Historique
Article de Périodique
Gamma-hydroxybutyrate (GHB), 1,4-butanediol (1,4BD), and gamma-butyrolactone (GBL) intoxication: A state-of-the-art review (2023)
Auteur(s) :
DUFAYET, L. ;
BARGEL, S. ;
BONNET, A. ;
BOUKERMA, A. K. ;
CHEVALLIER, C. ;
EVRARD, M. ;
GUILLOTIN, S. ;
LOEUILLET, E. ;
PARADIS, C. ;
POUGET, A. M. ;
REYNOARD, J. ;
VAUCEL, J. A.
Année
2023
Page(s) :
art. 105435
Sous-type de document :
Revue de la littérature / Literature review
Langue(s) :
Anglais
Domaine :
Autres substances / Other substances
Discipline :
PRO (Produits, mode d'action, méthode de dépistage / Substances, action mode, screening methods)
Thésaurus mots-clés
GHB
;
GBL
;
INTOXICATION
;
SURDOSE
;
TOXICOLOGIE
;
ABUS SEXUEL
;
NEUROBIOLOGIE
;
PHARMACOLOGIE
;
PHARMACOCINETIQUE
;
METABOLISME
;
SYMPTOME
;
SYNDROME DE SEVRAGE
;
EFFET SECONDAIRE
;
ANALYSE CHIMIQUE
Résumé :
gamma-hydroxybutyrate (GHB) is synthesized endogenously from gamma-aminobutyric acid (GABA) or exogenously from 1,4-butanediol (butane-1,4-diol; 1,4-BD) or gamma-butyrolactone (GBL). GBL, and 1,4-BD are rapidly converted to GHB. The gastric absorption time, volume of distribution, and half-life of GHB are between 5 and 45 min, 0.49 ± 0.9 L/kg, and between 20 and 60 min, respectively. GHB and its analogues have a dose-dependent effect on the activation of GHB receptor, GABA-B, and GABA localized to the central nervous system. After ingestion, most patients present transient neurological disorders (lethal dose: 60 mg/kg). Chronic GHB consumption is associated with disorders of use and a withdrawal syndrome when the consumption is discontinued. GHB, GBL, and 1,4-BD are classified as narcotics but only the use of GHB is controlled internationally. They are used for drug facilitated (sexual) assault, recreational purposes, slamsex, and chemsex. To confirm an exogenous intake or administration of GHB, GBL, or 1-4-BD, the pre-analytical conservation is crucial. The antemortem cutoff doses for detection are 5 and 5-15 mg/L, with detection windows of 6 and 10 h in the blood and urine, respectively Control of GHB is essential to limit the number of users, abuse, associated risks, and death related to their consumption.
Affiliation :
Unité Médico-judiciaire, Hôtel-Dieu, APHP, , Paris, France ; Centre Antipoison de Paris - Fédération de Toxicologie (FeTox), Hôpital Fernand-Widal, APHP, Paris, France ; INSERM, UMRS-1144, Faculté de Pharmacie, Paris, France ; UFR de Médecine, Université de Paris, Paris, France