Metabolic Disorders in Delirious Syndrome in Patients with Acute Poisoning with Gamma-Hydroxybutyric Acid and its Precursor
https://doi.org/10.23934/2223-9022-2020-9-2-210-214
Abstract
Abstract In 21 male patients aged 20 to 40 years, metabolic disorders in post-toxic delirious syndrome caused by gamma-hydroxybutyric acid poisoning and its precursors were studied. In the examined group of patients, hyperammonemia was detected in 71.4% of cases, metabolic lactic acidosis was revealed in 76.2%. The direct correlation between the severity of metabolic disorders and delirious syndrome according to DRS-R-98 scale was established. The statistically significant increase in capillary blood levels of lactate on day 3 of psychotic period was 4.9 mlmol/L and ammonia on day 5 was 187.0 mmol/L. The greatest severity of metabolic disorders was found in patients over the age of 27 years who systematically use the studied substances with narcotic effects for 7 months or more and combine their intake with other psychoactive substances.
About the Authors
A. G. Sinenchenko
Narcology and Psycho-rehabilitation I.I. Dzhanelidze St. Petersburg Research Institute of Emergency Medicine
Russian Federation
Russian Federation
Cand. Med. Sci., Head of the Department of Emergency Psychiatry
3A Budapeshtskaya St., St. Petersburg 192242
A. N. Lodyagin
Narcology and Psycho-rehabilitation I.I. Dzhanelidze St. Petersburg Research Institute of Emergency Medicine
Russian Federation
Russian Federation
Dr. Med. Sci., Associate Professor
3A Budapeshtskaya St., St. Petersburg 192242
B. V. Batotsyrenov
Narcology and Psycho-rehabilitation I.I. Dzhanelidze St. Petersburg Research Institute of Emergency Medicine
Russian Federation
Russian Federation
Dr. Med. Sci., Chief Scientific Officer of the Clinical Toxicology Department
3A Budapeshtskaya St., St. Petersburg 192242
References
1. Neu P. Course and complications of GHB detoxification treatment: a 1-year case series. Nervenarzt. 2019;90(5):509–515. PMID: 30362026 https://doi.org/10.1007/s00115-018-0636-8.
2. Sabaev AV. Gospitalizirovannaya zabolevaemost’ naseleniya goroda Omska v rezul’tate ostrykh otravleniy khimicheskoy etiologii za 2001–2013 gg. Eurasian Union of Scientists. 2014;8(6):92–95. (In Russ.)
3. Brunt TM, Koeter MW, Hertoghs N, van Noorden MS, van den Brink W. Sociodemographic and substance use characteristics of γ-hydroxybutyrate (GHB) dependent inpatients and associations with dependence severity. Drug Alcohol Depend. 2013;131(3):316–319. PMID: 23332440 https://doi.org/10.1016/j.drugalcdep.2012.12.023.
4. Beurmanjer H, Kamal RM, de Jong CAJ, Dijkstra BAG, Schellekens AFA. Baclofen to Prevent Relapse in Gamma-Hydroxybutyrate (GHB)- Dependent Patients: A Multicentre, Open-Label, Non-Randomized, Controlled Trial. CNS Drugs. 2018;32(5):437–442. PMID: 29651711 https://doi.org/10.1007/s40263-018-0516-6.
5. Dijkstra BA, Kamal R, van Noorden MS ,de Haan H, Loonen AJ, De Jong CA. Detoxification with titration and tapering in gammahydroxybutyrate (GHB) dependent patients: The Dutch GHB monitor project. Drug Alcohol Depend. 2017;170:164–173. PMID: 27923198. https://doi.org/10.1016/j.drugalcdep.2016.11.014.
6. Sofronov AG, Lodyagin AN, Prokopovich GA. Potrebiteli GOMK i ego prekursorov: klinicheskaya kartina otravleniy i sindrom otmeny. Ekstrennaya Meditsina. 2017;6(3):340–341. (In Russ.)
7. Kamal RM, van Iwaarden S, Dijkstra BA, de Jong CA. Decision rules for GHB (γ-hydroxybutyric acid) detoxification: a vignette study. Drug Alcohol Depend. 2014;135:146–151. PMID: 24380737 https://doi.org/10.1016/j.drugalcdep.2013.12.003.
8. McDonough M, Kennedy N, Glasper A, Bearn J.Clinical features and management of gamma-hydroxybutyrate (GHB) withdrawal: a review. (2004). Clinical features and management of gamma-hydroxybutyrate (GHB) withdrawal: a review. Drug and Alcohol Depend. 2004;75(1):3–9. PMID: 29933901 https://doi.org/10.1016/j.drugalcdep.2004.01.012
9. Alekseenko SA, Ageeva EA, Polkovnikova ОP. Modern approaches to diagnostics and treatment of hyperammonemia in patients with chronic liver disease at a precirrhotic stage. RMJ. Medical Review. 2018;7(I):19–23. (In Russ.)
Review
For citations:
Sinenchenko A.G., Lodyagin A.N., Batotsyrenov B.V. Metabolic Disorders in Delirious Syndrome in Patients with Acute Poisoning with Gamma-Hydroxybutyric Acid and its Precursor. Russian Sklifosovsky Journal "Emergency Medical Care". 2020;9(2):210-214. https://doi.org/10.23934/2223-9022-2020-9-2-210-214
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