Nademanee K
University of Colorado, Denver.
J Addict Dis. 1992;11(4):71-82. doi: 10.1300/J069v11n04_06.
Cocaine exerts a myriad of adverse cardiovascular effects which are dependent on the dose, rate of administration, and duration of use. The drug has two primary pharmacologic actions: it is a powerful sympathomimetic agent and a local anesthetic. The drug blocks the presynaptic reuptake of catecholamines resulting in the marked hormonal increase at the postsynaptic receptor sites. These effects, in turn, lower the threshold for coronary vasoconstriction and vasospasm, myocardial ischemia and infarction. In addition, the drug's multiple pharmacologic and electrophysiologic cardiovascular actions can promote arrhythmias, myocarditis, cardiomyopathy, as well as unmasking subclinical diseases. Long-term cocaine use can cause autonomic disturbances and alter catecholamine homeostasis: chronic cocaine addicts face serious cardiovascular sequelae from the drug's multiple adverse effects. It is important to assess the prevalence of cocaine-related cardiovascular diseases, to understand how the drug affects the autonomic nervous system, and to determine its long-term effects on the cardiovascular system.
可卡因会产生无数不良心血管效应，这些效应取决于剂量、给药速度和使用时长。该药物有两种主要药理作用：它是一种强效拟交感神经剂和局部麻醉剂。该药物会阻断儿茶酚胺的突触前再摄取，导致突触后受体部位的激素显著增加。这些效应进而降低冠状动脉收缩和血管痉挛、心肌缺血和梗死的阈值。此外，该药物的多种药理和电生理心血管作用会促发心律失常、心肌炎、心肌病，以及使亚临床疾病显现出来。长期使用可卡因会导致自主神经紊乱并改变儿茶酚胺稳态：慢性可卡因成瘾者因该药物的多种不良反应面临严重的心血管后遗症。评估可卡因相关心血管疾病的患病率、了解该药物如何影响自主神经系统以及确定其对心血管系统的长期影响很重要。
