RÉSUMÉ
We present two cases of GBL intoxication. Patient A is a 45-year old man who lost consciousness after drinking a clear unknown liquid. He was brought to the Emergency Departement (ED) after he was intubated. His partner notified the liquid could be GBL, a prodrug for GHB. He regained consciousness 16 hours later in the intensive care unit (ICU) where he could be successfully extubated. Patient B is a 25-year old man who was found unconscious at home with next to him an empty bottle of GBL. He was intubated in the intensive care unit. He could be extubated after 12 hours. GBL intoxication is becoming a more frequent problem and overdosage of GBL can rapidly occur because of its rapid onset and high potency when compared to GHB. We discuss the clinical course and complications after GBL ingestion and intoxication.
Sujet(s)
4-Butyrolactone/intoxication , Modulateurs GABA/intoxication , Adulte , Sujet âgé , Extubation , Soins de réanimation , Échelle de coma de Glasgow , Humains , Mâle , Oxygénothérapie , Ventilation artificielle , Perte de conscience/induit chimiquement , Perte de conscience/thérapieSujet(s)
Lésions traumatiques du coeur/psychologie , Épanchement péricardique/étiologie , Comportement auto-agressif/psychologie , Instruments chirurgicaux , Plaies par arme blanche/psychologie , Adulte , Diazépam/intoxication , Modulateurs GABA/intoxication , Lésions traumatiques du coeur/imagerie diagnostique , Ventricules cardiaques/traumatismes , Humains , Mâle , Satisfaction des patients , Épanchement péricardique/imagerie diagnostique , Échographie , Plaies par arme blanche/imagerie diagnostiqueRÉSUMÉ
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.
Sujet(s)
4-Butyrolactone/intoxication , Modulateurs GABA/intoxication , 4-Butyrolactone/pharmacocinétique , 4-Butyrolactone/pharmacologie , Adulte , Coma/induit chimiquement , Électrocardiographie , Modulateurs GABA/pharmacocinétique , Modulateurs GABA/pharmacologie , Échelle de coma de Glasgow , Humains , Mâle , Syndromes neurotoxiques/physiopathologieSujet(s)
4-Butyrolactone/intoxication , Modulateurs GABA/intoxication , Hydroxy-butyrates/intoxication , 4-Butyrolactone/sang , Adulte , Éthanol/sang , Éthanol/intoxication , Issue fatale , Femelle , Modulateurs GABA/sang , Humains , Hydroxy-butyrates/sang , Mâle , Respiration/effets des médicaments et des substances chimiquesSujet(s)
4-Butyrolactone/intoxication , Compléments alimentaires/intoxication , Modulateurs GABA/intoxication , Adolescent , Adulte , Enfant , Femelle , Humains , Mâle , Adulte d'âge moyen , Minnesota/épidémiologie , Nouveau Mexique/épidémiologie , Intoxication/diagnostic , Intoxication/épidémiologie , Intoxication/thérapie , Texas/épidémiologieRÉSUMÉ
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.