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Author Zvosec, Deborah L. ♦ Smith, Stephen W. ♦ Porrata, Trinka ♦ Strobl, A. Quinn ♦ Dyer, Jo Ellen
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Natural sciences & mathematics ♦ Chemistry & allied sciences ♦ Life sciences; biology ♦ Biochemistry ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Pharmacology and therapeutics ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Chemically-Induced Disorders ♦ Diseases ♦ Organic Chemicals ♦ Pharmaceutical Preparations ♦ Chemicals and Drugs ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Persons ♦ Persons ♦ Geographic Locations ♦ Geographic Locations
Subject Keyword Discipline Emergency ♦ Discipline Medicine ♦ Sodium Oxybate ♦ Poisoning ♦ Street Drugs ♦ Substance-related Disorders ♦ Mortality ♦ Adolescent ♦ Adult ♦ Female ♦ Humans ♦ Male ♦ Middle Aged ♦ Retrospective Studies ♦ Blood ♦ United States ♦ Young Adult ♦ Journal Article ♦ Review
Abstract γ-Hydroxybutyrate (GHB) and its prodrugs are drugs of abuse that were also sold as 'dietary supplements.' Users present to emergency departments with overdose, impaired driving, withdrawal, and associated trauma. We compiled a series of GHB-associated deaths to elucidate lethal risks, GHB concentrations, cointoxicants, products, uses, and medical interventions. Death records were reviewed for toxicology, autopsy findings, and history. Inclusion cutoffs were as follows: 5/10 mg/L of GHB (antemortem blood/urine) and 50/20/7 mg/L of GHB (postmortem blood/urine/vitreous). Of 226 deaths included, 213 had cardiorespiratory arrest and 13 had fatal accidents. Seventy-eight deaths (35%) had no cointoxicants. Sixteen deaths involved 'supplements' and 1 involved pharmaceutical GHB (Xyrem, Jazz Pharmaceuticals, Palo Alto, CA). Postmortem blood GHB was 18 to 4400 mg/L (median, 347 mg/L) in deaths negative for cointoxicants. Cardiorespiratory arrest occurred prehospital in 100% of 184 cases with available history. Of 72 cases with antemortem adverse effects reported, medical assistance was delayed or absent in 66; of these, acute GHB ingestion was known in 51, including 40 left to 'sleep off' adverse effects. Thirty others were left 'sleeping' and found dead. γ-Hydroxybutyrate is lethal even without cointoxicants, directly and through fatal accidents. Medical interventions were frequently delayed or absent despite known GHB ingestion, and witnessed adverse events and cardiorespiratory arrest occurred prehospital. Education is needed about the lethality of GHB and the necessity for prompt medical intervention.
Spatial Coverage United States
Description Country affiliation: United States
Author Affiliation: Zvosec DL ( Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN 55415, USA. dzvosec@gmail.com)
ISSN 07356757
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2011-03-01
Publisher Place United States
e-ISSN 15328171
Journal The American Journal of Emergency Medicine
Volume Number 29
Issue Number 3


Source: WHO-Global Index Medicus