Physostigmine for gamma-hydroxybutyrate coma: Inefficacy, adverse events, and review

Clinical Toxicology

Volumn 45, Issue 3, 2007, Pages 261-265

  Zvosec, Deborah L ^a   Smith, Stephen W ^a,b   Litonjua, Regina ^c   Westfal, Richard E J ^d  

^a HENNEPIN COUNTY MEDICAL CENTER   (United States)

^b MINNEAPOLIS MEDICAL RESEARCH FOUNDATION   (United States)

^c ST JOHN HOSPITAL AND MEDICAL CENTER   (United States)

^d ST VINCENT S HOSPITAL   (United States)

Author keywords

1,4 butanediol; Antidote; Gamma butyrolactone; Gamma hydroxybutyrate; Physostigmine

Indexed keywords

4 HYDROXYBUTYRIC ACID; ATROPINE; DILTIAZEM; GLUCOSE; LORAZEPAM; METOPROLOL; MIDAZOLAM; NALOXONE; PHYSOSTIGMINE; PYRAZINAMIDE; THIAMINE;

ADULT; AMBULANCE; ARTICLE; BRADYCARDIA; CASE REPORT; CLINICAL FEATURE; CLINICAL PROTOCOL; COMA; DRUG EFFICACY; ECHOCARDIOGRAPHY; EMERGENCY WARD; HEART ATRIUM FIBRILLATION; HUMAN; HYPOTENSION; INTOXICATION; LUNG INFILTRATE; MALE; MEDICAL RECORD; PHYSICAL EXAMINATION; TREATMENT OUTCOME; TREATMENT RESPONSE; URINALYSIS;

ADJUVANTS, ANESTHESIA; ADULT; ANTIDOTES; AROUSAL; CHOLINESTERASE INHIBITORS; COMA; EMERGENCY MEDICAL SERVICES; HUMANS; MALE; OVERDOSE; PHYSOSTIGMINE; SODIUM OXYBATE; STREET DRUGS; TREATMENT FAILURE;

ANIMALIA;

EID: 34047092887     PISSN: 15563650     EISSN: 15569519     Source Type: Journal    
DOI: 10.1080/15563650601072159     Document Type: Article

References (44)

