Editing Cocaine (section)

=== Medical ===

====Topical====
{{See also|Moffett's solution}}
[[File:Cocaine hydrochloride CII for medicinal use.jpg|thumb|upright|Cocaine [[hydrochloride]]]]

Topical cocaine is sometimes used as a local [[anesthetic|numbing agent]] and [[vasoconstrictor]] to help control pain and bleeding with surgery of the nose, mouth, throat or [[lacrimal duct]]. It is also used for topical airway anaesthesia for procedures such as awake fibreoptic [[bronchoscopy]] or [[intubation]]. Although some absorption and systemic effects may occur, the use of cocaine as a topical anesthetic and vasoconstrictor is generally safe, rarely causing [[cardiovascular]] toxicity, [[glaucoma]], and [[mydriasis|pupil dilation]].<ref name="Dwyer2016">{{Cite journal | vauthors = Dwyer C, Sowerby L, Rotenberg BW | title = Is cocaine a safe topical agent for use during endoscopic sinus surgery? | journal = The Laryngoscope | volume = 126 | issue = 8 | pages = 1721–1723 | date = August 2016 | pmid = 27075241 | doi = 10.1002/lary.25836 | type = Review | doi-access = free }}</ref><ref>{{Cite journal | vauthors = Latorre F, Klimek L | title = Does cocaine still have a role in nasal surgery? | journal = Drug Safety | volume = 20 | issue = 1 | pages = 9–13 | date = January 1999 | pmid = 9935273 | doi = 10.2165/00002018-199920010-00002 | s2cid = 40598106 }}</ref> Occasionally, cocaine is mixed with [[adrenaline]] and [[sodium bicarbonate]] and used topically for surgery, a formulation called [[Moffett's solution]].<ref>{{Cite journal | vauthors = Benjamin E, Wong DK, Choa D | title = 'Moffett's' solution: a review of the evidence and scientific basis for the topical preparation of the nose | journal = Clinical Otolaryngology and Allied Sciences | volume = 29 | issue = 6 | pages = 582–587 | date = December 2004 | pmid = 15533141 | doi = 10.1111/j.1365-2273.2004.00894.x | doi-access = free }}</ref>

=====Eye drops=====
Cocaine [[eye drop]]s are frequently used by [[Neurology|neurologists]] when examining people suspected of having [[Horner's syndrome|Horner syndrome]]. In Horner syndrome, [[sympathetic innervation]] to the eye is blocked. In a healthy eye, cocaine will stimulate the sympathetic nerves by inhibiting norepinephrine reuptake, and the [[pupil]] will dilate; if the patient has Horner syndrome, the [[sympathetic nervous system]] are blocked, and the affected eye will remain constricted or dilate to a lesser extent than the opposing (unaffected) eye which also receives the eye drop test. If both eyes dilate equally, the patient does not have Horner syndrome.<ref>{{Cite book | vauthors = Berkowitz AL |title=Clinical Neurology & Neuroanatomy: A Localization-Based Approach |publisher=McGraw Hill |year=2022 |isbn=978-1260453362 |edition=2nd |chapter=Chapter 10: Pupillary Control & Approach to Anisocoria: Cranial Nerves 2 & 3 |type=Digital}}</ref>

=====Nasal solution=====
Cocaine [[hydrochloride]] ('''Goprelto'''), an ester local anesthetic, was approved for medical use in the United States in December 2017, and is indicated for the introduction of local anesthesia of the [[mucous membrane]]s for diagnostic procedures and surgeries on or through the nasal cavities of adults.<ref>{{Cite web | title=Drug Approval Package: Goprelto (cocaine hydrochloride) | website=U.S. [[Food and Drug Administration]] (FDA) | date=30 April 2018 | url=https://www.accessdata.fda.gov/drugsatfda_docs/nda/2017/209963Orig1s000TOC.cfm | access-date=30 April 2020 | archive-date=28 July 2020 | archive-url=https://web.archive.org/web/20200728161852/https://www.accessdata.fda.gov/drugsatfda_docs/nda/2017/209963Orig1s000TOC.cfm | url-status=live }}</ref><ref name="Goprelto FDA label">{{Cite web | title=Goprelto – cocaine hydrochloride solution | website=DailyMed | date=3 January 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=689750b7-8e51-47d9-a428-078f3f6c9dec | access-date=30 April 2020 | archive-date=30 July 2020 | archive-url=https://web.archive.org/web/20200730202926/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=689750b7-8e51-47d9-a428-078f3f6c9dec | url-status=live }}</ref> Cocaine hydrochloride ('''Numbrino''') was approved for medical use in the United States in January 2020.<ref>{{Citation-attribution|1={{Cite web | title=Numbrino: FDA-Approved Drugs | website=U.S. [[Food and Drug Administration]] (FDA) | url=https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=209575 | access-date=30 April 2020 | archive-date=28 July 2020 | archive-url=https://web.archive.org/web/20200728172108/https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=209575 | url-status=live }} }}</ref><ref name="Numbrino FDA label">{{Cite web | title=Numbrino – cocaine hydrochloride nasal solution | website=DailyMed | date=28 February 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=94f9b3f8-bce5-41ed-9453-c54ed1d6c269 | access-date=30 April 2020 | archive-date=30 July 2020 | archive-url=https://web.archive.org/web/20200730063812/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=94f9b3f8-bce5-41ed-9453-c54ed1d6c269 | url-status=live }}</ref>

Headache and [[epistaxis]] are the most frequently reported adverse reactions with Goprelto,<ref name="Goprelto FDA label" /> while hypertension and tachycardia-including [[sinus tachycardia]]-are most common with Numbrino.<ref name="Numbrino FDA label" />