A chronic cocaine user reports that mixing cocaine with alcohol produces a longer lasting and more intense feeling of euphoria than either drug alone. The toxicological explanation is hepatic formation of which compound?

• A Cocaethylene ✓
• B Ecgonine methyl ester
• C Benzoylecgonine
• D Norcocaine

Explanation

When cocaine and ethanol are consumed together, hepatic carboxylesterase transesterifies cocaine with ethanol to form cocaethylene, an active metabolite with dopamine and serotonin reuptake blocking activity similar to cocaine but a longer half-life. It increases cardiotoxicity and seizure risk beyond either drug alone. Benzoylecgonine and ecgonine methyl ester are inactive breakdown products, and norcocaine forms by N-demethylation without ethanol.

Reference: Katzung's Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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