Gamma-hydroxybutyrate: bridging the clinical-analytical gap.
Laboratory detection of gamma-hydroxybutyrate (GHB) has been published as early as the 1960s. However, wide-scale use of GHB during the 1990s has led to the development of current analytic methods to test for GHB and related compounds. Detection of GHB and related compounds can be clinically useful in confirming the cause of coma in an overdose patient, determining its potential role in a postmortem victim, as well as evaluating its use in a drug-facilitated sexual assault victim. Analytical method sensitivity must be known in order to determine the usefulness and clinical application. Most laboratory cut-off levels are based on instrument sensitivity and will not establish endogenous versus exogenous GHB levels. Interpretation of GHB levels must include a knowledge base of endogenous GHB, metabolism of GHB and related compounds, as well as postmortem generation. Due to potential analytical limitations in various GHB methods, it is clinically relevant to specifically request for GHB as well as related GHB compounds if they are also in question. Various storage conditions (collection time, types of containers, use of preservatives, storage temperature) can also affect the analysis and interpretation of GHB and related compounds.
Navy Drug Screening Laboratory, Great Lakes, Illinois, USA.
Cynthia L
CL
Morris-Kukoski
D015107:4-Butyrolactone / Q000032:analysis / Q000737:chemistry; D002072:Butylene Glycols / Q000032:analysis / Q000737:chemistry; D055598:Chemical Phenomena; D002627:Chemistry, Physical; D002849:Chromatography, Gas; D018757:GABA Modulators / Q000032:analysis / Q000737:chemistry; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis / Q000737:chemistry*; D012978:Sodium Oxybate / Q000031:analogs & derivatives / Q000032:analysis / Q000737:chemistry*; D015813:Substance Abuse Detection
D002072:Butylene Glycols; D018757:GABA Modulators; D013287:Illicit Drugs; D012978:Sodium Oxybate; C039681:1,4-butanediol; D015107:4-Butyrolactone