title: [Digital ischemia following injection of a crushed tablet of zolpidem: tardive improvement with iloprost].
abstract: The intra-arterial injection of crushed tablets can lead to severe vascular disorders including necrosis. A 35-year-old patient was hospitalized after the involuntary intra-radial injection of a crushed tablet of zolpidem. As the initial treatment with heparin and vasodilators was inefficient, iloprost injections were proposed. A recovery of most lesions was obtained, but the middle finger distal phalange had to be amputated. Iloprost has already been used successfully in the treatment of lesions caused by the intra-arterial injections of drugs of abuse. It can limit ischemia and even lead to necrosis healing, thus being an alternative to conventional treatments when they are ineffective.
authors.affiliation: Centre d'Evaluation et d'Information sur la Pharmacodépendance de Lyon, Lyon, France. alexandra.boucher@chu-lyon.fr
authors.forename: Alexandra
authors.initials: A
authors.lastname: Boucher
authors.forename: Souad
authors.initials: S
authors.lastname: Assaad
authors.forename: Caroline
authors.initials: C
authors.lastname: Pariset
authors.forename: Jacques
authors.initials: J
authors.lastname: Descotes
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D005385:Fingers / Q000098:blood supply*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000494:pharmacology*; D016285:Iloprost / Q000627:therapeutic use*; D007269:Injections, Intra-Arterial; D007511:Ischemia / Q000209:etiology* / Q000601:surgery; D008297:Male; D011725:Pyridines / Q000008:administration & dosage / Q000494:pharmacology*; D012039:Regional Blood Flow / Q000187:drug effects; D015819:Substance Abuse, Intravenous; D014665:Vasodilator Agents / Q000627:therapeutic use*; D000077334:Zolpidem
chemical_list: D006993:Hypnotics and Sedatives; D011725:Pyridines; D014665:Vasodilator Agents; D000077334:Zolpidem; D006493:Heparin; D016285:Iloprost