Re: Cocaine, , Lidocaine, and mag

[Bob Breese <rbreese1@rochester.rr.com>]

Lidocaine, like phenytoin, raises the threshold for seizures.  Cocaine,
while in high concentration in tissues blocks sodium channels - ala
TCA's, the release and accumulation of EAAs in the brain may, in fact
increase the likelihood of sz activity, especially when combined with
EtOH use, as it increases toxic metabolite concentrations.  Cocaine,
also, is an ester, as opposed to lidocaine, which is an amine
(different reaction by the body).  Cocaine widens qrs and prolongs qt,
which would make mag effective in treatment of vent dysrhythmias.  I
have seen no proof that lidocaine is 'bad' for cocaine induced
arrhythmia.
Bob Breese, FP-C


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