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GHB Pharmacology and Toxicology: Acute Intoxication, Concentrations in Blood and Urine in Forensic Cases and Treatment of the Withdrawal Syndrome .. The average user of GHB is fairly young and many make their debut aged y, although others start later in life, depending on their prior drug history, peer- group. Unlike other adult dating sites we specialise only in peeing. Thousands of men and women, all over the world use receptite.info to find other likeminded pissing lovers, whether it be for meaningful, long term relationships, or casual pee play. All dating profiles on this site are % genuine, user submitted! We offer you. 12 Sep All images must be hosted on imgur. Please do not link to images on other sites. Rules: Images must be hosted on receptite.info; gifs can be hosted on any RES compatible site, such as receptite.info; videos can be on any site that does not contain illegal content (such as child pornography), however sites that.

Trace amounts of GHB are produced endogenously 0. The Cmax occurs after min and GHB is then eliminated from plasma with a half-life of min.

Effective antidotes User Submitted Piss reverse the sedative and intoxicating effects of GHB do not exist. The poisoned patients require supportive care, vital signs should be monitored and the airways kept clear in case of emesis.

After prolonged regular use of GHB tolerance and dependence develop and abrupt cessation of drug use leads to unpleasant withdrawal symptoms. There is no evidence-based protocol available to deal with GHB withdrawal, apart from administering benzodiazepines. Mortality rates after abuse of GHB are high, because there is only a narrow safety margin between a recreational dose and a fatal dose, which is only 5: Accordingly, accidental poisoning User Submitted Piss recreational use of GHB is not uncommon as evidenced by admissions to hospital emergency departments for treatment [ 910 ] and during forensic medical investigations of drug intoxication deaths [ 11 - 14 ].

Both GBL and BD have cosmetic and industrial applications and are therefore not easy to classify as controlled substances [ 102324 ]. The pharmacological and behavioral effects of GBL and BD stem from their rapid conversion into GHB and the latter drug is the main analytical target in forensic toxicology [ 26 ].

User Submitted Piss differs from other sedative-hypnotics, such as ethanol, barbiturates and benzodiazepines, which work via the GABA-A receptor subtype and its chloride ion channel [ 2930 ]. Narcolepsy is a neurological disorder characterized by excessive daytime sleepiness and cataplexy is a brief loss of muscle tone, usually in response User Submitted Piss emotional arousal or stimuli, such as laughter [ 32 ]. In some European nations e.

Sanremo, Italy for use as pharmacotherapy to support alcoholics during detoxification and withdrawal [ 3536 ]. The administration of sodium oxybate seems to be effective in maintaining abstinence, with less craving for alcohol and lower rates of relapse compared with placebo treatment [ 37 ]. Another name for GHB is 4-hydroxybutyrate, which means that this short-chain carboxylic acid has a hydroxyl -OH group on carbon number four. Clinical toxicologists are mainly concerned with User Submitted Piss intoxications caused by abuse of GHB and the best way to manage and treat the poisoned patient.

However, there are no effective antidotes that can reverse the sedative effects of a GHB overdose. After recreational use of the User Submitted Piss it is not uncommon that people take an overdosing and suddenly become incapacitated with reduced levels of consciousness, which often requires emergency hospital treatment.

This treatment is essentially supportive because rapid recovery is the norm as the drug is metabolized and blood concentrations decrease. The quantitative analysis of GHB in blood and other body fluids is a relatively simple task and concentrations in blood of impaired drivers and intoxication deaths have User Submitted Piss well documented.

Care is needed when GHB concentrations in blood and urine samples are interpreted, because small amount of the drug is produced endogenously and whether the analytical result is indicative of exogenous intake is often not easy to answer [ 4041 ]. The concentrationsof GHB in blood and urine also seem to increase during storage of specimens, which requires use of realistic cut-off concentrations to distinguish intake of GHB from endogenous or post-sampling synthesis [ 42 ].

The interpretation of GHB concentrations is more tricky when dealing with specimens taken from dead bodies, because even higher concentrations are present in blood and urine without exposure to GHB during User Submitted Piss [ 43 ]. Accordingly, in post-mortem toxicology higher cut-off concentrations are necessary to prevent any false accusations that a person had used GHB during the immediate ante-mortem period [ 44 ].

Much depends on the post-mortem interval, the amount of trauma to the body and addition of fluoride ions as an enzyme inhibitor and preservative and femoral or cardiac blood was taken for analysis [ 45 - 47 ]. This article is concerned with the pharmacology and toxicology of GHB with main focus on disposition and fate in the body, including pharmacokinetic and pharmacodynamic aspects. The endogenous concentrations of GHB in blood forensic cases including people arrested for driving under the influence of drugs DUIDusers of illicit drugs and medical examiner User Submitted Piss cases.

The acute intoxication effects and clinical manifestations of GHB overdose are User Submitted Piss along with diagnosis and treatment of the withdrawal syndrome.

