{"id":4026,"date":"2026-01-17T10:09:03","date_gmt":"2026-01-17T07:09:03","guid":{"rendered":"https:\/\/tatd.org.tr\/toksikoloji\/?p=4026"},"modified":"2026-01-17T10:09:04","modified_gmt":"2026-01-17T07:09:04","slug":"gama-hidroksibutirat-zehirlenmesi-klinik-tani-ile-laboratuvar-dogrulamasinin-karsilastirilmasi","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/toksikoloji\/2026\/01\/17\/gama-hidroksibutirat-zehirlenmesi-klinik-tani-ile-laboratuvar-dogrulamasinin-karsilastirilmasi\/","title":{"rendered":"Gama-Hidroksib\u00fctirat Zehirlenmesi: Klinik Tan\u0131 ile Laboratuvar Do\u011frulamas\u0131n\u0131n Kar\u015f\u0131la\u015ft\u0131r\u0131lmas\u0131"},"content":{"rendered":"\n<p>Herkese merhabalar, bu yaz\u0131da son y\u0131llarda pop\u00fcler hale gelmi\u015f, gama-hidrosib\u00fctirat zehirlenmesi ile ilgili 2025 y\u0131l\u0131nda Clinical Toxicology dergisinde yay\u0131nlanm\u0131\u015f Skjelland ve ark. (1) yapt\u0131\u011f\u0131 \u00e7al\u0131\u015fman\u0131n \u00f6zetini sunaca\u011f\u0131z. Keyifli okumalar.<\/p>\n\n\n\n<p><strong>Giri\u015f<\/strong><\/p>\n\n\n\n<p>Acil serviste bilin\u00e7 de\u011fi\u015fikli\u011fi ile ba\u015fvuran hastalar, klinisyenin en s\u0131k ve ayn\u0131 zamanda en zorland\u0131\u011f\u0131 hasta gruplar\u0131ndan birini olu\u015fturur. \u00d6zellikle ani geli\u015fen koma, dalgal\u0131 bilin\u00e7 d\u00fczeyi ve e\u015flik eden ajitasyon tablolar\u0131nda ay\u0131r\u0131c\u0131 tan\u0131 geni\u015ftir ve zaman bask\u0131s\u0131 alt\u0131nda do\u011fru klinik karar verilmesi hayati \u00f6nem ta\u015f\u0131r. Bu ba\u011flamda&nbsp;<strong>gama-hidroksib\u00fctirat (GHB) <\/strong>zehirlenmesi, son y\u0131llarda e\u011flence ama\u00e7l\u0131 madde kullan\u0131m\u0131n\u0131n art\u0131\u015f\u0131yla birlikte acil servislerde giderek daha s\u0131k kar\u015f\u0131la\u015f\u0131lan bir klinik tablo haline gelmi\u015ftir.<\/p>\n\n\n\n<p>GHB, santral sinir sistemi \u00fczerinde g\u00fc\u00e7l\u00fc depresan etkileri olan, dar terap\u00f6tik aral\u0131\u011fa sahip bir maddedir. Klinik etkileri, hafif sedasyondan derin komaya kadar geni\u015f bir spektrumda seyredebilir ve bilin\u00e7 d\u00fczeyi s\u0131kl\u0131kla k\u0131sa s\u00fcreler i\u00e7inde dalgalanma g\u00f6sterebilir. Bu \u00f6zellikleri nedeniyle GHB zehirlenmesi, hem etanol intoksikasyonu hem de di\u011fer santral sinir sistemi depresanlar\u0131yla kar\u0131\u015fabilen, tan\u0131s\u0131 g\u00fc\u00e7 bir klinik durumdur. Ayr\u0131ca GHB\u2019nin k\u0131sa yar\u0131 \u00f6mr\u00fc ve h\u0131zl\u0131 metabolizmas\u0131, laboratuvar do\u011frulamas\u0131n\u0131 klinik pratikte daha da zorla\u015ft\u0131rmaktad\u0131r.<\/p>\n\n\n\n<p>Bu \u00e7al\u0131\u015fman\u0131n temel \u00e7\u0131k\u0131\u015f noktas\u0131,&nbsp;<strong>\u201cKlinik olarak GHB zehirlenmesi d\u00fc\u015f\u00fcnd\u00fc\u011f\u00fcm\u00fcz hastalar\u0131n ger\u00e7ekten ka\u00e7\u0131 GHB alm\u0131\u015f?\u201d<\/strong>&nbsp;sorusudur. Klinik tan\u0131n\u0131n do\u011frulu\u011funu, kan \u00f6rneklerinde yap\u0131lan toksikolojik analizlerle kar\u015f\u0131la\u015ft\u0131rarak de\u011ferlendiren bu \u00e7al\u0131\u015fma, acil servis prati\u011fi a\u00e7\u0131s\u0131ndan son derece \u00f6\u011fretici veriler sunmaktad\u0131r.