The effects of nutrition on plasma cholinesterase activity and cocaine toxicity in mice

Prolonged neuromuscular blockade as a result of malnutrition-induced pseudocholinesterase deficiency

Mivacurium is a short-acting neuromuscular blocking drug, ideal for short surgical procedures. The brief duration of action depends on rapid hydrolysis by plasma cholinesterase. An inherited or acquired deficiency of plasma cholinesterase can prolong the effect of mivacurium. We present an unusual case of unanticipated postoperative apnea following mivacurium administration, as a result of acquired plasma cholinesterase deficiency, in a patient with previous uneventful exposure to both mivacurium and suxamethonium (succinylcholine).

Cardiovascular disorders associated with cocaine use: myths and truths

Cocaine produces a pattern of cardiovascular responses that are associated with apparent myocardial ischemia, arrhythmias, and other life-threatening complications in some individuals. Despite recent efforts to better understand the causes of cocaine-induced cardiovascular dysfunction, there remain a number of unanswered questions regarding the specific mechanisms by which cocaine elicits hemodynamic responses. This review will describe the actions of cocaine on the cardiovascular system and the evidence for the mechanisms by which cocaine elicits hemodynamic and pathologic responses in humans and animals. The emphasis will be on experimental data that provide the basis for our understanding of the mechanisms of cardiovascular toxicity associated with cocaine. More importantly, this review will identify several controversies regarding the causes of cocaine-induced cardiovascular toxicity that as yet are still debated. The evidence supporting these findings will be described. Finally, this review will outline the obvious deficits in our current concepts regarding the cardiovascular actions of cocaine in hope of encouraging additional studies on this grave problem in our society.

Variables influencing the toxic response to organophosphates in humans

Concerns and doubts associated with the predictable health effects in humans following exposure to xenobiotics is primarily due to the failure to consider the variables influencing the toxic response in each instance. Lack of correlation between laboratory data, animal experiments and clinical findings in man associated with exposure to organophosphates (OPs) is an example. We have reviewed the literature to identify the variables that need to be considered following exposure to OPs. These include factors related to the OP (physico-chemical properties, solvents, impurities), duration and routes of exposure, and factors related to the individual(s) exposed. Individual variables include variations in metabolic, sequestration and excretory processes and health status (age, gender, environmental factors, concurrent medications, cholinergic status). The assessment of ill-health following exposure is critical to the development and compliance with guidelines and to the adoption of the best instrumentation. We have suggested a schematic assessment that needs to be applied for each exposure associated with organophosphates and provided the reasons for the development of this format. Exposure to xenobiotics through the environment, occupation or following therapy is an unavoidable aspect of modern life. Application of the principles discussed to each xenobiotic exposure is necessary to provide accurate and adequate information to advance the prevention or minimising toxicity.

Diet influences cocaine withdrawal behaviors in the forced swimming test

The effects of drugs of abuse might depend on several environmental factors, among them the individual's feeding habits. It was our objective to study the influence of the diet on cocaine acute behavioral effects and during the first 5 days of withdrawal after prolonged treatment. Rats were fed a balanced diet, high-protein diet, high-carbohydrate diet or high-fat diet from weaning to adulthood. Adult rats were injected with 15 mg/kg cocaine 24, 5 and 1 h before the forced swimming retest or the drug was administered daily during 15 days and the animals were evaluated in the forced swimming test on five daily occasions after drug withdrawal. Diets alone did not induce significant behavioral differences in locomotion, immobility, swimming, climbing or head shakes. Acute cocaine reduced immobility during the forced swimming test and increased locomotion demonstrating a nonspecific antiimmobility effect related to hyperactivity. Acute cocaine reduced head shakes of rats fed high-protein and high-carbohydrate diets. After cocaine withdrawal, head shakes were decreased for rats fed any of the diets and rats were more immobile if fed a high-fat diet and were less immobile if fed a high-protein or high-carbohydrate diet. In conclusion, differences in the amounts of macronutrients in the diet may cause different behavioral outcomes after acute cocaine and during cocaine withdrawal.