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
Jay Khadpe MD
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