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(oxybate OR ghb) AND alcohol

Francesco Paolo Busardò, Chrystalla Kyriakou, Emilia Marchei, Roberta Pacifici, Daniel Sejer Pedersen, Simona Pichini
Gamma-hydroxybutyric acid (GHB) acts as a precursor and metabolite of the inhibitory central nervous system (CNS) neurotransmitter gamma-aminobutyric acid (GABA). Sodium salt of GHB has been used as a medication for narcolepsy and alcohol withdrawal. Moreover, GHB and its precursor gamma-butyrolactone (GBL), are illegal recreational drugs of abuse. A procedure based on ultra-high-performance liquid chromatography tandem mass spectrometry has been developed and validated in plasma, urine, cerebrospinal fluid and hair for acute and chronic exposure to GHB and in seized preparations coming from black market...
January 9, 2017: Journal of Pharmaceutical and Biomedical Analysis
Anna F Rumbach, Andrew Blitzer, Steven J Frucht, Kristina Simonyan
OBJECTIVES/HYPOTHESIS: Spasmodic dysphonia (SD) is a task-specific laryngeal dystonia that affects speech production. Co-occurring voice tremor (VT) often complicates the diagnosis and clinical management of SD. Treatment of SD and VT is largely limited to botulinum toxin injections into laryngeal musculature; other pharmacological options are not sufficiently developed. STUDY DESIGN: Open-label study. METHODS: We conducted an open-label study in 23 SD and 22 SD/VT patients to examine the effects of sodium oxybate (Xyrem), an oral agent with therapeutic effects similar to those of alcohol in these patients...
November 3, 2016: Laryngoscope
Karen E van den Hondel, Anne Linde Saaltink, Peter Paul M Bender
BACKGROUND: Forensic physicians are responsible for first-line medical care of detainees (individuals held in custody) in the police station. The Dutch police law contains a 'duty of care', which gives the police responsibility for the apparent mentally ill and/or confused people they encounter during their work. The police can ask a forensic physician to do a primary psychiatric assessment of any apparent mentally ill detainee. The forensic physician determines if the apparent mentally ill behavior of the detainee is due to a somatic illness, or has a psychiatric cause for which the detainee needs admission to a psychiatric hospital...
November 2016: Journal of Forensic and Legal Medicine
Michel Maitre, Christian Klein, Ayikoe G Mensah-Nyagan
Gamma-hydroxybutyrate (GHB or Xyrem(R)) is frequently used in humans for several clinical indications, including anesthesia, narcolepsy/cataplexy, and alcohol-withdrawal symptoms. Pharmacological effects induced in the brain by therapeutic doses of Xyrem(R) are generally GABAergic-dependent. These effects allow sedation, stress/anxiety reduction, deep sleep induction, decrease of neuroinflammation, and neuroprotection. Furthermore, Xyrem(R) promotes the expression of pivotal genes reducing toxic proteinopathies, as demonstrated in laboratory animal models...
September 6, 2016: Alzheimer's Research & Therapy
Evangelia Liakoni, Fabio Walther, Christian H Nickel, Matthias E Liechti
BACKGROUND: γ-Hydroxybutyrate (GHB) is a drug of abuse with dose-dependent sedative effects. Systematic data on the acute toxicity of GHB from emergency department (ED) presentations over a long period of time are currently missing from the literature. The present study described the clinical features of GHB toxicity. METHODS: Retrospective case series of GHB intoxications seen in an urban ED. RESULTS: From January 2002 to September 2015, 78 GHB-related intoxication cases were recorded (71 % male patients)...
August 31, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
M C Strand, H Gjerde, J Mørland
Experimental studies on the impairing effects of drugs of relevance to driving-related performance published between 1998 and 2015 were reviewed. Studies with on-the-road driving, driving simulators, and performance tests were included for benzodiazepines and related drugs, cannabis, opioids, stimulants, GHB, ketamine, antihistamines, and antidepressants. The findings in these experimental studies were briefly discussed in relation to a review of epidemiological studies published recently. The studies mainly concluded that there may be a significant psychomotor impairment after using benzodiazepines or related drugs, cannabis, opioids, GHB, or ketamine...
July 2016: Forensic Science Review
Fabio Caputo, Teo Vignoli, Claudia Tarli, Marco Domenicali, Giorgio Zoli, Mauro Bernardi, Giovanni Addolorato
The treatment of alcohol use disorder (AUD) with sodium oxybate (SMO) or gamma-hydroxybutyric acid (GHB) was introduced in Italy and Austria more than 20 years and 15 years ago, respectively, and it is now widely employed to treat alcohol withdrawal syndrome (AWS) and to maintain alcohol abstinence. These indications derive from its similar structure to the inhibitory neurotransmitter γ-amino-butyric acid (GABA), exerting an ethanol-mimicking effect, because it binds to GABAB receptors. Craving for, and abuse of, SMO remain a controversial issue; even though these unfavorable effects are evident in poly-drug addicted patients and in those with psychiatric diagnosis of borderline personality disorder...
