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- Title
Cardiac Complications of Unwitting Co-injection of Quinine/Quinidine with Heroin in an Intravenous Drug User.
- Authors
Phillips, Karran; Hirsch, Glenn; Epstein, David; Preston, Kenzie
- Abstract
Adulterants 'cut into' street heroin are common and often not detected by standard urine toxicology screening; however, their unwitting co-injection may have clinical consequences. We report a case of accelerated atrioventricular junctional arrhythmia that we determined to have been caused by quinine/quinidine cut into heroin. While identification and discontinuation of the offending agent helps confirm the diagnosis and is the treatment of choice, this is often complicated by the individual's dependence on the street drug in which the adulterant is mixed. This case highlights the need for clinicians to be aware of common adulterants, to know how to test for them, and to consider them as possible causes of medical complications in individuals who use drugs.
- Subjects
TOXICOLOGY; MEDICAL screening; QUINIDINE; QUININE; ARRHYTHMIA
- Publication
JGIM: Journal of General Internal Medicine, 2012, Vol 27, Issue 12, p1722
- ISSN
0884-8734
- Publication type
Article
- DOI
10.1007/s11606-012-2089-2