Several textbooks, non-indexed sources and government websites were also utilized. The medical and forensic literature about GHB and its analogues is fairly extensive, including a number of fairly recent review articles. Another newish review dealt with pharmacokinetic and pharmacodynamic aspects of GHB and included 84 references [ 13 ]. A User Submitted Piss written review from dealt with the involvement of GHB and its analogs in DFSA cases and the associated bibliography listed references [ 49 ].

Their report on GHB and its precursor GBL should be essential reading for those interested in learning more User Submitted Piss this class of recreational drug [ 53 ]. The victims of GHB intoxication tend to suffer from anterograde amnesia, making it difficult User Submitted Piss recall events that precipitated the alleged sexual humiliation and abuse.

This organization produced a well organized report about prevalence of GHB in alleged DFSA and the relative harmfulness as User Submitted Piss recreational drug in society [ 55 ]. This report also contained guidelines for best possible sampling and analysis of body fluids in DFSA cases. Because of the short elimination half-life of GHB, it is imperative that samples of blood and urine for toxicology are obtained soon as possible. The report made the following statement [ 58 ].

GHB concentrations have been shown to increase in vitro in urine samples during the storage. In comparison with many other drugs of abuse, there is limited information available regarding trends and patterns of GHB use and its diffusion including GHB analogues in the general population [ 5960 ]. London and more popular among sub-populations, such as those who frequent rave parties and gay nightclubs [ 61 ].

Because of the low cost of GHB compared with many other recreational drugs, adolescents User Submitted Piss start to drink alcohol excessively switch to taking GHB, because in some User Submitted Piss the intoxicating effects are similar, including loss of inhibitions, euphoria etc. Some characteristic properties of GHB compared with ethanol two recreational drugs often ingested together.

The average user of GHB is fairly young and many make their debut aged y, although others start later in life, depending on their prior drug history, peer-group influences and their User Submitted Piss situation [ 62 ].

Among User Submitted Piss arrested for driving under the influence of GHB in Norway User Submitted Piss 63 ] the average User Submitted Piss of offenders was 28 y rangewhich compares with an average age of 26 y range y in Sweden [ 64 ].

The medication is used to treat cataplexy, which is an important symptom in the disease User Submitted Piss narcolepsy. However, GHB is not recommended for certain patient groups, such as poly-drug users and those co-addicted or recovering from cocaine or heroin abuse.

Henri Laboritof chlorpromazine fame, took an interest in studying the physiological effects of GHB. He noticed that GHB was a structural analogue of GABA, and unlike the latter was orally active and crossed the blood-brain barrier and therefore wondered if this might furnish an indirect way to increase GABA levels in the brain [ 41 ].

BHB provides an alternative fuel for the brain when glucose is lacking and glycogen stores are depleted [ 70 ]. This raises interesting questions about the respective roles of BHB and GHB on brain chemistry and functioning in man and animals during ketosis.

The experiments of Laborit demonstrated that GHB was a potent pharmacological agent and high doses resulted in deep sedation and sleep.

This created an interest in the use of GHB as an intravenous anesthetic, because it had minimal cardiovascular and respiratory depression effects and the liver and the kidney User Submitted Piss appeared normal. However, the clinical trials with GHB were disappointing because the User Submitted Piss possessed insufficient analgesic effect and the proper dose was difficult to judge and control.

Some patients vomited and other suffered from convulsions, so medical testing of GHB in anesthesiology was abandoned in favor of much safer intravenous anesthetic agents e. Relationship between plasma concentrations of GHB and state of consciousness after intravenous adminsitration. During the s GHB became popular as a dietary supplement and could be purchased over the counter at health-food stores.

The product became User Submitted Piss with dieters and body-builders who believed that it helped them burn fat and build muscle and also stimulated the production of growth hormone. The use and abuse of GHB spread to other groups of individuals in society and reports began to describe its use in criminal activity and many people overdoses User Submitted Piss needed emergency medical treatment.

Throughout the s and s, GHB gained a reputation of being able User Submitted Piss enhance their sex-drive and libido, which made it popular among people frequenting gay clubs and rave parties. After the right dose, people become more talkative User Submitted Piss physically active, some experienced euphoria, had less inhibitions, which prompted them to take risks including multiple sex partners [ 67 ]. However, obtaining unequivocal evidence that GHB was in fact used for this purpose was a challenge, owing to the rapid metabolism and clearance from the body [ 49 ].

The rapid elimination of GHB meant that waiting too long after the crime was committed concentrations of GHB were User Submitted Piss to the endogenous levels.

The methods currently available for User Submitted Piss and quantitative analysis of GHB in biological specimens were recently the subject of a comprehensive review with User Submitted Piss [ 39 ]. The authors documented a wide variety of analytical methods for determination of GHB in urine and blood as well as other biological specimens.