1. Henderson RS, Holmes CM. Reversal of the anaesthetic action of sodium gamma-hydroxybutyrate. Anaesth Intensive Care 1976; 4:351-354.
2. Holmes CM, Henderson RS. The elimination of pollution by a non inhalational technique. Anaesth Intensive Care 1978; 6:120-124.
3. Caldicott DG, Kuhn M. Gamma-hydroxybutyrate overdose and physostigmine: teaching new tricks to an old drug? Ann Emerg Med 2001; 37:99-102.
4. Yates SW, Viera AJ. Physostigmine in the treatment of gamma-hydroxybutyric acid overdose. Mayo Clin Proc 2000; 75:401-402.
5. Boyce SH, Padgham K, Miller LD, Stevenson J. Gamma hydroxybutyric acid (GHB): an increasing trend in drug abuse. Eur J Emerg Med 2000; 7:177-181.
6. Chin RL, Sporer KA, Cullison B, Dyer JE, Wu TD. Clinical course of gamma-hydroxybutyrate overdose. Ann Emerg Med 1998; 31:716-722.
7. Dyer JE. Gamma-Hydroxybutyrate: a health-food product producing coma and seizurelike activity. Am J Emerg Med 1991; 9:321-324.
8. Eckstein M, Henderson SO, DelaCruz P, Newton E. Gamma hydroxybutyrate (GHB): report of a mass intoxication and review of the literature. Prehosp Emerg Care 1999; 3:357-361.
9. Elliott SP. Nonfatal Instances of Intoxication with gamma-Hydroxybutyrate in the United Kingdom. Ther Drug Monit 2004; 26:432-440.
10. Garrison G, Mueller P. Clinical features and outcomes after unintentional gamma hydroxybutyrate (GHB) overdose (Abstract). J Tox Clin Toxicol 1998; 36:503-504.
11. Harraway T, Stephenson L. Gamma hydroxybutyrate: The Gold Coast Experience. Emerg Med (Australia) 1999; 11:45-48.
12. Li J, Stokes SA, Woeckener A. A tale of novel intoxication: seven cases of gamma-hydroxybutyric acid overdose. Ann Emerg Med 1998; 31:723-728.
13. Liechti ME, Kupferschmidt H. Gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL): Analysis of overdose cases reported to the Swiss Toxicological Information Centre. Swiss Med Wkly 2004; 134:534-537.
14. Mahon KD, Tomaszewski CA, Tayal VS. Emergency department presentation of serum confirmed GHB ingestions. Acad Emerg Med 1999; 6:395-396.
15. Miro O, Nogue S, Espinosa G, To-Figueras J, Sanchez M. Trends in illicit drug emergencies: the emerging role of gamma-hydroxybutyrate. J Toxicol Clin Toxicol 2002; 40:129-135.
16. Ryan JM, Stell I. Gamma hydroxybutyrate - a coma inducing recreational drug. J Accid Emerg Med 1997; 14:259-261.
17. Sporer KA, Chin RL, Dyer JE, Lamb R. Gamma-hydroxybutyrate serum levels and clinical syndrome after severe overdose. Ann Emerg Med 2003; 42:3-8.
18. Van Sassenbroeck DK, Calle PA, Rousseau FM, Verstraete AG, Belpaire FM, Monsieurs KG, Haentjens R, Allonsius J, Van Brantegem J, Haenen W, Buylaert WA. Medical problems related to recreational drug use at nocturnal dance parties. Eur J Emerg Med 2003; 10:302-308.
19. Van Sassenbroeck DK, De Neve N, Debruyne C, Verstraete A, Calle P, Buylaert WA. Illustration of the sudden awakening of gamma-hydroxybutyrate (GHB) associated intoxications (Abstract). J Tox Clin Tox 2004; 42:478.
20. Williams H, Taylor R, Roberts M. Gamma-hydroxybutyrate (GHB): A new drug of abuse. Irish Med J 1998; 91:56-57.
21. Zvosec DL, Smith SW, McCutcheon JR, Spillane J, Hall BJ, Peacock EA. Adverse events, including death, associated with the use of 1,4 butanediol. N Engl J Med 2001; 344:87-94.
22. Zvosec DL, Smith SW. Agitation is common in Gamma-hydroxybutyrate toxicity. Am J Emerg Med 2005; 23:316-320.
23. Schneir AB, Offerman SR, Ly BT, Davis JM, Baldwin RT, Williams SR, Clark RF. Complications of diagnostic physostigmine administration to emergency department patients. Ann Emerg Med 2003; 42:14-19.
24. Howland MA. Antidotes in depth: Physostigmine. In: Goldfrank LR, Flomenbaum NE, Lewin NA, Weisman RS, Howland MA, Hoffman RS, eds. Goldfrank's Toxicologic Emergencies, 6th ed.; Stamford, CT: Appleton and Lange, 1998:614-617.
25. Bowden CA, Krenzelok EP. Clinical applications of commonly used contemporary antidotes: A U. S. perspective. Drug Saf 1997; 16:9-47.
26. Smilkstein MJ. Physostigmine. J Emerg Med 1991; 9:275-277.
27. Traub SJ, Nelson LS, Hoffman RS. Physostigmine as a treatment for gamma-hydroxybutyrate toxicity: A review. J Tox Clin Toxicol 2002; 40:781-787.
28. Mullins ME, Dribben W. Physostigmine treatment of gamma-hydroxybutyric acid overdose: Appropriate or inappropriate use of a reversal agent? Mayo Clin Proc 2000; 75:871-873.
29. Bania TC, Chu J. Physostigmine does not effect arousal but produces toxicity in an animal model of severe gamma-hydroxybutyrate intoxication. Acad Emerg Med 2005; 12:185-189.
30. Persson B, Henning M. Central cardiovascular effects of gamma-hydroxybutyric acid: interactions with noradrenaline, serotonin, dopamine and acetylcholine transmission. Acta Pharmacol Toxicol (Copenh) 1980; 47:335-346.
31. Nilsson E. Physostigmine treatment in various drug-induced intoxications. Ann Clin Res 1982; 14:165-172.
32. Kleinschmidt S, Schellhase C, Mertzlufft F. Continuous sedation during spinal anaesthesia: gamma-hydroxybutyrate vs. propofol. Eur J Anaesthesiol 1999; 16:23-30.
33. Virtue RW, Lund LO, Beckwitt HJ, Vogel JH. Cardiovascular reactions to gamma hydroxybutyrate in man. Can Anaesth Soc J 1966; 13:119-123.
34. Solway J, Sadove MS. 4-Hydroxybutyrate: a clinical study. Anesth Analg 1965; 44:532-539.
35. Mason PE, Kerns WP. Gamma hydroxybutyric acid (GHB) intoxication. Acad Emerg Med 2002; 9:730-739.
36. Walker WE, Levy RC, Hanenson IB. Physostigmine - its use and abuse. JACEP 1976; 5:436-439.
37. Newton RW. Physostigmine salicylate in the treatment of tricyclic antidepressant overdosage. JAMA 1975; 231:941-943.
38. Socher M, Eyer F, Felgenhauer N, Zilker T. The Physostigmine Test: An Approach to Anticholinergic Poisonings. (Abstract). J Tox Clin Tox 2003; 41:414.
39. Pentel PR, Peterson CD. Asystole complicating physostigmine treatment of tricyclic antidepressant overdose. Ann Emerg Med 1980; 9:588-590.
40. Shannon M. Toxicology reviews: Physostigmine. Pediatr Emerg Care 1998; 14:224-226.
41. Maister AH. Atrial fibrillation following physostigmine. Can Anaesth Soc J 1983; 30:419-421.
42. Boon J, Prideaux PR. Cardiac arrest following physostigmine. Anaesth Intensive Care 1980; 8:92-93.
43. Wax PM. Analeptic use in clinical toxicology: A historical appraisal. J Toxicol Clin Toxicol 1997; 35:203-209.
44. Sakles JC, Laurin EG, Rantapaa AA, Panacek EA. Airway management in the emergency department: a one-year study of 610 tracheal intubations. Ann Emerg Med 1998; 31:325-332.