<\/p>\n\n\n\n<p><strong>\u00c7al\u0131\u015fman\u0131n Amac\u0131 ve Klinik \u00d6nemi<\/strong><\/p>\n\n\n\n<p>Bu prospektif g\u00f6zlemsel \u00e7al\u0131\u015fman\u0131n temel amac\u0131,&nbsp;GHB zehirlenmesi \u00f6n tan\u0131s\u0131yla hastaneye yat\u0131r\u0131lan hastalarda klinik tan\u0131n\u0131n do\u011frulu\u011funu&nbsp;laboratuvar bulgular\u0131 ile kar\u015f\u0131la\u015ft\u0131rmakt\u0131r. \u0130kincil olarak ise, bu hastalar\u0131n&nbsp;ger\u00e7ekten hastane ve yo\u011fun bak\u0131m tedavisine ihtiya\u00e7 duyup duymad\u0131\u011f\u0131n\u0131&nbsp;de\u011ferlendirmek hedeflenmi\u015ftir.<\/p>\n\n\n\n<p>Bu soru, \u00f6zellikle acil servis triyaj\u0131 a\u00e7\u0131s\u0131ndan kritik \u00f6neme sahiptir. \u00c7\u00fcnk\u00fc GHB zehirlenmesi d\u00fc\u015f\u00fcn\u00fclen hastalar genellikle: yo\u011fun bak\u0131m yat\u0131\u015f\u0131, ent\u00fcbasyon, yak\u0131n monit\u00f6rizasyon gibi ileri d\u00fczey kaynaklar gerektirebilecek \u015fekilde y\u00f6netilmektedir. Ancak klinik tan\u0131 hatal\u0131ysa, hem hasta hem de sa\u011fl\u0131k sistemi a\u00e7\u0131s\u0131ndan gereksiz m\u00fcdahaleler s\u00f6z konusu olabilir.<\/p>\n\n\n\n<p><strong>Y\u00f6ntemsel Yakla\u015f\u0131m (K\u0131sa \u0130nceleme)<\/strong><\/p>\n\n\n\n<p>\u00c7al\u0131\u015fma Norve\u00e7\u2019in Oslo kentinde, iki b\u00fcy\u00fck hastanede y\u00fcr\u00fct\u00fclm\u00fc\u015f&nbsp;<strong>prospektif g\u00f6zlemsel<\/strong>&nbsp;bir \u00e7al\u0131\u015fmad\u0131r.<br>\u226516 ya\u015f olup,&nbsp;<strong>klinik olarak GHB zehirlenmesi tan\u0131s\u0131 alan<\/strong>&nbsp;hastalar \u00e7al\u0131\u015fmaya dahil edilmi\u015ftir. Klinik tan\u0131; hastay\u0131 de\u011ferlendiren hekimin klinik bulgulara, hasta veya yak\u0131nlar\u0131n\u0131n beyan\u0131na, ambulans ekibinin g\u00f6zlemlerine ve olay yerinden elde edilen bilgilere dayanarak konulmu\u015ftur.<\/p>\n\n\n\n<p>T\u00fcm hastalardan ba\u015fvuru s\u0131ras\u0131nda kan \u00f6rnekleri al\u0131nm\u0131\u015f ve&nbsp;y\u00fcksek duyarl\u0131l\u0131\u011fa sahip s\u0131v\u0131 kromatografisi\u2013tandem k\u00fctle spektrometrisi&nbsp;y\u00f6ntemiyle GHB ve di\u011fer maddeler analiz edilmi\u015ftir.<\/p>\n\n\n\n<p>Klinik karar\u0131n,&nbsp;laboratuvar sonucu bilinmeden&nbsp;verilmesi buradaki en \u00f6nemli noktalardan biridir. Bu durum \u00e7al\u0131\u015fmay\u0131 ger\u00e7ek ya\u015fam prati\u011fine olduk\u00e7a yak\u0131n k\u0131lmaktad\u0131r.<\/p>\n\n\n\n<p><strong>Hasta Profili ve Klinik Bulgular<\/strong><\/p>\n\n\n\n<p>\u00c7al\u0131\u015fmaya toplam&nbsp;<strong>87 hasta<\/strong>&nbsp;dahil edilmi\u015ftir (Tablo 1). Hastalar\u0131n:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ortanca ya\u015f\u0131&nbsp;<strong>35 y\u0131l<\/strong>&nbsp;civar\u0131ndad\u0131r,<\/li>\n\n\n\n<li>Yakla\u015f\u0131k&nbsp;<strong>%59\u2019u erkektir<\/strong>.<\/li>\n<\/ul>\n\n\n\n<p>Bu demografik yap\u0131, e\u011flence ama\u00e7l\u0131 madde kullan\u0131m\u0131na ba\u011fl\u0131 zehirlenmelerin tipik hasta profilini yans\u0131tmaktad\u0131r.