RESUMEN
Gamma-hydroxybutyrate (GHB) is a compound used in the treatment of alcohol withdrawal, narcolepsy, and for induction of anaesthesia. It is also contained in many products illegally marketed as "dietary supplements" and is increasingly being recognised as a potential drug of abuse. We report the case of a 44-year-old man who suffered coma and life-threatening respiratory depression following an accidental overdose of the GHB prodrug, gamma-butyrolactone (GBL), contained in a "health drink". He made a full recovery following appropriate supportive treatment. GHB toxicity should be included in the differential diagnosis of patients with altered mental state, particularly where there is a history of recreational drug abuse.
Asunto(s)
4-Butirolactona/envenenamiento , Moduladores del GABA/envenenamiento , 4-Butirolactona/farmacocinética , 4-Butirolactona/farmacología , Adulto , Coma/inducido químicamente , Electrocardiografía , Moduladores del GABA/farmacocinética , Moduladores del GABA/farmacología , Escala de Coma de Glasgow , Humanos , Masculino , Síndromes de Neurotoxicidad/fisiopatologíaRESUMEN
GHB, GBL, and 1,4-BD are prevalent drugs of abuse in the United States. Unfortunately, attempts to regulate GHB have been circumvented by clandestine trafficking through the Internet and marketing of "natural" chemical precursors . Despite repeated FDA warnings to the public about their dangers as well as recent federal scheduling of GHB and GBL, they remain accessible as "club drugs" on Internet websites, as natural dietary supplements in health food stores, and as illicit products manufactured at home or in clandestine laboratories. EDs and poison control centers nationwide will undoubtedly continue to manage GHB, GBL, and 1,4-BD toxicities.
Asunto(s)
4-Butirolactona/envenenamiento , Adyuvantes Anestésicos/envenenamiento , Butileno Glicoles/envenenamiento , Convulsiones/inducido químicamente , Oxibato de Sodio/envenenamiento , Trastornos Relacionados con Sustancias/diagnóstico , 4-Butirolactona/química , Adyuvantes Anestésicos/química , Adolescente , Butileno Glicoles/química , Servicios Médicos de Urgencia , Femenino , Humanos , Lorazepam/uso terapéutico , Convulsiones/tratamiento farmacológico , Oxibato de Sodio/química , Relación Estructura-Actividad , Resultado del TratamientoAsunto(s)
4-Butirolactona/envenenamiento , Suplementos Dietéticos/envenenamiento , Moduladores del GABA/envenenamiento , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Minnesota/epidemiología , New Mexico/epidemiología , Intoxicación/diagnóstico , Intoxicación/epidemiología , Intoxicación/terapia , Texas/epidemiologíaRESUMEN
Products containing gamma-butyrolactone (GBL) are marketed for many claimed purposes, including to induce sleep, release growth hormone, enhance sexual activity and athletic performance, relieve depression, and prolong life. GBL is converted by the body into gamma-hydroxybutyrate (GHB), a drug banned outside of clinical trials approved by the Food and Drug Administration (FDA). Recognized manifestations of GHB toxicity include bradycardia, hypothermia, central nervous system depression, and uncontrolled movements. This report describes seven cases of GBL toxicity involving the product "Revivarant," which is labeled as containing 1.82 g of GBL per fluid ounce, reported from two hospital emergency departments (EDs) in Minnesota during October-December 1998 and summarizes an additional 34 cases of GBL toxicity reported to poison centers in New Mexico and Texas during October 1998-January 1999.