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Gamma hydroxybutyrate

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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, April, 2014 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.
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