The Dept of Anaesthesia & Intensive Care, CUHK thanks

for an unrestricted education grant
Intensive Care Nephrology - beyond BASIC courses: London (June), Singapore (July)
Click here for details
Asian Intensive Care Conference, Hong Kong, November 21-22nd 2013

Home Feedback Contents

Gamma hydroxybutyrate

Up Beta blocker Carbon monoxide Cyanide Dextropropoxyphene Digoxin Ethylene glycol Gamma hydroxybutyrate Isopropanolol Lithium Methaemoglobinaemia Methanol Paracetamol Paraquat Pesticides Recreational drugs Salicylate Theophylline Tricyclic anti-depressants

 

Also known as "liquid ecstasy", "liquid G", "date-rape drug" or "fantasy"

Clinical features

  • regular use causes tolerance and dependence
    • abrupt withdrawal can produce delirium and psychosis
  • dose dependent clinical features
    • low dose: euphoria, amnesia, dizziness, drowsiness, hypotonia
    • high dose: deep coma and death
    • margin separating euphoric and life-threatening effects appears to be slim
  • emesis, hypothermia, symptomatic bradycardia, hypotension, respiratory acidosis
  • generalized convulsions
  • hypersalivation
  • hypothermia

Management

  • supportive
  • gastric lavage contraindicated (drug may induce rapid loss of consciousness)
  • most patients regain consciousness within 5h of ingestion but toxicity prolonged by co-ingestion of alcohol
  • gamma hydroxybutyrate can be detected in urine, blood and hair if needed for legal reasons

Further reading

Mokhlesi B et al. Adult toxicology in critical care. Part II: Specific poisonings. Chest 2003; 123:897-922

Smith KM et al. Club drugs: methylenedioxymetamphetamine, flunitrazepam, ketamine hydrochloride, and gamma-hydroxybutyrate. Am J Health-Syst Pharm, 2002; 59:1067-76

©Charles Gomersall, May, 2013 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
Copyright policy    Contributors