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Clinical course of gamma-hydroxybutyrate overdose.
Ann Emerg Med. 1998 Jun; 31(6):716-22.AE

Abstract

STUDY OBJECTIVE

To describe the clinical characteristics and course of gamma-hydroxybutyrate (GHB) overdose.

METHODS

We assembled a retrospective series of all cases of GHB ingestion see in an urban public-hospital emergency department and entered in a computerized database January 1993 through December 1996. From these cases we extracted demographic information, concurrent drug use, vital signs, Glasgow Coma Scale (GCS) score, laboratory values, and clinical course.

RESULTS

Sixty-one (69%) of the 88 patients were male. The mean age was 28 years. Thirty-four cases (39%) involved coingestion of ethanol, and 25 (28%) involved coingestion of another drug, most commonly amphetamines. Twenty-five cases (28%) had a GCS score of 3, and 28 (33%) had scores ranging from 4 through 8. The mean time to regained consciousness from initial presentation among nonintubated patients with an initial GCS of 13 or less was 146 minutes (range, 16-389). Twenty-two patients (31%) had an initial temperature of 35 degrees C or less. Thirty-two (36%) had asymptomatic bradycardia; in 29 of these cases, the initial GCS score was 8 or less. Ten patients (11%) presented with hypotension (systolic blood pressure < or = 90 mm Hg); 6 of these patients also demonstrated concurrent bradycardia. Arterial blood gases were measured in 30 patients; 21 had a PCO2 of 45 or greater, with pH ranging from 7.24 to 7.34, consistent with mild acute respiratory acidosis. Twenty-six patients (30%) had an episode of emesis; in 22 of these cases, the initial GCS was 8 or less.

CONCLUSION

In our study population, patients who overdosed on GHB presented with a markedly decreased level of consciousness. Coingestion of ethanol or other drugs is common, as are bradycardia, hypothermia, respiratory acidosis, and emesis. Hypotension occurs occasionally. Patients typically regain consciousness spontaneously within 5 hours of the ingestion.

Authors+Show Affiliations

Department of Emergency Services, San Francisco General Hospital, CA, USA. rchin@itsa.ucsf.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9624311

Citation

Chin, R L., et al. "Clinical Course of Gamma-hydroxybutyrate Overdose." Annals of Emergency Medicine, vol. 31, no. 6, 1998, pp. 716-22.
Chin RL, Sporer KA, Cullison B, et al. Clinical course of gamma-hydroxybutyrate overdose. Ann Emerg Med. 1998;31(6):716-22.
Chin, R. L., Sporer, K. A., Cullison, B., Dyer, J. E., & Wu, T. D. (1998). Clinical course of gamma-hydroxybutyrate overdose. Annals of Emergency Medicine, 31(6), 716-22.
Chin RL, et al. Clinical Course of Gamma-hydroxybutyrate Overdose. Ann Emerg Med. 1998;31(6):716-22. PubMed PMID: 9624311.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical course of gamma-hydroxybutyrate overdose. AU - Chin,R L, AU - Sporer,K A, AU - Cullison,B, AU - Dyer,J E, AU - Wu,T D, PY - 1998/6/13/pubmed PY - 1998/6/13/medline PY - 1998/6/13/entrez SP - 716 EP - 22 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 31 IS - 6 N2 - STUDY OBJECTIVE: To describe the clinical characteristics and course of gamma-hydroxybutyrate (GHB) overdose. METHODS: We assembled a retrospective series of all cases of GHB ingestion see in an urban public-hospital emergency department and entered in a computerized database January 1993 through December 1996. From these cases we extracted demographic information, concurrent drug use, vital signs, Glasgow Coma Scale (GCS) score, laboratory values, and clinical course. RESULTS: Sixty-one (69%) of the 88 patients were male. The mean age was 28 years. Thirty-four cases (39%) involved coingestion of ethanol, and 25 (28%) involved coingestion of another drug, most commonly amphetamines. Twenty-five cases (28%) had a GCS score of 3, and 28 (33%) had scores ranging from 4 through 8. The mean time to regained consciousness from initial presentation among nonintubated patients with an initial GCS of 13 or less was 146 minutes (range, 16-389). Twenty-two patients (31%) had an initial temperature of 35 degrees C or less. Thirty-two (36%) had asymptomatic bradycardia; in 29 of these cases, the initial GCS score was 8 or less. Ten patients (11%) presented with hypotension (systolic blood pressure < or = 90 mm Hg); 6 of these patients also demonstrated concurrent bradycardia. Arterial blood gases were measured in 30 patients; 21 had a PCO2 of 45 or greater, with pH ranging from 7.24 to 7.34, consistent with mild acute respiratory acidosis. Twenty-six patients (30%) had an episode of emesis; in 22 of these cases, the initial GCS was 8 or less. CONCLUSION: In our study population, patients who overdosed on GHB presented with a markedly decreased level of consciousness. Coingestion of ethanol or other drugs is common, as are bradycardia, hypothermia, respiratory acidosis, and emesis. Hypotension occurs occasionally. Patients typically regain consciousness spontaneously within 5 hours of the ingestion. SN - 0196-0644 UR - https://wwww.unboundmedicine.com/medline/citation/9624311/Clinical_course_of_gamma_hydroxybutyrate_overdose_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196064498001620 DB - PRIME DP - Unbound Medicine ER -