has been processed from cocaine hydrochloride to a ready-to-use free base for smoking. Rather than requiring the more volatile method of processing cocaine using ether, crack cocaine is processed with ammonia or sodium bicarbonate (baking soda) and water and heated to remove the hydrochloride, thus producing a form of cocaine that can be smoked. The term "crack" refers to the crackling sound heard when the mixture is heated, presumably from the sodium bicarbonate. On the illicit market, crack, or "rock," is sold in small, inexpensive dosage units. Smoking this form of the drug delivers large quantities of cocaine to the lungs, producing effects comparable to intravenous injection. These effects are felt almost immediately after smoking, are very intense, and do not last long. There is great risk associated with cocaine use whether the drug is ingested by snorting, injecting, or smoking. Excessive doses of cocaine may lead to seizures and death from respiratory failure, stroke, cerebral hemorrhage (bleeding into the brain), or heart failure.
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C17H21NO4; Benzoylmethylecgonine; a crystalline alkaloid obtained from the leaves of Erythroxylon coca (family Erythroxylaceae) and other species of Erythroxylon, or by synthesis from ecgonine or its derivatives; a potent central nervous system stimulant, vasoconstrictor, and topical anesthetic, widely abused as a euphoriant and associated with the risk of severe adverse physical and mental effects.The coca bush is indigenous to Bolivia and Peru, where for centuries natives have chewed its leaves along with limestone pellets or plant ashes in order to withstand hunger, thirst, and fatigue. During the 19th century c. was widely used in medicine as a stimulant, antidepressant, and topical anesthetic, but because of its strong potential for inducing dependency it is no longer administered systemically. Its popularity as a recreational drug waned slightly after amphetamines became available in the 1920s but returned in the 1960s. C. is generally sold on the street as the hydrochloride salt, a fine white powder known as “coke,” “C,” “snow,” “flake,” or “blow.” Street dealers cut or adulterate it with inert substances such as cornstarch, talcum powder, and sugar, or with active drugs such as procaine and benzocaine. In powder form it is usually “snorted” into the nostrils, although it may also be absorbed through the buccal, vaginal, or rectal mucosa or injected. A smokable form of c. can be prepared from the hydrochloride by a process called “free-basing.” Production of pure free-base c. is hazardous because it employs highly flammable solvents. The drug commonly called “crack” is a crude form of free base prepared from c. hydrochloride with ammonia or sodium bicarbonate and water. The hardened product of this process is cracked into irregular fragments called “rock,” “ready rock,” “french fries,” or “teeth.” Street use of crack exploded upon its introduction in the 1980s, causing increases in emergency department admissions for c. overdose, drug-related deaths, and births of c.-dependent babies. Administration of c. quickly produces intense euphoria, accompanied by a sense of increased energy, alertness, and self-confidence and diminished need for food and sleep. Pulse, blood pressure, and respiratory rate are increased. Higher doses can lead to bizarre or violent behavior, paranoia, chest pain, tremors, seizures, coma, and death due to coronary artery spasm or respiratory arrest. Smoked crack c. reaches the brain more quickly than snorted c.. The effects of either form wear off in less than 30 minutes, to be succeeded by profound depression, irritability, and fatigue (“coke crash”). Prolonged use of c. leads to chronic symptoms including restlessness, irritability, depression, insomnia, and a reversible psychosis characterized by paranoia, hallucinations, and delusions. Repeated snorting of c. causes rhinitis, which can culminate in perforation of the nasal septum. C. is not truly addictive because tolerance does not develop; in fact, some regular users note increasing sensitivity to its physical and psychologic effects. But psychological dependency can develop in less than 2 weeks. Withdrawal is associated with intense craving for another dose; sustained abstinence may lead to anxiety, depression, and disorders of appetite and sleep.
- crack c. a derivative of c., usually smoked, resulting in a brief, intense high. Crack is relatively inexpensive and extremely addictive. See street drug.
- c. hydrochloride a water-soluble salt used for local anesthesia of the eye or mucous membranes.

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co·caine kō-'kān, 'kō-. n a bitter crystalline alkaloid C17H21NO4 obtained from coca leaves that is used medically esp. in the form of its hydrochloride C17H21NO4·HCl as a topical anesthetic and illicitly for its euphoric effects and that may result in a compulsive psychological need

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an alkaloid that is derived from the leaves of the coca plant (Erythroxylon coca) or prepared synthetically and is sometimes used as a local anaesthetic in eye, ear, nose, and throat surgery. It constricts the small blood vessels at the site of application and therefore need not be given with adrenaline. Since it causes feelings of exhilaration and may lead to psychological dependence, cocaine has largely been replaced by safer anaesthetics.

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co·caine (ko-kānґ) [USP] a crystalline alkaloid, obtained from leaves of Erythroxylon coca (coca leaves) and other Erythroxylon species, or by synthesis from ecgonine or its derivatives; used as a local anesthetic and vasoconstrictor applied topically to mucous membranes. Abuse of cocaine or its salts leads to dependence.

Medical dictionary. 2011.

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