What is the recommended treatment for cocaine-induced vasospasm?

Cocaine-induced vasospasm is a specific condition related to the effects of cocaine on the cardiovascular system. Cocaine acts as a potent vasoconstrictor by increasing sympathetic outflow and inhibiting norepinephrine reuptake, which can lead to significant vasospasm, particularly affecting blood vessels in the heart.

Calcium-channel blockers are considered the treatment of choice for this condition because they directly relax vascular smooth muscle, leading to vasodilation. This action counteracts the vasospastic effects caused by cocaine, helping to relieve symptoms such as chest pain and prevent potential complications like myocardial infarction.

In this context, calcium-channel blockers are effective in reversing the vasospasm and improving blood flow through the coronary arteries, whereas other medication classes do not have the same efficacy for this specific scenario. For instance, beta-blockers can potentially worsen vasospasm by leaving unopposed alpha-adrenergic receptor activity, while ACE inhibitors and anticoagulants would not directly address the immediate vasospasm issue. Thus, the recommendation for treating cocaine-induced vasospasm is to use calcium-channel blockers for their vasodilatory properties.