Tropane Stimulants

Cocaine and the compounds sharing its tropane bicycle while blocking monoamine reuptake. The same skeleton appears under Deliriants — atropine and scopolamine are tropanes too, and they are antimuscarinic — which is why this tree carries two tropane families and why structure alone never settles what a compound does.

Cocaine blocks the dopamine, noradrenaline and serotonin transporters and is also a sodium-channel-blocking local anaesthetic. That second action is not incidental: it numbs a gum, and it is part of why the cardiac risk — arrhythmia, coronary vasoconstriction, infarction in people with no other risk factors — is what kills. Taken with alcohol it forms a further active compound, longer-lasting and itself cardiotoxic. Benzoylecgonine and ecgonine are metabolites, so a laboratory naming them is describing what has already broken down. The cuts that arrive alongside — levamisole, phenacetin, the local anaesthetics — are filed under Adulterants, grouped by the role that carries their risk.