POISONING WITH GAMMA-HYDROXYBUTYRATE, GAMMA-BUTYROLACTONE AND 1.4-BUTANDIOL
Keywords:
gamma-hydroxybutyrate, gamma-butyrolactone, 1.4-butandiol, drugs, case reportAbstract
Background. Gamma-hydroxybutyrate (GHB) is a popular recreational drug. GHB overdose typically presents with decreased level of consciousness, miosis, bradycardia, respiratory depression and death. Typically, combativeness, confusion and vomiting occur once the patient begins to recover. Gamma-butyrolactone (GBL) and 1.4-butandiol (1.4-BD) are the prodrugs of GHB and have similar clinical presentation. We present the case of GHB poisoning in Ljubljana.
Conclusions. Physicians should suspect GHB poisoning in young ravers who present with CNS depression. Treatment is symptomatic. There is no specific antidote. Gastric lavage is not beneficial but activated charcoal is recommended.
Downloads
References
Clancy C. Sport drugs of abuse. In: Viccellio P ed. Emergency toxicology. 2nd ed. Philadelphia: Lippincott-Raven Publishers, 1999: 933–46.
Li J, Stokes SA, Woeckener A. A tale of novel intoxication: A review of the effects of γ-hydroxybutyric acid with recommendations for management. Ann Emerg Med 1998; 31: 729–36.
Shannon M, Quang LS. Gamma-hydroxybutyrate, gamma-butyrolactone, and 1.4-butanediol: A case report and review of the literature. Pediatr Emerg Care 2000; 16: 435–40.
Winickoff JP, Houck CS, Rothman EL, Bauchner H. Verve and Jolt: Deadly new Internet drugs. Pediatrics 2000; 106: 829–31.
Zvosec DL, Smith SW, McCutcheon JR, Spillane J, Hall BJ, Peacock EL. Adverse events, including death, associated with the use of 1.4-butanediol. N Eng J Med 2001; 344: 87–94.
Curry SC, Mills KC, Graeme KA. Neurotransmitters. In: Goldfrank LR et al. Goldfrank’s toxicologic emergencies. 6th ed. Stamford: Appleton and Lange, 1999: 137–73.
Dupont P, Thornton J. Near-fatal gamma-butyrolactone intoxication – first report in the UK. Hum Exp Toxicol 2001; 20: 19–20.
Chin RL, Sporer KA, Cullison B, Dyer JE, Wu TD. Clinical course of γ-hydroxybutyrate overdose. Ann Emerg Med 1998; 31: 716–22.
Li J, Stokes SA, Woeckener A. A tale of novel intoxication: seven cases of γ-hydroxybutyric acid overdose. Ann Emerg Med 1998; 31: 723–8.
Caldicott DGE, Kuhn M. Gamma-hydroxybutyrate overdose and physostigmine: Teaching new tricks to an old dog? Ann Emerg Med 2001; 37: 99–102.
Downloads
Issue
Section
License
The Author transfers to the Publisher (Slovenian Medical Association) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Slovenian Medical Association) has the right to transfer the rights of acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
