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 |
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Ingested Substance |
Ingested Dose |
Measured Substance(s) |
Source(s) |
Concentration** |
Reference |
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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 |
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GHB |
25 mg/kg |
GHB |
Plasma |
55 mg/L (range 24-88 mg/L) |
Ferrara et al. 1993 |
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50 mg/kg |
GHB |
Plasma |
90 mg/L (range 51-158 mg/L) |
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GHB |
25 mg/kg |
GHB |
Plasma |
Mean = 54 mg/L (SD=19), N=10 |
Ferrara et al. 1992 |
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TOXIC DRUG CONCENTRATIONS |
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Ingested Substance |
Ingested Dose |
Measured Substance(s) |
Source(s) |
Concentration |
Comments |
Reference |
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1,4-BD |
6.3-8.4 g |
1,4-BD |
Urine |
undetectable |
GCS=3* |
Zvosec et al. 2001 |
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GHB |
Urine |
415 mg/L |
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1,4-BD |
4.5 g |
1,4-BD |
Urine |
undetectable |
GCS=ll*; labile level of conciousness |
Zvosec et al. 2001 |
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GHB |
Serum |
317 mg/L |
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GHB |
Urine |
716 mg/L |
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1,4-BD |
unknown |
1,4-BD |
Urine |
undetectable |
withdrawal; same patient as above, subsequent event |
Zvosec et al. 2001 |
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GHB |
Urine |
5,140 mg/L |
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GHB |
unknown |
GHB |
Serum |
125 mg/L |
ethanol a coingestant; GCS=6* |
Louagie et al. 1997 |
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GHB |
unknown |
GHB |
Serum |
101 mg/L |
1HR postingestion; GCS=3*; 2-month delay in analysis |
Dyer et al. 1994 |
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GHB |
Urine |
141,000 mg/L |
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GHB |
unknown |
GHB |
Serum |
0 mg/L |
1HR postingestion; GCS=3*; 2-month delay in analysis |
Dyer et al. 1994 |
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GHB |
Urine |
1,857 mg/L |
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GHB |
Unknown |
GHB |
Serum |
0 mg/L |
1HR postingestion; GCS=3*; 2-month delay in analysis |
Dyer et al. 1994 |
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GHB |
Urine |
521 mg/L |
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GHB |
Unknown |
GHB |
Urine |
1,975 mg/L |
THC metabolite also present; severe ataxia |
Stephens and Baselt 1994 |
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POSTMORTEM DRUG CONCENTRATIONS |
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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 |
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Urine |
870 mg/L |
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GHB |
Heart Blood |
416 mg/L |
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Urine |
1810 mg/L |
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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 |
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Urine |
1756 mg/L |
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GHB |
Blood |
837 mg/L |
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Urine |
1161 mg/L |
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1,4-BD |
20 g (estimated to be 300 mg/kg) |
1,4-BD |
Urine |
845 mg/L |
McCutcheon et al. 2000 |
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GHB |
Blood |
432 mg/L |
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Urine |
5430 mg/L |
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1,4-BD |
Unknown |
1,4-BD |
Blood |
7.6 mg/L |
Kraner et al. 2000 |
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Urine |
146 mg/L |
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Bile |
0 mg/L |
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Vitreous H. |
12.3 mg/L |
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GHB |
Blood |
280 mg/L |
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Urine |
6,171 mg/L |
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Bile |
218 mg/L |
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Vitreous H. |
324 mg/L |
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GHB |
Unknown |
GHB |
Blood |
140 mcg/g |
ethanol, fenfluramine & norfenfluramine also present |
Timby et al. 2000 |
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Urine |
620 mcg/g |
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GHB |
Unknown |
GHB |
Blood |
170 mcg/g |
ethanol & nordazepam also present |
Timby et al. 2000 |
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Urine |
300 mcg/g |
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GHB |
Unknown |
GHB |
Heart Blood |
66 mg/L |
second case may have also involved ingestion of gamma-butyrolactone |
Marinetti et al. 2000 |
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Urine |
1260 mg/L |
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GHB |
Unknown |
GHB |
Heart Blood |
15 mg/L |
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Urine |
150 mg/L |
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GHB |
Unknown |
GHB |
Blood |
11.5 mg/L |
heroin was a co-ingestant: morphine and 6-monoacetyl-morphine also present |
Ferrara et al. 1995 |
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Urine |
258.3 mg/L |
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Bile |
57.0 mg/L |
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Vitreous H. |
84.3 mg/L |
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NONE |
GHB |
Blood, N=20 |
0-168 mg/L |
mean 25 mg/L |
Fieler et al. 1998 |
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Urine, N=8 |
0 mg/L |
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NONE |
GHB |
Blood, N=13 |
0-197 mg/L |
mean 57 mg/L |
Elliot 2001 |
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Urine, N=13 |
0-217 mg/L |
mean 56 mg/L |
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* Glascow Coma Scale
** Those laboratory values reported as mg/mL converted to mg/L for consistency.