UMEM Educational Pearls

Category: Toxicology

Title: Non-Cardiac Cocaine Toxicity

Keywords: Cocaine, stroke, crack lung, headache, seizures, hyperthermia, stroke (PubMed Search)

Posted: 1/1/2009 by Ellen Lemkin, MD, PharmD (Updated: 1/18/2022)
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Although we tend to think of ACS with cocaine use, there are many other serious complications, including:

  • Agitation, psychosis, and anxiety
  • Hyperthermia
  • Vascular headache of withdrawal
  • Seizures
  • Hemorrhagic stroke (many of these patients have an underlying vascular abnormality)
  • Ischemic stroke
  • Acute Renal Failure
  • Crack Lung: acute pulmonary syndrome that occurs after inhaling freebase cocaine presents as fever, dyspnea, hypoxemia, diffuse alveolar infiltrates, and respiratory failure
  • Intestinal perforations


1. Glauser J, Queen JR. Non-Cardiac Cocaine Toxicity. JEM Feb 2007;32(2):181-6.