&Otoacoustic emissions

Cocaine Exposure

Coke

C Snow

Flake

Blow

Often cut with:

Cocaine + Heroin = Speedball

AKA

Crack: freebase cocaineRefers to crackling sound heard when mixture is

smoked

• Cornstarch• Talcum Powder• Baking Soda

• Sugar• Procaine (anesthetic)• Amphetamine (stimulant)

Effect on Adults:

Powerful CNS stimulant

Effects last 15 minutes to an hour, depending on method of ingestion

Increases alertness, feelings of well-being & euphoria, energy & motor activity, feelings of competence & sexuality

Athletic performance may be enhanced (attention & endurance)

Schweitzer Case Study• 18 yo Female• 3 yr hx of alcohol & drug abuse• Binged on heroin, benzodiazepine (Xanax), alcohol,

and crack

Initial audio: •Bilateral, severe SNHL (flat)•Normal tympanometry•Absent ipsi and contra acoustic reflexes•Absent DPOAEs

Ciorba Case Study

• 30 yo Female• Heroin addict• Overdose: IV Cocaine

12 hrs post: Severe symmetrical SNHL

• SRT predictable by pure tone threshold

• WRS 0% @ 80dB HL, 40-50% @ 100 dB HL

• Wave V detectible at 90dB HL• Tympanometry WNL• DPOAEs absent

Day 3

Day 30

Ciorba’s Conclusions

Typically, the basal cochlear turn is most damaged by vasospasm. More sensitive to hypoxia.

This case showed a flat audiogram initially, equal improvement, and full recovery- suggests equal

dysfunction across cochlea and hearing loss is not due to hypoxia as that’s permanent

“Perturbation of cochlear homeostasis”Likely caused by “transient disruption of cochlear K+

recycling pathway induced by cocaine”

Sodium & Potassium

DPOAEsAbsent OAEs in the presence of normal out/middle ear

function

Tang, 1996

Moderate low doses of cocaine to Chinchillas every day for 30 days

Little or no difference in DPOAEs in chronic and acute groups

Shivapuia, 1993

Newborns of cocaine abusing mothers do not have

increased incidence of HL and peak latencies normalize

by one year of life.

Effect during Pregnancy

Spontaneous abortion & stillbirth

Preterm labor & delivery

Fetal hypoxemia & distress

Placental abruption

Intrauterine growth retardation

Fetal vascular accidents

Basically, we don’t know cocaine’s effect(s)

on the cochlea yet.

Works Cited(2004). Intensive care nursery house staff manual. Retrieved from The Regents of the University of California website:

http://www.ucsfbenioffchildrens.org/health_professionals/intensive_care_nursery_house_staff_manual/index.html

Bauman, J. L., & Didomenico, R. J. (2002). Cocaine-induced channelopathies: Emerging evidence on the multiple mechanisms of sudden death. Journal of Cardiovascular Pharmacol Therapeut, 7(3), 195-2002.

Ciorba, A., Bovo, R., & Prosser, S. (2009). Considerations on the physiopathological mechanism of inner ear damage induced by intravenous cocaine abuse: Cues from a case report. Auris Nasus Larynx, 36, 213-217.

Grimmer, I., Buhrer, C., & Aust, G. (1999). Hearing in newborn infants of opiate-addicted mothers. European Journal of Pediatrics, 158, 653-657.

Jospe, N. (2009, December). Prenatal drug exposure. Retrieved from http://www.merckmanuals.com/professional/pediatrics/metabolic_electrolyte_and_toxic_disorders_in_neonates/prenatal_drug_exposure.html

Ritchie, J.M. and Greene, N.M. (1990) local anesthetics. In:A.G. Gilman, L.S. goodman, T.W. Rall and F. Murad (Eds.), The pharmacological basis of therapeutics. 8th ed., Macmallian, MY, pp.311-331.

Schweitzer, V. G., Darrat, I., & Stach, B. A. (2011). Sudden bilateral sensorineural hearing loss following polysubstance narcotic overdose. Journal of American Academy of Audiology, 22, 208-214.

Shivapuja, B. G., Gu, Z. P., & Liu, S. Y. (1994). Effects of repeated cocaine injections on cochlear function. Brain Research, 668, 230-238.

Shivapuja, B. G., Gu, Z. P., & Saunders, S. S. (1993). Acute effects of cocaine on cochlear function. Hearing Research, 69, 243-250.

Tan-Laxa, M. A., Sison-Switala, C., & Rintelman, W. (2004). Abnormal auditory brainstem response among infants with prenatal cocaine exposure. American Academy of Pediatrics, 113, 357-360.

Tang, W. X., Shivapuja, B. G., & Salvi, R. J. (1996). Effects of cocaine on distortion-product otoacoustic emissions in the chinchillas. Association for Research in Otolaryngology, 103(B5).

Trigueiros-Cunha, N., Ledo, P., & Renard, N. (2006). Prenatal cocaine exposure accelerates morphological changes and transient expression of tyrosine hydroxyls in the cochlea of developing rats. Brain Research, 1086, 55-64.

Volkow, N. D. (2010). Cocaine: Abuse and addiction. Retrieved from National institute on drug abuse website: http://www.nida.nih.gov/researchreports/cocaine/cocaine.html

Otoacoustic emissions assess cochlear

function