Document Detail


Intra-arterial self-injection of methadone tablets into the femoral artery.
MedLine Citation:
PMID:  19150193     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Paul Gramenz; David Roberts; Laura Schrag
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-01-15
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  39     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-06     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e125-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Hennepin County Medical Center, Minneapolis, Minnesota 55415, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
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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