COCAINE

Cocaine is a sympathomimetic tropane alkaloid derived from Erythroxylon coca leaves, consumed worldwide as a powder (hydrochloride) or freebase ('crack'). Its pharmacological effects stem from monoamine reuptake inhibition and sodium channel blockade, producing both euphoric and cardiovascular toxic effects. Hepatic metabolism yields ecgonine methyl ester and benzoylecgonine, while co-consumption with alcohol produces cocaethylene, a pharmacologically active and cardiotoxic metabolite. Chronic use is associated with neurotoxicity via mitochondrial dysfunction, immunosuppression, endocrine disruption, and reproductive harm. Evidence on cocaine's long-term effects on cytochrome P450 regulation and neuroendocrine function remains incomplete, particularly regarding self-administration models and human data.