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Elsie F. Meyers, MD

Arch Ophthalmol. 1980;98(5):842-843.

Abstract
• Toxic effects were observed in two healthy patients who received cocaine intranasally before dacryocystorhinostomy. One patient suffered an additional reaction to intranasally administered phenylephrine (Neo-Synephrine) hydrochloride. Because cocaine blocks uptake of catecholamines and has a sympathetic potentiating effect, its use is dangerous in patients with hypertensive cardiovascular disease or in conjunction with sympathomimetic or -modifying drugs. Use of dilute solutions carefully measured for select patients is mandatory. The total dose of cocaine should not exceed 3 mg/kg.

Author Affiliations
From the Department of Anesthesiology, Washington University School of Medicine, St Louis.

Footnotes
Accepted for publication Aug 31, 1979.

Reprint requests to Department of Anesthesiology, Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110 (Dr Meyers).

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