title: Acute ischaemia of the leg following accidental intra-arterial injection of dissolved flunitrazepam tablets.
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.
authors.affiliation: Department Internal Medicine, University Hospital Freiburg, Germany. jens.leifert@uniklinik-freiburg.de
authors.forename: J A
authors.initials: JA
authors.lastname: Leifert
authors.forename: L
authors.initials: L
authors.lastname: Bossaller
authors.forename: M
authors.initials: M
authors.lastname: Uhl
mesh_terms: D000208:Acute Disease; D000925:Anticoagulants / Q000627:therapeutic use; D001157:Arterial Occlusive Diseases / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D004359:Drug Therapy, Combination; D005260:Female; D005263:Femoral Artery; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005445:Flunitrazepam / Q000008:administration & dosage / Q000009:adverse effects*; D018757:GABA Modulators / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007269:Injections, Intra-Arterial; D007511:Ischemia / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D007866:Leg / Q000098:blood supply*; D011453:Prostaglandins / Q000627:therapeutic use; D011859:Radiography; D012206:Rhabdomyolysis / Q000139:chemically induced; D012995:Solubility; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013607:Tablets; D016909:Tibial Arteries / Q000000981:diagnostic imaging / Q000187:drug effects*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D018757:GABA Modulators; D011453:Prostaglandins; D013607:Tablets; D005445:Flunitrazepam