Petkovska Lidija, Chibishev Andon, Stevcevska Aleksandra, Smokovski Ivica, Petkovski Dusan, Antova Emilija
University Clinic of Toxicology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
University Clinic of Cardiology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Open Access Maced J Med Sci. 2017 Mar 22;5(2):231-235. doi: 10.3889/oamjms.2017.046. eCollection 2017 Apr 15.
Use and abuse of cocaine are associated with numerous adverse effects, independent of the route of administration. More severe conditions of poisoning, however, are observed after cocaine intravenous administration.
We present a case of severe poisoning after violent intravenous injection of cocaine, but with a good outcome.
Cocaine was intravenously (i.v.) administered in 16-years old female patient as a homicide attempt. Shortly after that, patient experienced series of generalised tonic-clonic seizures, was highly febrile (40°C), somnolent, agitated, presenting with tachycardia, tachypnea and with increased blood pressure 150/90 mmHg. Neurologic status, lumbar puncture and computerised tomography (CT) of the brain were without remarks. Electroencephalogram (EEG) was characterised with signs of diffuse encephalopathy, and acid-base analyses resulted in metabolic acidosis. Urine screening revealed the presence of cocaine and benzodiazepines. The patient presented with signs of the hepatic lesion, acute renal insufficiency (ARI), and increased D-dimers resulting from activated fibrinolysis. The patient was discharged in stable general condition after being hospitalised for 23 days.
Intravenous abuse of cocaine results in overdose and serous multi-system complications requiring multidisciplinary diagnostic and intensive therapeutic approach.
可卡因的使用和滥用会带来诸多不良反应，与给药途径无关。然而，静脉注射可卡因后会出现更严重的中毒情况。
我们报告一例因暴力静脉注射可卡因导致严重中毒但预后良好的病例。
一名16岁女性患者为自杀企图静脉注射了可卡因。此后不久，患者出现一系列全身性强直阵挛性发作，高热（40°C），嗜睡、烦躁，伴有心动过速、呼吸急促，血压升高至150/90 mmHg。神经系统检查、腰椎穿刺及脑部计算机断层扫描（CT）均无异常。脑电图（EEG）表现为弥漫性脑病迹象，酸碱分析结果为代谢性酸中毒。尿液筛查显示存在可卡因和苯二氮䓬类药物。患者出现肝脏损伤、急性肾功能不全（ARI）迹象，以及因纤溶激活导致的D-二聚体升高。患者住院23天后病情稳定出院。
静脉滥用可卡因会导致过量中毒及严重的多系统并发症，需要多学科诊断和强化治疗。
