Service de Pharmacologie-Toxicologie Pharmacovigilance, CHU Angers, Angers, France.
Université d'Angers, Angers, France.
Ther Drug Monit. 2023 Apr 1;45(2):277-281. doi: 10.1097/FTD.0000000000001011.
Despite a better safety profile than illicit γ-hydroxybutyric acid (GHB) and other GHB analogs, sodium oxybate continues to raise serious concerns regarding clinical safety. In this study, the authors report the case of near-fatal intoxication involving sodium oxybate-alcohol combination in a 40-year-old woman. In addition, a review of the literature on published cases of intoxication involving this pharmaceutical form of GHB was conducted. A 40-year-old woman was admitted to the intensive care unit in a coma after voluntary ingestion of 18 g of sodium oxybate and alcohol.
The GHB plasma concentration was quantified to be 146 mg/L using liquid chromatography coupled with tandem mass spectrometry. An English literature search was performed using PubMed without any limiting period to identify all available scientific publications involving cases of sodium oxybate intoxication.
Six cases were identified. Five involved fatal intoxication cases, with GHB postmortem blood concentrations ranging from 11.5 to 3500 mg/L. One involved a nonfatal intoxication case with a GHB serum concentration of 569 mg/L 7 hours postingestion.
In the present case, the estimated elimination half-life was 154 minutes. The risk of acute poisoning seems to be high considering the pharmacokinetic properties of sodium oxybate. Physicians and toxicologists must take such properties into account.
尽管相较于非法 γ-羟基丁酸（GHB）和其他 GHB 类似物，羟丁酸钠具有更好的安全性，但它仍引发了人们对临床安全性的严重担忧。在本研究中，作者报告了一例涉及羟丁酸钠-酒精联合用药的 40 岁女性近乎致命性中毒的病例。此外，还对涉及该种 GHB 药物制剂的已发表中毒病例的文献进行了综述。
一名 40 岁女性因自愿摄入 18 克羟丁酸钠和酒精而昏迷，被送入重症监护病房。
使用液相色谱-串联质谱法对 GHB 血浆浓度进行定量，检测结果为 146mg/L。使用 PubMed 进行英文文献检索，未设置任何时间限制，以确定所有涉及羟丁酸钠中毒病例的可用科学出版物。
共确定了 6 例病例。其中 5 例涉及致命性中毒，死后血液中 GHB 浓度范围为 11.5 至 3500mg/L。其中 1 例为非致命性中毒，摄入后 7 小时血清中 GHB 浓度为 569mg/L。
在本病例中，估计的消除半衰期为 154 分钟。鉴于羟丁酸钠的药代动力学特性，急性中毒的风险似乎很高。医生和毒理学家必须考虑到这些特性。
