ABSTRACT
B. General Medical Risks: Hypertension ................................................................ 135
III. Placental Function ..................................................................................................... 138 A. Cocaine and Uterine Blood Flow ....................................................................... 139 B. Placental Transfer of Cocaine and Its Metabolites ............................................ 140
I. Human Model: A Perfused Placental Cotyledon .......................................... 140 2. A Pregnant Monkey Model ........................................................................... 141 3. A Pregnant Sheep Model ............................................................................... 141 4. A Pregnant Rabbit Model .............................................................................. 142 5. A Pregnant Guinea Pig Model ...................................................................... 143 6. A Pregnant Rodent Model ............................................................................. 144
IV. Placental Biogenic Amines and Cocaine .................................................................. 144 A. Catecholamines ................................................................................................... 145
B. Acetylcholine ...................................................................................................... 147 l. Functions of Acetylcholine in Placenta ......................................................... 147 2. Effect of Cocaine on the Release of Placental Acetylcholine ...................... 147
C. Cocaine-Binding Proteins or Receptors in Placenta .......................................... 147
VI. Cocaine Abuse During Pregnancy: Effects on the Fetus and Newborn .................. 151 A. Growth Retardation, Prematurity, and Low Birth Weight ................................ 151
G-8493-1s 12-5mJSO.oo.s~ C 1995 by CRC Pras. Inc:. 133
134 Placental Toxicology
B. Sudden Infant Death Syndrome .•........•.............................................................. 152 C. Teratologic, Destructive, and Neurobehavioral Effects ..................................... 153
Acknowledgments ............................................................................................................... 154
References ........................................................................................................................... 155
Cocaine (benzoylmethylecgonine) is an alkaloid derived from the leaves of the plant Erythroxylon coca, which grows in Peru, Chile, and Bolivia. It is marketed as a pure hydrochloride. "Crack", a vernacular expression for cocaine base, is formed by mixing cocaine hydrochloride, baking soda, and warm water in suitable proportions. The resulting solid base (street name, "rock") is broken off and smoked by users of illicit drugs.• The name "crack" is possibly derived from the crackling noise made when "rock" is heated.1 Smoking "rock" or "crack" may cause a euphoric rush within seconds and a high that lasts for lO to 12 min. After nasal insufflation, plasma concentrations of cocaine reach peak values in about 15 to 60 min.2 The euphoria induced by smoking cocaine has possibly contributed to its illicit use.
