17 / 22
Page 36
Notes:
allied
academies
Archives of General Internal Medicine | Volume 2
&
April 04-05, 2018 | Miami, USA
International Conference on
Internal Medicine & Practice and Primary Care
International Meeting on
Breast Pathology & Cancer Diagnosis
Introduction
: Cocaine abuse causes various complications
including hypertension (HTN), acute coronary syndrome,
Myocardial infarction (MI), stroke, and even death. The
use of β-Blockers (BB) can cause unopposed α-receptor
stimulation, resulting in HTN and coronary vasospasm (CVS).
Methodology
: 5123 patients who presented to our hospital
between 2012-2016 and had Urine Drug Screen positive
for Cocaine (UDS-C) were identified by retrospective chart
review. Inclusion criteria, older than 18 years, UDS-C. The
quality improvement study (QI) got institutional review
board release. Cerebral-cardiovascular diseases (CCVD) were
compared between the exposed and non-exposed group.
MI was detected, either by the rise in troponin with and
without ST-segment elevation (STEMI). Angina was detected
by chest pain without troponin rise. HTN was detected by BP
180/120 or above. The cerebral complication was confined
to non-traumatic brain bleed (NTBB). The use of BB in-home
medication or in the hospital was reported. The Chi square
test χ2 was used for statistical analysis. For the analysis,
p≥0.05 and modified standardized residuals >2 or -2 were
regarded as statistically significant. The analysis was done by
the medical resident using SPSS.
Results
: The use of BB either at home (UBBH) or hospital
was associated with increased risk of CCVD, HTN, angina,
and NSTEMI. Labetalol was found to increase the risk of
HTN. Carvedilol was found to be associated with increased
risk of CCVD and HTN. UBBH was associated with CCVD, HTN,
NSTEMI, STEMI and NTBB.
Discussion
: The use of BB with cocaine increases risk of
CCVD. Previous data showed safe profile with of labetalol;
however, higher association with HTN is shown here.
QI intervention
: Our study starting a power chart
intervention that pop-up when the prescriber orders BB in
a patient who had a UDS-C. Another study to be done to
evaluate the effectiveness of the intervention in decreasing
the above-mentioned complications.
Speaker Biography
Ahmed Elshazly MD has graduated from medical school during 2012. He then was a
research fellow for 2 years at Albert Einstein College of Medicine, Mayo Clinic and West
Virginia University. He is currently pursuing Internal Medicine residency at Atlantic
Care Regional Hospital, Atlantic City, NJ.
e:
aelshazly5@gmail.comQuality improvement study to decrease complications associated with the use of beta blocker with
cocaine
Ahmed Elshazly
Atlantic Care Regional Hospital, USA