Morning Report: 8/14/2014

Thanks to Dr. Adesina for presenting today’s Morning Report!

 

GBL Toxicity

 

Gamma-Butyrolactone (GBL) is an addictive depressant used for its euphoric and sleep inducing effects. It is a prodrug to GHB.

GBL can be synthesized from gamma-hydroxybutyric acid (GHB) by removal of water or by distillation from such a mixture.

 

Pathophysiology:

GBL readily crosses the blood-brain barrier with rapid onset of anxiolytic, sedative and euphoric effects. It acts in the central nervous system at the GABABB receptor and the GHB receptor.

 

Uses:

 

Recreational:

–       date rape drug

–       body builders

 

Household products:

Pain thinners, stain remover, super glue, wheel cleaner

 

Signs and Symptoms:

▪   Central Nervous System (CNS) depression

▪   Euphoria

▪   Sedation/ Restful sleep

▪   Insomnia

▪   Increased energy/agitation/anxiety

▪   Loss of inhibition

▪   Increased sex drive

▪   Unconsciousness/ coma/ death

▪   Hot/cold flushes

▪   Uncontrolled body movements

▪   Muscle relaxation

▪   Gastro-intestinal irritation/vomiting

▪   Respiratory failure

▪   Seizures

▪   Hypotension

▪   Addiction and dependency

 

Dependence and Withdrawal:

Similar to chronic alcohol dependence and benzodiazepine dependence: Symptoms include anxiety, insomnia, tremor, confusion, nausea, vomiting, hypertension and tachycardia.

 

Treatment:

-Benzodiazepine: (GABA-A)

-Chlordiazepoxide/Baclofen (GABA-B)

-Gabapentin/Pregablain( GABA-B)

 

References

1)   GBL. https://www.drugs-forum.com

2)   Gamma-butyrolactone. http://en.wikipedia.org/wiki/Gamma-Butyrolactone.

3)   Paul Bracchi. Coma in a bottle: GBL , the 50 p party drug that is easier to obtain than heroin…and is legal. http://www.dailymail.co.uk

The views expressed on this blog are the author's own and do not reflect the views of their employer. Please read our full disclaimer here. Any references to clinical cases refer to patients treated at a virtual hospital, Janus General Hospital.
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Jay Khadpe MD

Editor in Chief of "The Original Kings of County" Assistant Professor of Emergency Medicine Assistant Residency Director SUNY Downstate / Kings County Hospital

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