Abstract
Background. Gamma-Butyrolactone (GBL), a chemical in many solvents that is metabolized into Gam-ma-Hydroxybutyrate (GHB) which acts as a precursor to Gamma-AminoButyric Acid (GABA) in the Central Nervous System, which is known for its calming effect leading to unconsciousness and coma making it popular in the drug-abusing scene, such cases reported in the country are limited, leading to weak understanding of a patients' presentation. Case report. A 21-years-old male patient presented by ambulance to the Emergency department (ED) of Tertiary hospital in Saudi Arabia after being found un-conscious due to GBL and methamphetamine ingestion which was obtained from Gel-removers. Patient was unconscious with bilateral pinpoint pupils, sinus bradycardia, and bradypnea. Initial intervention with atropine and naloxone IV improved the heart rate without respiratory rate or mental state improve-ment. agitation and confusion were noted, thus midazolam was administered and brain CT was done to rule out intracranial pathologies which was negative. Another naloxone dose was administered after an hour due to the development of snoring and posterior displacement of the tongue with no improvement, intubation was done and maintenance sedation started. After 1.5 hours the patient woke-up agitated and Sedation was discontinued, he was hemodynamically stable and gradually gained full consciousness. It was revealed that the patient had been abusing a GBL-containing substance and methamphetamine, which accounted for the clinical presentation and progression of symptoms. Conclusion. Due to the rise of GBL/GHB intoxication cases, further literature must be established and more cases should be report-ed to raise the awareness regarding this substance.
Published Version
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