Propranolol: A Specific Antagonist To Sub Acute Cocaine Intoxication

Authors

Richard T. Rappolt Sr., 4104 Geary Blvd., San Francisco, California 94118
Nancy Rappolt, 4104 Geary Blvd., San Francisco, California 94118
Richard T. Rappolt Jr., 4104 Geary Blvd., San Francisco, California 94118
George R. Gay, P.O. Box 1169, Mendocino, California 95460
Darryl S. Inaba, Haight-Ashbury Free Medical Clinics

Date of this Version

1977

Citation

Published in Transactions of the Nebraska Academy of Science, Volume 4 (1977).

Comments

Copyright 1977 by the Authors; used by permission of the NAS

Abstract

In the clinical treatment of over fifty cases of "overdose" with cocaine, the authors have become aware of the strikingly specific antagonistic effects of propranolol HC1 (Inderal^R) on the manifestations of central cardiovascular hypermetabolism.

CASE-REPORT: A

The patient was a 28-year-old, well-developed, Caucasian blue-collar, outdoor, heavy laborer. Past medical history revealed childhood "asthma" and several episodes of childhood "pneumonia." There had been no further history of problems of this nature for over ten years. History of drug habits revealed a rather heavy intake of beer, consisting of from six to twelve bottles per day. When seen at a "rock concert" he reported that he had drunk over six bottles of beer that day, had smoked two "joints," and had just done two amyl nitrite "poppers." He appeared rather giddy, was pale, sweaty, and obviously intoxicated. He was reported to have just snorted several "lines" of "good coke" (translated here as 200 mg. cocaine), after which he became tremulous, nauseous, and faint. When initially seen, his blood pressure was 140/90 mm. Hg; his pulse rate was 130/min., and his respirations, 36/min. He was notably tremulous and anxious at this time. After a further two minutes, he was given 2 mi. of propranolol hydrochloride intravenously. Subsequent blood pressure readings and pulse and respiration rates 2 mi. (2 mgm.) of propranolol hydrochloride intravenously and 80 mgm. p.o. Subsequent blood pressure readings and pulse and respiration rates were:

He reported that he was much more relaxed but was still "high on coke." He was released to the care of his friends. At this time he appeared visibly calm, rational, and in control of his motor and sensory facilities. He was subsequently seen on several occasions in the crowd, dancing to the music, and apparently in need of no further medical intervention.