<\/p>\n\n\n\n<p>Hastalar\u0131n ba\u015fvuru an\u0131ndaki&nbsp;Glasgow Koma Skoru (GKS)&nbsp;dikkat \u00e7ekici derecede d\u00fc\u015f\u00fckt\u00fcr:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>T\u00fcm hastalar i\u00e7in ortanca <strong>GKS:<\/strong>&nbsp;<strong>6<\/strong><\/li>\n\n\n\n<li>GHB pozitif hastalar\u0131n&nbsp;<strong>yar\u0131s\u0131ndan fazlas\u0131<\/strong>, <strong>GKS&nbsp;3<\/strong>&nbsp;ile ba\u015fvurmu\u015ftur.<\/li>\n<\/ul>\n\n\n\n<p>Bu bulgu, GHB\u2019nin ciddi santral sinir sistemi depresyonu yapabildi\u011fini ve klinik olarak dramatik tablolarla kar\u015f\u0131m\u0131za \u00e7\u0131kabildi\u011fini g\u00f6stermektedir.<\/p>\n\n\n\n<p>Tablo 1: Klinik olarak gama-hidroksib\u00fctirat (GHB) zehirlenmesi tan\u0131s\u0131 alan, gama-hidroksib\u00fctirat a\u00e7\u0131s\u0131ndan pozitif veya negatif saptanan hastalarda demografik veriler, klinik bulgular, uygulanan tedaviler ve tespit edilen di\u011fer ila\u00e7lar.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img fetchpriority=\"high\" decoding=\"async\" width=\"936\" height=\"517\" src=\"https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image.png\" alt=\"\" class=\"wp-image-4027\" srcset=\"https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image.png 936w, https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-300x166.png 300w, https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-768x424.png 768w, https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-585x323.png 585w\" sizes=\"(max-width: 936px) 100vw, 936px\" \/><\/figure>\n\n\n\n<p><strong>Klinik Tan\u0131 ile Laboratuvar Do\u011frulamas\u0131n\u0131n Kar\u015f\u0131la\u015ft\u0131r\u0131lmas\u0131<\/strong><\/p>\n\n\n\n<p>\u00c7al\u0131\u015fman\u0131n en \u00e7arp\u0131c\u0131 bulgusu \u015fudur: <strong>klinik olarak GHB zehirlenmesi d\u00fc\u015f\u00fcn\u00fclen hastalar\u0131n yaln\u0131zca %69\u2019unda kan \u00f6rne\u011finde GHB saptanm\u0131\u015ft\u0131r.<\/strong><\/p>\n\n\n\n<p>Bu durum, acil serviste&nbsp;GHB zehirlenmesinin klinik olarak a\u015f\u0131r\u0131 tan\u0131 konulan&nbsp;bir tablo olabilece\u011fini d\u00fc\u015f\u00fcnd\u00fcrmektedir. \u00d6te yandan, gamma-hidroksib\u00fctirat\u0131n kanda k\u0131sa eliminasyon yar\u0131 \u00f6mr\u00fcne sahip olmas\u0131 nedeniyle baz\u0131 ger\u00e7ek vakalar\u0131n saptanamam\u0131\u015f olmas\u0131 da m\u00fcmk\u00fcnd\u00fcr. Bu durum, klinik tan\u0131n\u0131n \u00f6zg\u00fcll\u00fc\u011f\u00fcn\u00fcn oldu\u011fundan d\u00fc\u015f\u00fck hesaplanmas\u0131na yol a\u00e7m\u0131\u015f olabilir.<\/p>\n\n\n\n<p>Bununla birlikte GHB pozitif hastalarda:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>GKS daha d\u00fc\u015f\u00fckt\u00fcr,<\/li>\n\n\n\n<li>GHB d\u00fczeyi ile GKS aras\u0131nda&nbsp;<strong>ters korelasyon<\/strong>&nbsp;vard\u0131r (\u015fekil 1),<\/li>\n\n\n\n<li>Y\u00fcksek GHB d\u00fczeyleri, daha derin koma ile ili\u015fkilidir.<\/li>\n<\/ul>\n\n\n\n<p>Bu bulgular,&nbsp;ger\u00e7ek GHB zehirlenmesinde klinik tablonun daha a\u011f\u0131r&nbsp;seyretti\u011fini desteklemektedir.<\/p>\n\n\n\n<p>\u015eekil 1: Serum gama-hidroksib\u00fctirat konsantrasyonlar\u0131 ile Glasgow Koma Skoru aras\u0131ndaki ili\u015fki (rs = \u22120,45; P &lt; 0,001).