Hornfeldt, Table 1

TABLE 1.  Summary of Therapeutic, Toxic, and Postmortem Laboratory Findings Following Exposure to Gamma-Hydroxybutyric Acid and Related Compounds.

THERAPEUTIC DRUG CONCENTRATIONS

Ingested Substance

Ingested Dose

Measured Substance(s)

Source(s)

Concentration**

Reference

GHB

3 g repeated after 4 hrs (26.4-52.4 mg/kg)

GHB

Plasma

Two doses resulted in two peaks. Means =62.8  mg/L (SD=27.4) and 91.2 mg/L (SD=25.6),  N=6

Scharf et al. 1998B

 

GHB

25 mg/kg

GHB

Plasma

55 mg/L (range 24-88 mg/L)

Ferrara et al. 1993

50 mg/kg

GHB

Plasma

90 mg/L (range 51-158 mg/L)

 

GHB

25 mg/kg

GHB

Plasma

Mean = 54 mg/L (SD=19),  N=10

Ferrara et al. 1992

TOXIC DRUG CONCENTRATIONS

Ingested Substance

Ingested Dose

Measured Substance(s)

Source(s)

Concentration

Comments

Reference

1,4-BD

6.3-8.4 g

1,4-BD

Urine

undetectable

GCS=3*

Zvosec et al. 2001

GHB

Urine

415 mg/L

 

1,4-BD

4.5 g

1,4-BD

Urine

undetectable

GCS=ll*; labile level of conciousness

Zvosec et al. 2001

GHB

Serum

317 mg/L

GHB

Urine

716 mg/L

 

1,4-BD

unknown

1,4-BD

Urine

undetectable

withdrawal; same patient as above, subsequent event

Zvosec et al. 2001

GHB

Urine

5,140 mg/L

 

GHB

unknown

GHB

Serum

125 mg/L

ethanol a coingestant; GCS=6*

Louagie et al. 1997

 

GHB

unknown

GHB

Serum

101 mg/L

1HR postingestion; GCS=3*; 2-month delay in analysis

Dyer et al. 1994

GHB

Urine

141,000 mg/L

 

GHB

unknown

GHB

Serum

0 mg/L

1HR postingestion; GCS=3*; 2-month delay in analysis

Dyer et al. 1994

GHB

Urine

1,857 mg/L

 

GHB

Unknown

GHB

Serum

0 mg/L

1HR postingestion; GCS=3*; 2-month delay in analysis

Dyer et al. 1994

GHB

Urine

521 mg/L

 

GHB

Unknown

GHB

Urine

1,975 mg/L

THC metabolite also present; severe ataxia

Stephens and Baselt 1994

POSTMORTEM DRUG CONCENTRATIONS

Ingested Substance

Ingested Dose

Measured Substance(s)

Source(s)

Concentration

Comments

Reference

1,4-BD

26 g

(estimated to be 320 mg/kg)

1,4-BD

Heart Blood

78 mg/L

 

Martin and Duer 2001

Urine

870 mg/L

GHB

Heart Blood

416 mg/L

Urine

1810 mg/L

 

1,4-BD

5.4–10.8 g

(estimated to be 95–189 mg/kg)

1,4-BD

Blood

220 mg/L

 

Zvosec et al. 2001

Urine

1756 mg/L

GHB

Blood

837 mg/L

Urine

1161 mg/L

 

1,4-BD

20 g

(estimated to be 300 mg/kg)

1,4-BD

Urine

845 mg/L

 

McCutcheon et al. 2000

GHB

Blood

432 mg/L

Urine

5430 mg/L

 

1,4-BD

Unknown

1,4-BD

Blood

7.6 mg/L

 

Kraner et al. 2000

Urine

146 mg/L

Bile

0 mg/L

Vitreous H.

12.3 mg/L

GHB

Blood

280 mg/L

Urine

6,171 mg/L

Bile

218 mg/L

Vitreous H.

324 mg/L

 

GHB

Unknown

GHB

Blood

140 mcg/g

ethanol, fenfluramine & norfenfluramine also present

Timby et al. 2000

Urine

620 mcg/g

 

GHB

Unknown

GHB

Blood

170 mcg/g

ethanol & nordazepam  also present

Timby et al. 2000

Urine

300 mcg/g

 

GHB

Unknown

GHB

Heart Blood

66 mg/L

second case may have also involved ingestion of gamma-butyrolactone

Marinetti et al. 2000

Urine

1260 mg/L

GHB

Unknown

GHB

Heart Blood

15 mg/L

Urine

150 mg/L

 

GHB

Unknown

GHB

Blood

11.5 mg/L

heroin was a co-ingestant: morphine and 6-monoacetyl-morphine also present

Ferrara et al. 1995

Urine

258.3 mg/L

Bile

57.0 mg/L

Vitreous H.

84.3 mg/L

 

NONE

 

GHB

Blood, N=20

0-168 mg/L

mean 25 mg/L

Fieler et al.  1998

Urine, N=8

0 mg/L

 

NONE

 

GHB

Blood, N=13

0-197 mg/L

mean 57 mg/L

Elliot 2001

Urine, N=13

0-217 mg/L

mean 56 mg/L

*   Glascow Coma Scale

** Those laboratory values reported as mg/mL converted to mg/L for consistency.