KOKAIN ILE İLIŞKILI PATOLOJILER

Year 2021, Volume: 5 Issue: 1, 16 - 24, 31.03.2021

Mustafa Akan Hatice Birgül Cumurcu

https://doi.org/10.5455/car.105-1632808119

Abstract

Hızlıca bağımlılık geliştirebilen uyarıcı bir madde olan
kokainin, Avrupa’ da ve Türkiye’ de kullanımı giderek artmaktadır. Kokain kullanımı bireyde psikiyatrik ve fiziksel
hastalıklara neden olmakla birlikte, toplumsal ve yasal
sorunlara da neden olabilir. Kokain bağımlılığının etyolojisinde genetik, sosyokültürel ve farmakolojik etkenler,
öğrenme ve koşullanma ile ilgili bazı faktörler önemli yer
tutar. Kokain, psikoaktif ve bağımlılık yaratan etkilerini,
zevk alma ve motivasyonu düzenleyen beyindeki limbik
sistem üzerinden gerçekleştirir. Limbik sistemin bir parçası olan nükleus akkumbens, kokain etkisine aracılık eden
en önemli bölgedir. Kokain kullanımı sıklıkla diğer psikiyatrik hastalıklarla birlikte görülebilir, ayrıca başta santral
sinir sistemi olmak üzere diğer sistem organlarını etkileyerek hasara neden olabilir. Bu yazıda, kokainin nörokimyasal etkileri, ilişkili psikiyatrik/fiziksel hastalıklar ve tedavi
seçenekleri güncel bilgiler ışığında sunulmuştur

Keywords

Bağımlılık, kokain, limbik sistem, nükleus akkumbens, dopamin.

