PMID: 7533806Nov 1, 1994

Airway compromise and delayed death following attempted central vein injection of propylhexedrine

The Journal of Emergency Medicine
J PerezJ G McGirr

Abstract

Propylhexedrine is a potent alpha-adrenergic drug available as a nasal decongestant, which drug abusers sometimes extract and inject into a central vein. A 25-year-old white male presented to a local emergency department 32 h after attempting to inject his right internal jugular vein with "home-made crank." Following injection, he noted right neck pain, followed by fever and chills. On emergency department admission, he had inspiratory stridor and respiratory distress. Massive edema of his right neck extended from his anterior chest to the right parotid. Neck radiographs showed extensive paracervical swelling with displacement of the trachea. The patient was taken to surgery for nasotracheal intubation with fiberoptic guidance and surgical exploration. The neck contained extensive necrotic tissue that was surgically debrided. In spite of treatment with antibiotics, he developed progressive renal failure and hypotension unresponsive to fluid therapy, followed by cardiopulmonary arrest and death.

References

Jan 1, 1975·Clinical Toxicology·J C Garriott
Nov 10, 1977·The New England Journal of Medicine·L White, V Dimaio
Jul 1, 1979·The American Journal of Medicine·R J AndersonV Dimaio
Jun 1, 1986·Drug and Alcohol Dependence·D R Wesson
Oct 1, 1988·Journal of Psychoactive Drugs·D E SmithJ P Morgan
Jan 1, 1983·Journal of Toxicology. Clinical Toxicology·H R Mancusi-UngaroS R Lewis

Citations

Sep 6, 2005·Community Mental Health Journal·Andrés J PumariegaJoanne B Pumariega

Related Concepts

Propylhexedrine hydrochloride, (S)-isomer
Intravenous Injections
Structure of Jugular Vein
Propylamines
Respiratory Tract Diseases
Decongestants
Fatal Outcome
Drug Overdose

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