Ischaemia following selfadministered intra-arterial injection of methylphenidate and diamorphine. A case report of treatment with intra-arterial urokinase and review.
A patient presented with a painful, oedematous, cyanosed hand having injected a solution of diamorphine and methylphenidate into his radial artery. Treatment was started with heparin and vasodilators. Benefit from this was limited and a course of intra-arterial urokinase was instituted. This gave almost total resolution of the injury. The mechanisms producing ischaemia following intra-arterial injection of drugs of abuse and possible treatment are discussed.
D000059:Accidents; D000328:Adult; D005542:Forearm / Q000098:blood supply*; D003932:Heroin / Q000506:poisoning*; D006801:Humans; D007269:Injections, Intra-Arterial / Q000009:adverse effects; D007511:Ischemia / Q000139:chemically induced* / Q000188:drug therapy; D008297:Male; D008774:Methylphenidate / Q000506:poisoning*; D019966:Substance-Related Disorders; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D008774:Methylphenidate; D003932:Heroin; D014568:Urokinase-Type Plasminogen Activator