References

• 1. Ögel K. Bağımlılık Yapan Maddeler. In: Sigara, Alkol ve Madde Kullanım bozuklukları: Tanı, Tedavi ve Önleme. İstanbul: Yeniden Yayınları; 2010. p. 53–5. 2. Arıkan Z. Kokain Kullanımına Bağlı Ruhsal ve Davranışsal Bozukluklar. In: Akvardar Y, Arıkan Z, Berkman K, Dilbaz N, Oral G, Uluğ B, et al., editors. TC Sağlık Bakanlığı Sağlık Hizmetleri Genel Müdürlüğü Madde Bağımlılığı Tanı ve Tedavi Kılavuzu El Kitabı. Ankara: Pozitif Matbaa; 2011. p. 147–54. 3. Köknel Ö. Bağımlılık. 1st ed. Altın Kitaplar Yayınevi; 1998. 76 p. 4. Avrupa Uyuşturucu ve Uyuşturucu Bağımlılığını İzleme Merkezi. Avrupa Uyuşturucu Raporu Eğilimler ve Gelişmeler. 2020. 5. Türkiye Uyuşturucu Raporu. 2020. 33–66 p. 6. Türkiye Uyuşturucu Raporu. 2020. 95–110 p. 7. Rounsaville BJ, Anton SF, Carroll K, Budde D, Prusoff BA, Gawin F. Psychiatric diagnoses of treatment-seeking cocaine abusers. Arch Gen Psychiatry. 1991;48(1):43–51. 8. Ford JD, Gelernter J, DeVoe JS, Zhang W, Weiss RD, Brady K, et al. Association of psychiatric and substance use disorder comorbidity with cocaine dependence severity and treatment utilization in cocaine-dependent individuals. Drug Alcohol Depend. 2009;99(1–3):193–203. 9. Ziedonis DM, Kosten TR. Depression as a prognostic factor for pharmacological treatment of cocaine dependence. Psychopharmacol Bull. 1991;27(3):337–43. 10. Hyman SE, Malenka RC. Addiction and the brain: The neurobiology of compulsion and its persistence. Nat Rev Neurosci. 2001;2:695–703. 11. Li MD, Burmeister M. New insights into the genetics of addiction. Nat Rev Genet. 2009;10:225–31. 12. Duncan JR. Current perspectives on the neurobiology of drug addiction: A focus on genetics and factors regulating gene expression. ISRN Neurol. 2012;2012:1–24. 13. Levran O, Yuferov V, Kreek MJ. The genetics of the opioid system and specific drug addictions. Hum Genet. 2012;131(6):823–42. 14. Palmer RHC, Brick L, Nugent NR, Bidwell LC, Mcgeary JE, Knopik VS, et al. Examining the role of common genetic variants on alcohol, tobacco, cannabis and illicit drug dependence: Genetics of vulnerability to drug dependence. Addiction. 2015;110(3):530–7. 15. Bühler KM, Giné E, Echeverry-Alzate V, Calleja-Conde J, De Fonseca FR, Lõpez-Moreno JA. Common single nucleotide variants underlying drug addiction: More than a decade of research. Addict Biol. 2015;20(5):845–71. 16. Clarke TK, Bloch PJ, Ambrose-Lanci LM, Ferraro TN, Berrettini WH, Kampman KM, et al. Further evidence for association of polymorphisms in the CNR1 gene with cocaine addiction: Confirmation in an independent sample and meta-analysis. Addict Biol. 2013;18(4):702–8. 17. Zhang H, Kranzler HR, Yang BZ, Luo X, Gelernter J. The OPRD1 and OPRK1 loci in alcohol or drug dependence: OPRD1 variation modulates substance dependence risk. Mol Psychiatry. 2008;13(5):531–43. 18. Huiping Zhang ZL. Analyzing interaction of μ-, δ- and κ-opioid receptor gene variants on alcohol or drug dependence using a pattern discovery-based method. J Addict Res Ther. 2013;s7(203). 19. Bauer IE, Soares JC, Nielsen DA. The role of opioidergic genes in the treatment outcome of drug addiction pharmacotherapy: A systematic review. Am J Addict. 2015;24(1):15–23. 20. Sadock BJ, Saddock VA. Kaplan & Sadock’ s Comprehensive Textbook of Psychiatry. 11th ed. Ali Bozkurt, editor. Güneş Tıp Kitabevi; 2016. 21. Heath DB. Culture and substance abuse. Psychiatr Clin North Am. 2001;24(3):479–96. 22. Whitaker LR, Degoulet M, Morikawa H. Social deprivation enhances VTA synaptic plasticity and drug-induced contextual learning. Neuron. 2013;77(2):335–45. 23. Karkhanis AN, Locke JL, Mccool BA, Weiner JL, Jones SR. Social isolation rearing increases nucleus accumbens dopamine and norepinephrine responses to acute ethanol in adulthood. Alcohol Clin Exp Res. 2014;38(11):2770–9. 24. Brown E, Prager J, Lee HY, Ramsey RG. CNS complications of cocaine abuse: Prevalence, pathophysiology, and neuroradiology. Am J Roentgenol. 1992;159(1):137–47. 25. Nestler EJ. The neurobiology of cocaine addiction. Sci Pract Perspect. 2005;3(1):4–10. 26. Volkow ND, Fowler JS, Wang G-J. The addicted human brain: Insights from imaging studies. J Clin Invest. 2003;111(10):1444–51. 27. Nestler EJ, Malenka RC. The addicted brain. Sci Am. 2004;290(3):78–85. 28. Nestler EJ. Molecular basis of long-term plasticity underlying addiction. Nat Rev Neurosci. 2001;2(2):119–28. 29. Kalivas PW, McFarland K. Brain circuitry and the reinstatement of cocaine-seeking behavior. Psychopharmacology (Berl). 