Gamma-Hydroxybutyrate Toxicity Medication

Updated: Dec 29, 2015
  • Author: Theodore I Benzer, MD, PhD; Chief Editor: Asim Tarabar, MD  more...
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Medication Summary

Most GHB ingestions require only supportive management. In cases of persistent coma or known massive ingestion, a reversal agent may be considered. Several drugs have been studied as potential GHB antagonists, including neostigmine, physostigmine, flumazenil, naloxone, and various antiepileptics. One study from the New York City Poison Control reviewed the literature and concluded that there is insufficient evidence for the routine use of physostigmine for GHB intoxication. [9]


GI decontaminant

Class Summary

Prevents further absorption of adsorbable toxins from the GI tract if administered soon after ingestion (typically < 1 h).

Activated charcoal (Liqui-Char)

Emergency treatment in poisoning caused by drugs and chemicals. Network of pores present in activated charcoal adsorbs 100-1000 mg of drug per gram of charcoal. Does not dissolve in water.

For maximum effect, administer within 30 min of ingesting poison. Administer cathartic (sorbitol) with first dose.


Cardiovascular agents

Class Summary

Bradycardia may be encountered in GHB overdose. Atropine, as an anticholinergic agent, may be useful for treatment of bradycardia.

Atropine IV/IM (Atropair)

Enhances sinus node automaticity by blocking effects of acetylcholine at the AV node, decreasing refractory time and speeding conduction through the AV node.