Blackwell's Five-Minute Veterinary Consult Clinical Companion. Группа авторов

       Accidental ingestion is unlikely.

       Illicit administration for performance‐enhancing effects in racehorses could occur.

       Inadvertent exposure from by a human abuser or from a contaminated environment is theoretically possible.

       Owners and trainers may be reluctant to admit possession and use.

       In many cases, the source may not be identified.

       Worldwide problem, not just limited to the United States.

       Intentional exposure by direct administration to horse.

       Unintentional exposure by careless placement of product or inadvertent transfer from personnel could theoretically cause detectable concentrations of cocaine or its metabolites to be present in blood and urine samples, but toxic concentrations are unlikely.

       With pharmacologically significant doses:CNS stimulation.Tachycardia.Arrhythmias.Bilateral mydriasis.Increased locomotor activity.

       Many exposures are not pharmacologically significant, although they produce detectable concentrations of cocaine metabolites in urine and blood samples.

       CNS stimulants (amphetamines, methamphetamine).

       High doses of beta2‐adrenergic agonists.

       High doses of caffeine or other methylxanthines.

       BUN, creatinine, and creatine kinase for evidence of rhabdomyolysis

       Immunoassay screening.

       LC‐MS.

       ECG as needed for tachydysrhythmia and cardiac effects.

       None reported in the horses, but from other species, if dose was high enough one would predict:Myocardial necrosis and hemorrhage.Pulmonary hemorrhage.

       Monitor ECG and treat arrhythmias.

       Maintain blood volume, pH, and electrolyte balance.

       Monitor for hyperthermia.

       Avoid CNS stimulation; dark quiet stall if possible.

       IV fluids as needed.

       For excitation:Detomdine 20–40 μg/kg IV.Romifidine 40–120 μg/kg IV.

       Control life‐threatening cardiac arrhythmias:Propranolol 0.02 mg/kg IV slowly, maximum of 1 mg/kg.Esmolol CRI 25–75 μg/kg/min.

       Ethanol potentiates the effects and may increase the risk of toxicity.

       Protection of the head and limbs may be necessary with excitation.

       LC‐MS may be useful in legal cases.

       Prevent exposure to illegal drugs.

       Keep animals away from illegal drugs.

       Educate trainers/riders/grooms of the risk of low‐level contamination.

       Avoid access to illegal drugs.

       Acute fatal toxicity has not been reported. Toxic effects would likely reside within hours.

      1 Kollias‐Baker C, Maxwell L, Stanley S, Boone T. Detection and quantification of cocaine metabolites in urine samples from horses administered cocaine. J Vet Pharmacol Ther. 2003; 26(6):429–434.

      2 Richards JR, Hollander JE, Ramoska EA, et al. β‐Blockers, cocaine, and the unopposed α‐stimulation phenomenon. J Cardiovasc Pharmacol Ther 2017; 22(3):239–249.

      3 Zimmerman JL. Cocaine intoxication. Crit Care Clin 2012; 28(4):517–526.