Intoxicated persons who seek assistance with less severe cocaine complications are more likely to present with panic, irritability, hyperreflexia, paranoia, hallucinations, and stereotyped repetitive movements. Assurance in a calm, nonthreatening environment is a prerequisite for successful patient management. Psychosis can be treated with haloperidol, although caution is necessary, because this medication can lower the seizure threshold. Monoamine oxidase inhibitors are contraindicated, because they block cocaine degradation. Infectious diseases and other complications need to be treated appropriately. Sodium nitroprusside, phentolamine, and calcium channel blockers are effective therapies for hypertension. Propranolol is controversial due to resultant unopposed alpha-receptor stimulation.
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