Valium for chest pain pt. with recent cocaine use?

jeepmedic

jeepmedic

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Have/Do any of you use Valium for a pt. C/O of chest pain with a recent Hx. of cocaine use? I was reading about it in another Forum and Looked interesting.
 
Yes, Valium is actually the "preferred" medication of choice for "Cocaine" or "crank" AMI's. Remember that an infarct is occurring not because of an thrombus occlusion, rather a coronary vasoconstriction secondary to the drug induce state. Valium is a smooth muscle relaxer and thus relaxes and increases the lumen size. NTG is of beneficial as well, do to the same properties...

I have seen some "Coke" induced AMI's in young healthy people and it is really the craps, because there is nothing much you can do for them.. even a cath lab can't help. ...

R/r 911
 
Ridryder911 said:
I have seen some "Coke" induced AMI's in young healthy people and it is really the craps, because there is nothing much you can do for them.. even a cath lab can't help. ...

R/r 911
Click to expand...

Yeah, I have seen several as well. All you can do is treat with supporting care and hope if anything happens it is a rhythm you can fix, even if just temporarily.

I had a kid in his late teens, that was running from the cops and had eaten a large amount of powder cocaine. Enroute to the hospital, I gave lido and hung a drip and still had to cardiovert him multiple times. He was in and out of V-Tach throughout. I kept him alive until we got to the hospital, but he eventually died. I guess the heart can only take so much.
 
Ridryder911 said:
Yes, Valium is actually the "preferred" medication of choice for "Cocaine" or "crank" AMI's. Remember that an infarct is occurring not because of an thrombus occlusion, rather a coronary vasoconstriction secondary to the drug induce state. Valium is a smooth muscle relaxer and thus relaxes and increases the lumen size. NTG is of beneficial as well, do to the same properties...

I have seen some "Coke" induced AMI's in young healthy people and it is really the craps, because there is nothing much you can do for them.. even a cath lab can't help. ...

R/r 911
Click to expand...
Is it due to the damage of the coronary arteries from the cocaine or crank? what kind of damage happens?
 
I'm interested in some of the the pathophys of it all if someone cares to elaborate. Our cardiac protocol just had this added except with Versed instead of Valium for CP secondary to simpathomimetic abuse.

I figured it's partially for the downer effect of the benzos to counter the speed effect of the crack. I assume the CP can be caused by ischemia from the elevated heart rate and sympathetic reaction; and I suppose tissue damage could occur. This is just something that was not talked about much in school and I'd like to know more.
 
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