Journal article
Clinical features of gamma-hydroxybutyrate and gamma-butyrolactone toxicity and concomitant drug and alcohol use.
- Liechti ME Department of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland. meliechti@dplanet.ch
- Kunz I
- Greminger P
- Speich R
- Kupferschmidt H
- 2005-09-07
Published in:
- Drug and alcohol dependence. - 2006
4-Butyrolactone
Adolescent
Adult
Alcoholism
Anesthetics, Intravenous
Bradycardia
Case-Control Studies
Coma
Drug Overdose
Female
Humans
Hypothermia
Male
Opioid-Related Disorders
Retrospective Studies
Sodium Oxybate
Solvents
English
OBJECTIVE
To describe the clinical features of gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL) toxicity.
METHODS
Retrospective case-study of 65 GHB and GBL intoxications seen in an urban emergency department.
RESULTS
63% of intoxications occurred in male patients. The median age was 24 years (range 16-41 years). 65% co-ingested alcohol or illicit drugs, mostly MDMA and cocaine. 83% presented with coma. The mean+/-S.D. time to regain consciousness among comatose patients was 111+/-61 min and was significantly longer in patients who co-abused illicit drugs such as cocaine or MDMA (155+/-60 min). Bradycardia occurred in 38%, hypotension in 6% and hypothermia in 48%. Agitation was observed in 17% of all patients and was significantly more frequent in patients with alcohol co-use (29%). Vomiting occurred in 31% of all patients and tended to be more frequent in patients who co-used alcohol (39%). Management of GHB and GBL overdose was supportive. Four patients needed admission to an intensive care unit for mechanical ventilation (6%).
CONCLUSIONS
Overdosing of GHB and GBL frequently results in non-reactive coma reflecting the severity of poisoning. Multiple drug use is common and significantly influences the clinical presentation.
To describe the clinical features of gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL) toxicity.
METHODS
Retrospective case-study of 65 GHB and GBL intoxications seen in an urban emergency department.
RESULTS
63% of intoxications occurred in male patients. The median age was 24 years (range 16-41 years). 65% co-ingested alcohol or illicit drugs, mostly MDMA and cocaine. 83% presented with coma. The mean+/-S.D. time to regain consciousness among comatose patients was 111+/-61 min and was significantly longer in patients who co-abused illicit drugs such as cocaine or MDMA (155+/-60 min). Bradycardia occurred in 38%, hypotension in 6% and hypothermia in 48%. Agitation was observed in 17% of all patients and was significantly more frequent in patients with alcohol co-use (29%). Vomiting occurred in 31% of all patients and tended to be more frequent in patients who co-used alcohol (39%). Management of GHB and GBL overdose was supportive. Four patients needed admission to an intensive care unit for mechanical ventilation (6%).
CONCLUSIONS
Overdosing of GHB and GBL frequently results in non-reactive coma reflecting the severity of poisoning. Multiple drug use is common and significantly influences the clinical presentation.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.drugalcdep.2005.07.010
- PMID 16143455
- Persistent URL
- https://sonar.rero.ch/global/documents/219343
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