Cocaine & Ecstasy Poisoning

Key points

• Cocaine: blocks noradrenaline/dopamine/serotonin reuptake → tachycardia, hypertension, hyperthermia, agitation, chest pain; avoid beta-blockers alone (unopposed alpha).
• Cocaine chest pain: benzodiazepines + GTN; manage MI per protocol.
• Ecstasy (MDMA): serotonin syndrome features + hyponatraemia (SIADH + water intoxication), hyperthermia, DIC.
• MDMA hyperthermia → dantrolene may be used; check sodium urgently in collapsed ecstasy users.

Decision points in this pathway

• MDMA hyperthermia?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.