md-medicaldata

Authors

Isidora Petrović¹, Nikola Milašinović¹, Biljana Koturević¹, Vera Lukić², Nataša Perković Vukčević^3,4, Snežana Đorđević<sup>3,4

1</sup>University of Criminal Investigation and Police Studies, Belgrade
²Institute for Forensic Medicine, Medical Faculty, University of Belgrade
³National Poisoning Control Centre, Military Medical Academy, Belgrade
⁴Medical Faculty of the Military Medical Academy, University of Defence, Belgrade

 

UDK: 615.212.7.099

The paper was received / Rad primljen 01.08.2025.

Accepted / Rad prihvaćen: 24.08.2025.

 

Correspondence to:

Isidora Petrović
e-mail: i7sidora@gmail.com

 

 

Abstract

 

 

As an endogenous substance, gamma-hydroxybutyrate (GHB) is naturally present in the central nervous system (CNS) of mammals as well as in peripheral tissues. It also acts as a minor metabolite and precursor of GABA, a major inhibitory neurotransmitter in the CNS. Interest in GHB began in the 1960s when it was initially used in anesthesiology. However, due to negative patient reactions, this use was quickly discontinued. In subsequent years, GHB saw renewed interest, particularly in the fields of nutrition and bodybuilding. By the end of the 20th century, GHB’s popularity surged as a “club” drug. It can appear as a white powder or a colorless liquid, with the latter often being dyed to conceal its presence and make it easier to add to drinks. The effects of GHB start 10-20 minutes after consumption and can last up to 11 hours. Chromatography coupled with tandem mass spectrometry (LC-MS/MS) has proven to be an effective method for detecting GHB in biological samples such as urine and blood.
This article presents case of young man after acute ingestion of GHB, who was unconsciousness at admission with data about recreational abuse of GHB. He had hypooxigenation and hypotension.  Urine test for standard psychoactive substances was negative. The liquid chromatography coupled with tandem mass spectrometry was used for detection of GHB in blood and urine samples.
GHB poisonings are not common, but they can have severe clinical picture. In most cases, diagnosis is made on the basis of the clinical picture, but analytical confirmation can facilitate it.

 

Keywords:

Gamma-Hydroxybutyrate, case report, liquid chromatography tandem mass spectrometry, urine, psychoactive substances

 

 

 

Sažetak

 

Kao endogena supstanca, gama-hidroksibutirat (GHB) je prirodno jedinjenje prisutno u centralnom nervnom sistemu (CNS) sisara, kao i u perifernim tkivima. Deluje i kao minorni metabolit i prekursor GABA, glavnog inhibitornog neurotransmitera u CNS-u. Interesovanje za GHB počelo je 1960-ih kada je prvobitno korišćen u anesteziologiji. Međutim, zbog negativnih reakcija pacijenata, ova upotreba je brzo prekinuta. U narednim godinama, interesovanje za GHB se ponovo javilo, posebno u oblasti ishrane i bodibildinga. Do kraja 20. veka, popularnost GHB-a je porasla kao „klubske“ droge. Može se pojaviti kao beli prah ili bezbojna tečnost, pri čemu je ova druga često obojena kako bi se prikrilo njegovo prisustvo i olakšalo dodavanje u piće. Efekti GHB počinju 10-20 minuta nakon konzumiranja i mogu trajati do 11 sati. Hromatografija u kombinaciji sa tandem masenom spektrometrijom (LC-MS/MS) se pokazala kao efikasna metoda za detekciju GHB u biološkim uzorcima kao što su urin i krv.
U ovom članku  prikazan je slučaj mladića nakon akutnog uzimanja GHB, koji je bio u nesvesti pri prijemu sa podacima o rekreativnoj zloupotrebi GHB. Imao je hipooksigenaciju i hipotenziju.  Test urina na standardne psihoaktivne supstance bio je negativan. Za detekciju GHB u uzorcima krvi i urina korišćena je tečna hromatografija u kombinaciji sa tandem masenom spektrometrijom. Trovanja GHB nisu česta, ali mogu imati tešku kliničku sliku. U većini slučajeva dijagnoza se postavlja na osnovu kliničke slike, ali analitička potvrda to može olakšati.

 

Ključne reči:

gama-hidroksibutirat, prikaz slučaja, tečna hromatografija sa tandem masenom spektrometrijom, urin, psihoaktivne supstance

 

 

 

 

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PDF: 06-Petrović I et al MD-Medical Data 2025;17(3) 171-174.pdf