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C Snow BlowAKA Coke Flake Often cut with: • Cornstarch • Sugar • Talcum Powder • Procaine (anesthetic) • Baking Soda • Amphetamine (stimulant) Cocaine + Heroin = Speedball Crack: freebase cocaine Refers to crackling sound heard when mixture is smoked
Effect on Adults: Powerful CNS stimulant Effects last 15 minutes to an hour, depending on method of ingestion Increases alertness, feelings of well-being & euphoria, energy & motor activity, feelings of competence & sexuality Athletic performance may be enhanced (attention & endurance)
Schweitzer Case Study• 18 yo Female• 3 yr hx of alcohol & drug abuse• Binged on heroin, benzodiazepine (Xanax), alcohol, and crackInitial audio:•Bilateral, severe SNHL (flat)•Normal tympanometry•Absent ipsi and contra acoustic reflexes•Absent DPOAEs
Ciorba Case Study• 30 yo Female• Heroin addict• Overdose: IV Cocaine12 hrs post: Severe symmetrical SNHL • SRT predictable by pure tone threshold • WRS 0% @ 80dB HL, 40-50% @ 100 dB HL • Wave V detectible at 90dB HL • Tympanometry WNL • DPOAEs absent
Ciorba’s Conclusions Typically, the basal cochlear turn is most damaged by vasospasm. More sensitive to hypoxia.This case showed a flat audiogram initially, equal improvement,and full recovery- suggests equal dysfunction across cochlea and hearing loss is not due to hypoxia as that’s permanent “Perturbation of cochlear homeostasis”Likely caused by “transient disruption of cochlear K+ recycling pathway induced by cocaine”
DPOAEsAbsent OAEs in the presence of normal out/middle ear functionTang, 1996 Shivapuia, 1993Moderate low doses ofcocaine to Chinchillas Newborns of cocaine abusingevery day for 30 days mothers do not have increased incidence of HL and peakLittle or no difference in latencies normalize by one year ofDPOAEs in chronic and life.acute groups
Basically, we don’t knowcocaine’s effect(s) on the cochlea yet.
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