title: Toxic ingestion of gamma-hydroxybutyric acid.
abstract: Gamma-hydroxybutyric acid (GHB) has become a popular new drug of abuse. Its effects include euphoria and disinhibition. Recently, several cases have been reported in the literature of life-threatening or lethal ingestions. We report the case of a 17-year-old male who became unresponsive after taking GHB. Gamma-hydroxybutyric acid is used outside the United States to treat narcolepsy. In the past, it was touted as a muscle-bulking aid and was taken by body-builders. It has also been implicated as a drug involved in "date-rapes." Patients who ingest excessive GHB have a markedly altered level of consciousness, as did the patient in this illustrative case. Neostigmine and physostigmine show promise as potential reversal agents. Gamma-hydroxybutyric acid overdose should be considered in any patient with altered mental status and a history of recreational drug abuse.
authors.affiliation: Department of Family Practice, Naval Hospital Jacksonville, FL 32114, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Viera
authors.forename: S W
authors.initials: SW
authors.lastname: Yates
mesh_terms: D000293:Adolescent; D062787:Drug Overdose / Q000628:therapy; D004630:Emergencies; D015600:Glasgow Coma Scale; D006801:Humans; D006885:Hydroxybutyrates / Q000506:poisoning*; D008297:Male; D019966:Substance-Related Disorders
chemical_list: D006885:Hydroxybutyrates; C111420:4-hydroxybutyric acid