@article{ref1,
title="Clinical features of gamma-hydroxybutyrate and gamma-butyrolactone toxicity and concomitant drug and alcohol use",
journal="Drug and alcohol dependence",
year="2006",
author="Liechti, Matthias E. and Kunz, Isabelle and Greminger, Peter and Speich, Rudolf and Kupferschmidt, Hugo",
volume="81",
number="3",
pages="323-326",
abstract="OBJECTIVE: To describe the clinical features of gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL) toxicity. METHODS: Retrospective case-study of 65 GHB and GBL intoxications seen in an urban emergency department. RESULTS: 63% of intoxications occurred in male patients. The median age was 24 years (range 16-41 years). 65% co-ingested alcohol or illicit drugs, mostly MDMA and cocaine. 83% presented with coma. The mean+/-S.D. time to regain consciousness among comatose patients was 111+/-61 min and was significantly longer in patients who co-abused illicit drugs such as cocaine or MDMA (155+/-60 min). Bradycardia occurred in 38%, hypotension in 6% and hypothermia in 48%. Agitation was observed in 17% of all patients and was significantly more frequent in patients with alcohol co-use (29%). Vomiting occurred in 31% of all patients and tended to be more frequent in patients who co-used alcohol (39%). Management of GHB and GBL overdose was supportive. Four patients needed admission to an intensive care unit for mechanical ventilation (6%). CONCLUSIONS: Overdosing of GHB and GBL frequently results in non-reactive coma reflecting the severity of poisoning. Multiple drug use is common and significantly influences the clinical presentation.<p /><p>Language: en</p>",
language="en",
issn="0376-8716",
doi="10.1016/j.drugalcdep.2005.07.010",
url="http://dx.doi.org/10.1016/j.drugalcdep.2005.07.010"
}