EVALUATION OF THE COMBINED TOXIC EFFECTS OF COCAINE AND ETHANOL ON PRIMARY MYOCARDIAL-CELL CULTURES

Since 1978, the most prevalent drug used in conjunction with cocaine in cocaine-associated myocardial deaths is ethanol. Primary myocardial cell cultures were used to evaluate the acute additive cardiotoxic effects of cocaine and ethanol. The cultures were exposed to 1 x 10(-3) M or 1 x 10(-5) M-cocaine or combinations of both concentrations of cocaine with 600 mg ethanol/100 ml. Alterations in beating activity, morphology, and lactate dehydrogenase (LDH) release were evaluated after 1, 4 and 24 hr of treatment. Although cells exposed to 1 x 10(-5) M-cocaine or to 1 x 10(-5) M-cocaine and ethanol were able to retain some beating activity, no beating activity occurred in cells exposed to 1 x 10(-3) M-cocaine with or without ethanol. Morphologically, pseudopodia and disruption of the monolayer were more extensive in cells treated for 4 or 24 hr with the combinations of cocaine and ethanol in comparison with those treated with cocaine alone. After 24 hr, LDH release in cells exposed to 1 x 10(-3) M-cocaine or 1 x 10(-3) M-cocaine with ethanol was elevated over the level in untreated controls. These data suggest that ethanol enhances cocaine-induced beating abnormalities and morphological alterations in primary myocardial cell cultures.