UNRAVELLING THE G-FORCE

Abstract

Introduction

Liquid G or known as Gamma Hydroxybutyrate is a mysterious drug in medical field, hence the flow of management is still unclear. Here, an adult presented to us with complication post ingestion of Liquid G.

Case summary

23 yrs old,gentleman brought in to A&E by his friend,who found him unconscious after consumed  recreational drug named as “Liquid G” mixed with estacy. Upon arrival to A&E ,noted patient unconscious with gcs 4/15 with impending airway ,pupils 3/3 sluggish, all other vital signs within normal parameter and  intubated for airway protection. Post intubation, drug toxicology shows positive for Metamphathamine and Amphathamine. Antibiotic initiated to cover for aspiration pneumonia in view of checked xray showed right lung haziness.On day 3 of admission, patient was extubated and transferred to general ward. Hollistic approach ranged from Emergency room care, ICU care, medical treatment, psychiatric team and addiction team review were given until patient discharged home with followup to our clinic to ensure lung recovery and addiction anticipation were given.

Discussion and Conclusion

Liquid G or know as Gamma Hydroxybutyrate (C₄H₈O₃), used as “Club drug”. Popular as strength enhancer,euphoriant and aphrodisiac also known as “date rape” drug. Previously illegal drug, but in 2002 its been approved by FDA as part of narcolepsy treatment. However this drug can be lethal if consumed together with alcohol beverages.Many case reports pointed out death associated with intoxication, withdrawal complications,even intubation and post intubation care. However no clear guideline on indication of intubation. In Malaysia, Liquid G still remain as “Mysterious drug” and doctor still clueless about treating patient accordingly post intoxication including decision making for intubation, need for RSI, post intubation care and extubation.No case been reported so far in Malaysia makes us first to report such intoxication.