| Intra-arterial self-injection of methadone tablets into the femoral artery. | |
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MedLine Citation:
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PMID: 19150193 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Accidental intra-arterial (IA) injection of a drug of abuse is a rare but potentially limb-threatening occurrence that causes rhabdomyolysis and limb ischemia through a number of mechanisms. Methadone tablets contain microcrystalline cellulose, which has been shown to cause gangrene in animal studies. OBJECTIVES: We present a case of IA injection of methadone tablets dissolved in water, followed by a brief review of the literature. CASE REPORT: A former heroin abuser presented to the Emergency Department after injecting 10 10-mg methadone tablets dissolved in water into his femoral artery. He had severe pain and cyanosis of his leg. Laboratory data revealed a creatine kinase (CK) of 4208. He was started on heparin, low molecular-weight dextran, decadron, sodium bicarbonate, and intravenous dilaudid. An angiogram showed distal small particle embolization and focal areas of spasm. He was discharged on hospital day 6 with patchy mottling throughout the lower extremity and a CK of 30,000. He was treated with nifedipine, enoxaparin, and Coumadin, as well as pain medications. CONCLUSION: We report a case of IA injection of methadone into the femoral artery causing limb ischemia and rhabdomyolysis. This patient responded to medical therapy. |
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Authors:
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Paul Gramenz; David Roberts; Laura Schrag |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2009-01-15 |
Journal Detail:
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Title: The Journal of emergency medicine Volume: 39 ISSN: 0736-4679 ISO Abbreviation: J Emerg Med Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-06 Completed Date: 2011-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8412174 Medline TA: J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: e125-7 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Hennepin County Medical Center, Minneapolis, Minnesota 55415, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Femoral Artery* Humans Injections, Intra-Arterial Ischemia / chemically induced* Male Methadone / administration & dosage, adverse effects* Narcotics / administration & dosage, adverse effects* Rhabdomyolysis / chemically induced* Tablets |
| Chemical | |
Reg. No./Substance:
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0/Narcotics; 0/Tablets; 76-99-3/Methadone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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