Cocaine and adrenergic receptors

Q: Cocaine stimulates which adrenergic receptors? - select one

A) alpha-1

B) alpha-2

C) beta-1

D) beta-2 

E) All of the above

Answer: E

Cocaine is considered highly toxic as it stimulates all adrenergic receptors via increasing levels of norepinephrine, and to a lesser extent, epinephrine. Coronary syndromes occur via the alpha-adrenergic agonist's vasoconstrictive effect in both cardiac and peripheral vasculature.

Contrary to conventional belief, the central and euphoric effects occur via inhibition of neuronal serotonin reuptake, causing psychological addiction. The physiological addiction is primarily due to the dopamine reuptake effect on the dopamine-containing neuronal systems traveling from the limbic region to the frontal cortex. Also, the increased levels of the excitatory amino acids glutamate and aspartate have been described.

#toxicity

References:

1. Nestler EJ. The neurobiology of cocaine addiction. Sci Pract Perspect. 2005 Dec;3(1):4-10. doi: 10.1151/spp05314. PMID: 18552739; PMCID: PMC2851032.

2. Gawin FH. Cocaine addiction: psychology and neurophysiology. Science. 1991 Mar 29;251(5001):1580-6. doi: 10.1126/science.2011738. Erratum in: Science 1991 Aug 2;253(5019):494. PMID: 2011738.

3. Mahoney JJ 3rd, Haile CN, De La Garza R 2nd, Thakkar H, Newton TF. Electrocardiographic characteristics in individuals with cocaine use disorder. Am J Addict. 2017 Apr;26(3):221-227. doi: 10.1111/ajad.12524. Epub 2017 Mar 1. PMID: 28248441.