# Acute Gamma-Hydroxybutyrate (GHB) Intoxication Requiring Hemodialysis in Southern Brazil: A Case Report

## TL;DR

This case report details two severe cases of GHB intoxication in Brazil requiring intensive care and highlights the importance of recognizing GHB's effects in emergency settings.

## Contribution

The paper presents two clinical cases emphasizing the need for prompt recognition and management of GHB intoxication.

## Key findings

- Two adult males experienced severe GHB intoxication with bradycardia and respiratory depression.
- Patients required intubation and ICU care due to decreased consciousness and life-threatening symptoms.
- GHB's rapid metabolism and frequent co-ingestion complicate diagnosis and treatment in emergencies.

## Abstract

Gamma-hydroxybutyrate (GHB) is a central nervous system (CNS) depressant with psychoactive and anesthetic properties, increasingly implicated in recreational use and drug-facilitated crimes. Its effects are amplified when combined with alcohol, posing diagnostic and therapeutic challenges in emergency settings due to its rapid metabolism and frequent co-ingestion with other substances. We describe two cases of severe GHB intoxication in adult male patients resulting in bradycardia, respiratory depression, and decreased level of consciousness requiring orotracheal intubation and intensive care unit (ICU) stabilization. Awareness of GHB’s clinical profile is essential for timely diagnosis and treatment. Given its association with drug-facilitated sexual assault and the potential for life-threatening outcomes, healthcare professionals must maintain a high index of suspicion and initiate appropriate supportive measures promptly.