Sunday, May 5, 2013

Cocaine and beta blockers: all it's cracked up to be?

This post has been updated, and moved to a new blog at the following URL:


Anusha said...

I'm so happy this post came up on my google search, because it's hard to find any evidence-based commentary of beta blocker use in patients that abuse cocaine. Do you know the place in therapy of beta blockers for rate control in patients with atrial fibrillation and also abuse cocaine? I'm not finding a lot out there, but it sounds like rhythm control might be preferred.

Brent N Reed said...

Hi Anusha,

Thank you for your comment. Regarding atrial fibrillation, I am not aware of any data specifically looking at it in patients who abuse cocaine. Based on their co-morbidities (i.e., no heart failure or prior MI), you may have other options -- non-dihydropyridine calcium channel blockers, for example. I don't know that I would necessarily pursue rhythm control unless the patient remains symptomatic despite maximally-tolerated AV nodal blockade.


Anusha said...

Thank you so much! I was thinking ND CCBs as well, but I wanted to see if you came across anything about beta blockers. It sounds like a lot of the risks of cocaine and beta blocker interactions are anecdotal and theoretical. Thanks for keeping your great blog!