2003;168(1–2):44–56. 30. Nestler EJ, Barrot M, Self DW. ΔFosB: A sustained molecular switch for addiction. Proc Natl Acad Sci. 2001;98(20):11042–6. 31. Sanchez-Ramos J. Neurologic complications of psychomotor stimulant abuse. Int Rev Neurobiol [Internet]. 1st ed. 2015;120:131–60. Available from: http://dx.doi.org/10.1016/bs.irn.2015.02.003 32. Hearn WL, Flynn DD, Hime GW, Rose S, Cofino JC, Mantero‐Atienza E, et al. Cocaethylene: A unique cocaine metabolite displays high affinity for the dopamine transporter. J Neurochem. 1991;56(2):698–701. 33. Lewis RJ, Johnson RD, Angier MK, Ritter RM. Determination of cocaine, its metabolites, pyrolysis products, and ethanol adducts in postmortem fluids and tissues using Zymark® automated solid-phase extraction and gas chromatography-mass spectrometry. J Chromatogr B. 2004 Jul 5;806(2):141–50. 34. Madden JA, Powers RH. Effect of cocaine and cocaine metabolites on cerebral arteries in vitro. Life Sci. 1990;47(13):1109–14. 35. Shuster L, Garhart CA, Powers J, Grunfeld Y, Kanel G. Hepatotoxicity of cocaine. In: Clouet D, Asghar K, Brown R, editors. Mechanisms of Cocaine Abuse and Toxicity. NIDA Research Monographs Series; 1988. p. 250–75. 36. Jufer RA, Wstadik A, Walsh SL, Levine BS, Cone EJ. Elimination of cocaine and metabolites in plasma, saliva, and urine following repeated oral administration to human volunteers. J Anal Toxicol. 2000;24(7):467–77. 37. Seyer BA, Grist W, Muller S. Aggressive destructive midfacial lesion from cocaine abuse. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(4):465–70. 38. Brand HS, Gonggrijp S, Blanksma CJ. Cocaine and oral health. Br Dent J. 2008;204(7):365–9. 39. Ata-Ali, J , C Carrillo , C Bonet , J Balaguer , M Peñarrocha MP. Oral mucocele: review of the literature. 2010;2(1):18–21. 40. Serrano-Sánchez P, Sarrión G, Bagán J V., Jiménez-Soriano Y. Palatal perforations secondary to inhaled cocaine abuse: Presentation of five cases. J Clin Exp Dent. 2010;2(2):105–9. 41. Alnas M, Altayeh A, Zaman M. Clinical course and outcome of cocaine-induced pneumomediastinum. Am J Med Sci. 2010;339(1):65–7. 42. Kanel GC, Cassidy W, Shuster L, Reynolds TB. Cocaine-induced liver cell injury: Comparison of morphological features in man and in experimental models. Hepatology. 1990;11(4):646–51. 43. Petkovska L, Chibishev A, Stevcevska A, Smokovski I, Petkovski D, Antova E. Multi–system complications after intravenous cocaine abuse. Open Access Maced J Med Sci. 2017;5(2):231–5. 44. Gorelik N, Tampieri D. Cocaine-induced vasospasm causing spinal cord transient ischemia. Neuroradiol J. 2012;25(3):364–7. 45. Farrell CM, Cucu DF. Cocaine related acute spinal cord infarction. R I Med J (2013). 2018;101(1):28–9. 46. Pascual-Leone A, Dhuna A, Anderson DC. Cerebral atrophy in habitual cocaine abusers: A planimetric CT study. Neurology. 1991;41(1):34–8. 47. Pinto SM, Dodd S, Walkinshaw SA, Siney C, Kakkar P, Mousa HA. Substance abuse during pregnancy: Effect on pregnancy outcomes. Eur J Obstet Gynecol Reprod Biol. 2010;150(2):137–41. 48. Havakuk O, Rezkalla SH, Kloner RA. The cardiovascular effects of cocaine. J Am Coll Cardiol. 2017;70(1):101–13. 49. Kim ST, Park T. Acute and chronic effects of cocaine on cardiovascular health. Int J Mol Sci. 2019;20(3):584. 50. Andersen PH. The dopamine uptake inhibitor GBR 12909: Selectivity and molecular mechanism of action. Eur J Pharmacol. 1989;166(3):493–504. 51. Glowa JR, Wojnicki FHE, Matecka D, Bacher JD, Mansbach RS, Balster RL, et al. Effects of dopamine reuptake inhibitors on food- and cocaine-maintained responding: I. Dependence on unit dose of cocaine. Exp Clin Psychopharmacol. 1995;3(3):219–31. 52. Rothman RB, Mele A, Reid AA, Akunne HC, Greig N, Thurkauf A, et al. GBR 12909 antagonizes the ability of cocaine to elevate extracellular levels of dopamine. Pharmacol Biochem Behav. 1991;40(2):387–97. 53. Kadric S, Mohler H, Kallioniemi O, Altmann KH. A multicenter, randomized, placebo-controlled study to evaluate the efficacy and safety of long-acting injectable formulation of vanoxerine (vanoxerine consta 394.2 mg) for cocaine relapse prevention. World J Neurosci. 2019;9(3):113–37. 54. Demirbay S, Algan Z, Cansel N, Cumurcu HB. Use of vanoxerine consta in cocaine addiction : A case report. Cyprus Turkish J Psychiatry Psychol. 2019;1(1):69–71. 55. Matsumoto N, Khrestian CM, Ryu K, Lacerda AE, Brown AM, Waldo AL. Vanoxerine, a new drug for terminating atrial fibrillation and flutter. J Cardiovasc Electrophysiol. 2010;21(3):311–9.