Abstract
Accidental intra-arterial injection of drugs is a sporadic complication in i.v. drug addicts. A 22-year-old drug-abuser injected flunitrazepam tablets dissolved in tap water into her left femoral artery and presented with clinical signs of acute ischaemia of the left leg. Severe rhabdomyolysis developed within 5 hours after the injection. Selective arterial catheter angiography showed an acute occlusion of the posterior tibial artery. Combination therapy with i.a. urokinase, i.a. prostaglandines and i.v. anticoagulation resulted in re-opening of the obstructed distal artery and complete cessation of symptoms.
MeSH terms
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Acute Disease
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Anticoagulants / therapeutic use
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Arterial Occlusive Diseases / chemically induced*
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Arterial Occlusive Diseases / drug therapy
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Arterial Occlusive Diseases / pathology
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Drug Therapy, Combination
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Female
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Femoral Artery
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Fibrinolytic Agents / therapeutic use
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Flunitrazepam / administration & dosage
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Flunitrazepam / adverse effects*
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GABA Modulators / administration & dosage
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GABA Modulators / adverse effects*
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Humans
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Injections, Intra-Arterial
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Ischemia / chemically induced*
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Ischemia / drug therapy
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Ischemia / pathology
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Leg / blood supply*
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Prostaglandins / therapeutic use
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Radiography
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Rhabdomyolysis / chemically induced
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Solubility
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Substance Abuse, Intravenous / complications*
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Tablets
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Tibial Arteries / diagnostic imaging
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Tibial Arteries / drug effects*
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Treatment Outcome
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Young Adult
Substances
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Anticoagulants
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Fibrinolytic Agents
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GABA Modulators
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Prostaglandins
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Tablets
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Flunitrazepam