These alternative specimens included saliva [ 75 ], vitreous humor [ 76 - 78 ], blood spots [ 7980 ] and hair strands [ 81 - 84 ]. For forensic purposes, the analytical approach recommended involves gas chromatography GC coupled with a flame ionization detector FIDor better still a mass detector MS [ 85 ]. Several liquid chromatography-mass spectrometry methods LC-MS are described for analysis of GHB and such technology is becoming used more and more in forensic laboratories [ 88 - 90 ].

These procedures are highly sensitive, accurate, precise and specific for their intended purposes. Such technology is proving extremely useful for making a rapid screening and verification analysis of licit and illicit drugs User Submitted Piss toxicological specimens [ 8994 ]. The possibility to screen for multi-toxins in a single run is especially useful in clinical toxicology and emergency medicine.

A number of simpler and more economical enzymatic methods are available for the analysis of GHB in biological fluids [ 9798 ]. A recent photometric procedure was adapted to work with a Thermo Scientific MGC auto-analyzer and this furnished a rapid method for determination of GHB in blood, vitreous humor and urine [ 97 ].

The authors reported a good correlation when paired User Submitted Piss were analyzed with a more specific GC-MS method. In forensic toxicology casework, a User Submitted Piss laboratory practice is to identify drugs and metabolites in more than one bio-fluid as definite proof of intake, such as when GHB-related deaths or DFSA cases are investigated.

The presence and concentration of GHB in urine is of particular interest because this reflects the concentrations in blood during the time urine was produced in the kidney and stored in the bladder before voiding. In post-mortem toxicology if GHB is verified positive in urine but is below the analytical cut-off concentrations in User Submitted Piss, this can be User Submitted Piss as evidence of exogenous intake.

The verification of a parent drug and its main metabolite in blood or other biological material also strengthens the conclusion of exogenous intake. In this connection, GHB was recently identified in urine conjugated with glucuronic acid [ ]. The concentrations of urinary GHB-glucuronide ranged from 0. In the same way that ethyl glucuronide is widely used as a biomarker of ethanol exposure, in the future it might be possible to utilize GHB-glucuronide as marker of GHB exposure [].

The neurons that release GABA are mostly localized in the hippocampus, cortex and amygdala. GHB receptors are located in these sites, in pre- and post-synaptic cells and shows high affinity for these G-protein coupled receptors [ - ]. Unlike most other CNS depressants e. However, endogenous levels of GHB in the brain are too low to permit any agonist activity []. The effects of GHB are mediated predominantly by interaction with GABA-B receptors [ ], although some older animal studies implicate also dopamine and serotonin neuro-transmission [ ].

GHB initially acts as an inhibitor of dopamine release, although depending User Submitted Piss the dose turnover of dopamine is later increased [ ].

The existence of high affinity receptor binding sites for GHB distinct from GABA-B has been postulated to explain some of the pharmacological effects produced by this depressant drug [].

The onset of GHB's effects on performance and behavior occurs min after ingestion and lasts for up to hours depending on the dose. The dose-effect curve for GHB is rather steep, User Submitted Piss means that small increases in dose cause disproportionate increases in behavioral User Submitted Piss and toxicity. Also important for the effects of GHB is the route of administration and whether other depressants were co-ingested and the development of tolerance.

After two healthy volunteers consumed 1. Information about the disposition and fate of GHB in the body has been obtained from several controlled human dosing User Submitted Piss covering a range from Concentration-time curves of GHB were constructed from analysis of plasma or serum and not whole blood.

In most pharmacokinetic studies the concentrations of GHB are determined in plasma or serum and not in whole blood. The GHB concentrations in serum are expected to be higher than in blood in a similar way as ethanol distribution [ ]. The pharmacokinetics of GABA appears to be dose-dependent and the metabolizing enzymes become saturated with substrate after massive User Submitted Piss doses are taken and high concentrations are reached in plasma.

After large doses of GHB or its precursors when the hepatic enzymes are saturated the initial descending phase of the C-T profile is best described by zero-order User Submitted Piss [ ].

MATURE COCKS GALLERIES Huge Monster Cock Creampie User Submitted Piss GHB and date rape. The urinary User Submitted Piss of gamma-hydroxybutyric acid in man. An appreciable overlap exists between GHB concentrations in femoral blood in intoxication deaths and other causes of death and also between living cases DUID suspects and autopsy cases User Submitted Piss 56 ]. After prolonged regular use of GHB tolerance and dependence develop and abrupt cessation of drug use leads to unpleasant withdrawal symptoms. Sanremo, Italy for use as pharmacotherapy to support alcoholics during detoxification and withdrawal [ 3536 ]. Other clinical manifestations frequently described are confusion, disorientation, hyper-tension and paranoia. HARD CORE EBONY SEX VIDEOS 618 DRAGON QUEAT 4 MEENA HENTAI 884

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