March 5, 2016: International Journal of Environmental Research and Public Health
Fabio Caputo, Angelo G I Maremmani, Giovanni Addolorato, Marco Domenicali, Giorgio Zoli, Antonio D'Amore, Icro Maremmani, Mauro Bernardi
The treatment of alcohol use disorder still remains a challenge. The efficacy of the combined pharmacological treatment for alcohol use disorder has been widely investigated with controversial results. The aim of our case series was to investigate the effect of nalmefene in patients not responding to sodium oxybate therapy. We describe seven cases of consecutive patients affected by alcohol use disorder, and treated with sodium oxybate (50 mg/kg per day) who did not achieve complete alcohol abstinence after at least one month of pharmacological treatment...
April 2016: Journal of Psychopharmacology
Lena Kristoffersen, Dag Helge Strand, Veronica Horpestad Liane, Vigdis Vindenes, Ingunn Fride Tvete, Magne Aldrin
Legislative limits for driving under the influence of 20 non-alcohol drugs were introduced in Norway in February 2012. Per se limits corresponding to blood alcohol concentrations (BAC) of 0.2g/kg were established for 20 psychoactive drugs, and limits for graded sanctions corresponding to BACs of 0.5 and 1.2g/kg were determined for 13 of these drugs. This new legislation made it possible for the courts to make sentences based on the analytical results, similar to the situation for alcohol. To ensure that the reported concentration is as least as high as the true concentration, with a 99% safety level, safety margins had to be calculated for each of the substances...
February 2016: Forensic Science International
Madelon E van Hemel-Ruiter, Reinout W Wiers, Frank G Brook, Peter J de Jong
BACKGROUND: Research in adults shows that substance dependent individuals demonstrate attentional bias (AB) for substance-related stimuli. This study investigated the role of AB in adolescents diagnosed with alcohol, cannabis, amphetamine or GHB dependency on entering therapy and six months later, and the role of executive control (EC) as a moderator of the relationship between problem severity and AB. METHODS: Seventy-eight young substance-dependent (SD) patients (mean age=19...
February 1, 2016: Drug and Alcohol Dependence
V Rosato, L Abenavoli, A Federico, M Masarone, M Persico
AIMS: Alcohol is the most commonly used addictive substance and alcoholic liver disease (ALD) is a major cause of chronic liver disease worldwide, responsible for 47.9% of all liver chronic deaths. Despite ALD has a significant burden on the health, few therapeutic advances have been made in the last 40 years, particularly in the long-term management of these patients. METHODS: we searched in PubMed, Scopus, Google Scholar, and MEDLINE databases to identify relevant English language publications focused on long-term therapy of ALD...
February 2016: International Journal of Clinical Practice
F P Busardò, C Kyriakou, S Napoletano, E Marinelli, S Zaami
Gamma-hydroxybutyrate (GHB) is a short chain fatty acid endogenously produced within the central nervous system (CNS) and acts as a precursor and metabolite of the inhibitory neurotransmitter γ-aminobutyric acid (GABA). Although, it is an illegal recreational drug of abuse, its sodium salt (sodium oxybate) has been utilized as a medication for a number of medical conditions. The first aim of this review was to focus on current applications of sodium oxybate for the treatment of narcolepsy, with a particular emphasis on the key symptoms of this disorder: cataplexy and excessive daytime sleepiness (EDS)...
December 2015: European Review for Medical and Pharmacological Sciences
Matthias E Liechti, Boris B Quednow, Evangelia Liakoni, Dario Dornbierer, Robin von Rotz, Maria Salomé Gachet, Jürg Gertsch, Erich Seifritz, Oliver G Bosch
AIMS: γ-Hydroxybutyrate (GHB) is used as a treatment for narcolepsy and alcohol withdrawal and as a recreational substance. Nevertheless, there are limited data on the pharmacokinetics and pharmacokinetic-pharmacodynamic relationships of GHB in humans. We characterized the pharmacokinetic profile and exposure-psychotropic effect relationship of GHB in humans. METHODS: Two oral doses of GHB (25 and 35 mg kg(-1) ) were administered to 32 healthy male subjects (16 for each dose) using a randomized, placebo-controlled, cross-over design...
