Characteristics and dose-effect relationship of clinical gamma-hydroxybutyrate intoxication: A case series

Abid, Madelaine, Kietzerow, Jana, Iwersen-Bergmann, Stefanie, Schnitgerhans, Tino and Andresen-Streichert, Hilke . Characteristics and dose-effect relationship of clinical gamma-hydroxybutyrate intoxication: A case series. J. Forensic Sci.. HOBOKEN: WILEY. ISSN 1556-4029

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DOI:10.1111/1556-4029.14880

Abstract

Gamma-Hydroxybutyrate (GHB) overdoses cause respiratory depression, coma, or even death. Symptoms and severity of poisoning depend on blood-concentrations and individual factors such as tolerance. A retrospective case study was conducted, evaluating GHB intoxication cases. GHB-concentrations in blood and urine were determined by gas chromatography-mass spectrometry (GC-MS) along with, in part, via enzymatic assay. GHB-concentrations, demographic data, and additional drug use, as well as specific clinical information, were evaluated. The correlation between GHB-levels in blood and associated symptoms were examined. In total, 75 cases originating from the Emergency Departments (EDs) of Hamburg and surrounding hospitals were included. Fifty-four of the patients (72%) were male. The mean GHB-concentration in blood was 248 mg/L (range 21.5-1418 mg/L). Out of the group with detailed clinical information (n = 18), the comatose group (n = 10/18) showed a mean of 244 mg/L (range 136-403 mg/L), which was higher than that of the somnolent and awake patients. Of the comatose collective, 70% (n = 7) showed co-use of one or more substances, with the additional use of cocaine being the most frequently detected (n = 5). In conclusion, a moderate dose-effect relationship was observed, although, there was some overlap in dosage concentration levels of GHB in awake and comatose patients. In GHB-intoxication cases, co-use was common as were clinical effects such as acidosis, hypotension, and impact on the heart rate. Timely analytical determination of the GHB-concentration in blood could support correct diagnosis of the cause of unconsciousness.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Abid, Madelaine	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Kietzerow, Jana	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Iwersen-Bergmann, Stefanie	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Schnitgerhans, Tino	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Andresen-Streichert, Hilke	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED