sodium-oxybate and Acute-Disease

The chronic abuse of Gamma-Hydroxybutyrate (GHB) as a designer drug as well as it's physiological precursors Gamma-Butyrolactone (GBL) and 1,4-Butandiole (1,4-BD) confronts child and adolescent psychiatrists with new challenges. The acute withdrawal of GHB with its cardiovascular and delirant symptoms is of particular importance for child and adolescent psychiatrists.. In the present paper theoretical and biological aspects of acute GHB-/GBL-/1,4-BD-withdrawal syndrome are presented, and selected cases are discussed as regards potential treatment.. High dose treatment with benzodiazepines was successful in some cases of acute GHB-/GBL-/1,4-BD-withdrawal syndrome. Complications were severe dystonia under neuroleptic treatment, and also side-effects of treatment with benzodiazepines. Further problems were vegetative symptoms, electrocardiographic changes, rhabdomyolysis, acute renal failure, and death.. Acute GHB-withdrawal syndrome is a life-threatening condition which requires immediate intensive care treatment along with continuous monitoring of vital parameters. As acute GHB-withdrawal syndrome can present with symptoms close to psychotic episodes or acute alcohol withdrawal this condition is relevant for child and adolescent psychiatrists.

Topics: 4-Butyrolactone; Acute Disease; Adolescent; Anesthetics, Intravenous; Antipsychotic Agents; Benzodiazepines; Butylene Glycols; Child; Critical Care; Delusions; Diagnosis, Differential; Drug Interactions; Humans; Psychoses, Substance-Induced; Sodium Oxybate; Substance Withdrawal Syndrome; Substance-Related Disorders

Topics: 5-Methoxytryptamine; Acute Disease; Adult; Designer Drugs; Female; Humans; Male; Sodium Oxybate

Use of and acute poisoning by substances of abuse represent a major health problem and are often linked to social destitution. We describe associations between place of residence, living conditions and the incidence of poisoning by substances of abuse in Oslo.. All patients who were 12 years of age or older and resident in Oslo and who were treated for acute poisoning by substances of abuse at the Oslo Accident and Emergency Outpatient Clinic (OAEOC) were included prospectively for a continuous period of one year, from October 2011 to September 2012. The 15 districts of Oslo were categorised into three groups of living conditions, from the best (I) to the poorest (III) living conditions, based on the City of Oslo's living conditions index. Homeless people were grouped separately. The incidence of poisoning by substances of abuse treated in the OAEOC was estimated.. Of a total of 1,560 poisonings by substances of abuse, 1,094 cases (70%) affected men. The median age was 41 years. The most frequent toxic agents were ethanol, with 915 cases (59%), and heroin, with 249 cases (16%). The incidence of poisoning by substances of abuse treated in the OAEOC per year per 1,000 inhabitants amounted to 1.75 in living conditions group I, to 2.76 in living conditions group II and 3.41 in living conditions group III. Living conditions group III had a significantly higher incidence than living conditions group II (p < 0.001), and living conditions group II had a significantly higher incidence than living conditions group I (p < 0.001).. The incidence of acute poisoning by substances of abuse was higher, the poorer the living conditions in the district.

Topics: Acute Disease; Adolescent; Adult; Aged; Ambulatory Care Facilities; Analgesics, Opioid; Benzodiazepines; Central Nervous System Stimulants; Child; Ethanol; Female; Heroin; Humans; Ill-Housed Persons; Male; Middle Aged; Norway; Poisoning; Prospective Studies; Social Conditions; Socioeconomic Factors; Sodium Oxybate; Substance-Related Disorders; Urban Population

Topics: Acute Disease; Adjuvants, Anesthesia; Adult; Brain Chemistry; Dopamine; Female; Homovanillic Acid; Humans; Male; Sodium Oxybate; Substance-Related Disorders

Topics: Acute Disease; Anilino Naphthalenesulfonates; Animals; Antioxidants; Benzimidazoles; Butylated Hydroxytoluene; Carbon Tetrachloride Poisoning; Fluorescent Dyes; Male; Rats; Serum Albumin; Sodium Oxybate

Gamma hydroxybutyrate (GHB) is an illicitly marketed substance promoted by body builders as a growth hormone releaser. Poisoning can produce seizures and coma. Acute poisonings from GHB have primarily been reported on the West coast and the Southeast. We report two cases from Kansas City where the patients presented in, or developed profound coma. Physicians should suspect GHB poisoning in patients who present with unexplained seizures and/or coma, particularly if they are body builders, health food fanatics or dieters.

Topics: Acute Disease; Adult; Alcohol Drinking; Coma; Diet Fads; Female; Humans; Male; Missouri; Seizures; Sodium Oxybate; Weight Lifting

Influence of natrii hydroxybutyrate (100 mg/kg), ascorbate (100 mg/kg), cavinton (5 mg/kg), bemitil (50 mg/kg), ethomersol (50 mg/kg) on Hb-O2 affinity and cortex PO2 after both carotid artery occlusion in rats was investigated. Correlation (r-0.87; P less than 0.05) between lowering of Hb-O2 affinity and antihypoxic effect was demonstrated in the line of these drugs.

Topics: Acute Disease; Animals; Antioxidants; Ascorbic Acid; Benzimidazoles; Brain Ischemia; Drug Evaluation, Preclinical; Hemoglobins; Hypoxia, Brain; Oxygen; Rats; Sodium Oxybate; Vasodilator Agents; Vinca Alkaloids

Topics: Acid-Base Equilibrium; Acute Disease; Anesthesia, General; Animals; Dogs; Ether; Fentanyl; Hemodynamics; Myocardial Infarction; Respiration, Artificial; Sodium Oxybate; Tracheotomy

The investigation of indices of hemodynamics and oxygen regimen in 58 patients with acute purulent peritonitis has shown the programmed intravenous narcosis in combination with Darenthin to promote increasing the cardiac and stroke index. Darenthin included in the complex intensive therapy of peritonitis was found to increase the portal blood flow and to cause early reestablishment of the intestine peristalsis.

Topics: Acute Disease; Adult; Anesthesia, Intravenous; Critical Care; Female; Fentanyl; Humans; Male; Middle Aged; Peritonitis; Postoperative Care; Preanesthetic Medication; Sodium Oxybate

After clinical death caused by acute blood loss, hearts of rats were essentially damaged. In isolated hearts, these damages were manifested in the decrease of major contractility parameters with the preferential disturbance of relaxation, increased loss of enzymes (lactate dehydrogenase and creatine phosphokinase) into the perfusate and a significant decrease of the cardiac muscle resistance to hypoxia. All these effects could be, to a large extent, prevented by gamma-hydroxybutyric acid, an endogenous metabolite having central inhibitory effect, which was administered to the animals before the loss of blood.

Topics: Acute Disease; Animals; Creatine Kinase; Death; Heart Diseases; Heart Rate; Hemorrhage; Hydroxybutyrates; In Vitro Techniques; L-Lactate Dehydrogenase; Male; Myocardial Contraction; Rats; Resuscitation; Sodium Oxybate; Time Factors

Topics: Acute Disease; Animals; Blood Transfusion, Autologous; Dextrans; Dogs; Hemorrhage; Humans; Hydroxybutyrates; Sodium Oxybate