May 2016: British Journal of Clinical Pharmacology
Varadharajan Madhavan, Anita Murali, Doppalapudi Sree Lalitha, Sunkam Yoganarasimhan
BACKGROUND/AIM: To determine the anti-hyperglycemic effect of Euphorbia antiquorum L. root. MATERIALS AND METHODS: The study evaluates the anti-hyperglycemic effect of E. antiquorum root in streptozotocin-nicotinamide-induced Type 2 diabetes mellitus and fructose-induced insulin resistance models. Alcohol and aqueous extracts of E. antiquorum root were administered at doses 200 and 400 mg/kg p.o. Serum levels of glucose, total cholesterol, triglycerides, glycosylated hemoglobin (GHb), and hepatic levels of malondialdehyde, glutathione, and glycogen were estimated...
October 2015: Journal of Intercultural Ethnopharmacology
Maria A Saracino, Maria C Catapano, Rosa Iezzi, Lorenzo Somaini, Gilberto Gerra, Laura Mercolini
γ-Hydroxybutyric acid (GHB) is a powerful central nervous system depressant, currently used in medicine for the treatment of narcolepsy and alcohol dependence. In recent years, it has gained popularity among illegal club drugs, mainly because of its euphoric effects as well as doping agent and date rape drug. The purpose of the present work was the development of a rapid analytical method for the analysis of GHB in innovative biological matrices, namely dried blood spots (DBSs) and dried urine spots (DUSs)...
November 2015: Analytical and Bioanalytical Chemistry
T Drogies, A Willenberg, A Ramshorn-Zimmer, L Weidhase, S Petros, C Hädrich, J Thiery, A Gries, M Bernhard
BACKGROUND: Many patients present to emergency departments (EDs) with an altered state of consciousness. Fast exclusion of gamma hydroxybutyrate (GHB)-associated intoxication in these patients may optimize diagnostic and therapeutic algorithms and decisions in the ED. METHODS: Between January and March 2014, a novel enzymatic test system was used to quantify GHB in blood and urine samples of suspected intoxicated patients in the ED of the University Hospital. The underlying causes for suspected intoxication and the diagnostic and therapeutic measures were documented and analysed retrospectively...
July 2016: Human & Experimental Toxicology
Kiara S Hagan, Lisa Reidy
Drug facilitated sexual assault (DFSA) can be defined as sexual activity occurring whereby the victim is incapacitated by drugs and/or alcohol and thereby unable to consent. A new wave of designer drugs is emerging in the community at large and one group, the synthetic cathinones, is described in this study. Analyzing urine samples from reported sexual assaults submitted to the University of Miami Toxicology Lab in 2013 determined that methylone has become a popular drug encountered in these cases. Derivatization of these synthetic cathinones enabled a validated a qualitative method to identify ten different designer drugs...
December 2015: Forensic Science International
Antonio Mirijello, Fabio Caputo, Gabriele Vassallo, Benjamin Rolland, Claudia Tarli, Antonio Gasbarrini, Giovanni Addolorato
Almost 10% of the world's population is affected by alcohol use disorder (AUD). The combination between psychosocial intervention and pharmacological treatment seems to be the most effective approach for patients affected by AUD. Among effective drugs useful in the treatment of AUD, GABAB-ergic medications have been tested with encouraging results (i.e. sodium oxybate, baclofen, gabapentin, pregabalin and tiagabine). The present review will summarize available data on these medications.
2015: Current Pharmaceutical Design
Francesco P Busardò, Alan W Jones
The illicit recreational drug of abuse, γ-hydroxybutyrate (GHB) is a potent central nervous system depressant and is often encountered during forensic investigations of living and deceased persons. The sodium salt of GHB is registered as a therapeutic agent (Xyrem®), approved in some countries for the treatment of narcolepsy-associated cataplexy and (Alcover®) is an adjuvant medication for detoxification and withdrawal in alcoholics. Trace amounts of GHB are produced endogenously (0.5-1.0 mg/L) in various tissues, including the brain, where it functions as both a precursor and a metabolite of the major inhibitory neurotransmitter γ-aminobutyric acid (GABA)...
January 2015: Current Neuropharmacology
Claus Aichmüller, Michael Soyka
Fatigue is a common symptom in substance abuse disorders. The most frequent and relevant addiction disorders like alcoholism and dependence of illegal drugs like THC, opioids, cocaine, ecstasy, psycho-stimulants, and GHB/GBL (gamma hydroxybutyrate/gamma butyrolactone; "Liquid Ecstasy") are described, especially the associated symptomatology and specific psychosocial features. The dependence on drugs like benzodiazepines, analgesics, amphetamines and others is also outlined. The distinction between justified and abusive consumption can often be difficult...
April 22, 2015: Revue Médicale Suisse
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