<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img decoding=\"async\" width=\"909\" height=\"602\" src=\"https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-1.png\" alt=\"\" class=\"wp-image-4029\" srcset=\"https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-1.png 909w, https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-1-300x199.png 300w, https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-1-768x509.png 768w, https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-1-780x516.png 780w, https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-1-585x387.png 585w, https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-1-263x175.png 263w\" sizes=\"(max-width: 909px) 100vw, 909px\" \/><\/figure>\n\n\n\n<p><strong>E\u015f Zamanl\u0131 Madde Kullan\u0131m\u0131: Tan\u0131y\u0131 Buland\u0131ran Ana Fakt\u00f6r<\/strong><\/p>\n\n\n\n<p>\u00c7al\u0131\u015fmada hastalar\u0131n&nbsp;<strong>%87.3\u2019\u00fcnde birden fazla madde<\/strong>&nbsp;saptanm\u0131\u015ft\u0131r. GHB pozitif hastalar\u0131n ise&nbsp;<strong>%96.7\u2019sinde<\/strong>&nbsp;ek maddeler mevcuttur (Tablo 2).<\/p>\n\n\n\n<p>En s\u0131k saptanan maddeler:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Amfetaminler,<\/li>\n\n\n\n<li>Benzodiazepinler,<\/li>\n\n\n\n<li>Kokain,<\/li>\n\n\n\n<li>Etanol.<\/li>\n<\/ul>\n\n\n\n<p>\u00d6zellikle benzodiazepin ve etanol, GHB negatif hastalarda daha s\u0131k g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Bu durum, klinik olarak GHB\u2019yi taklit eden tablolar\u0131n \u00f6nemli bir k\u0131sm\u0131n\u0131n asl\u0131nda&nbsp;di\u011fer santral sinir sistemi depresanlar\u0131na ba\u011fl\u0131&nbsp;olabilece\u011fini d\u00fc\u015f\u00fcnd\u00fcrmektedir.<\/p>\n\n\n\n<p>Klinik pratikte s\u0131k kar\u015f\u0131la\u015ft\u0131\u011f\u0131m\u0131z \u015fu durumu teyit eder niteliktedir:<\/p>\n\n\n\n<p>\u201cKoma + dalgal\u0131 bilin\u00e7 + madde \u00f6yk\u00fcs\u00fc = otomatik GHB tan\u0131s\u0131\u201d<\/p>\n\n\n\n<p>Bu refleksin her zaman do\u011fru olmayabilece\u011fi bu \u00e7al\u0131\u015fmayla net bi\u00e7imde ortaya konmu\u015ftur.<\/p>\n\n\n\n<p>Tablo 2: Gama-hidroksib\u00fctirat zehirlenmesitan\u0131s\u0131 konulan hastalarda tespit edilen ila\u00e7lar (n = 87).<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img decoding=\"async\" width=\"467\" height=\"523\" src=\"https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-3.png\" alt=\"\" class=\"wp-image-4030\" srcset=\"https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-3.png 467w, https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-3-268x300.png 268w\" sizes=\"(max-width: 467px) 100vw, 467px\" \/><\/figure>\n\n\n\n<p><strong>Yo\u011fun Bak\u0131m ve Hastane Yat\u0131\u015f\u0131 Gereksinimi<\/strong><\/p>\n\n\n\n<p>GHB pozitif hastalar\u0131n yakla\u015f\u0131k&nbsp;yar\u0131s\u0131 yo\u011fun bak\u0131m \u00fcnitesine&nbsp;yat\u0131r\u0131lm\u0131\u015ft\u0131r.<br>Ancak daha \u00f6nemlisi \u015fudur:<\/p>\n\n\n\n<p>GHB pozitif hastalar\u0131n&nbsp;<strong>%83.9\u2019u<\/strong>, retrospektif kriterlere g\u00f6re&nbsp;<strong>ger\u00e7ekten hastane tedavisine ihtiya\u00e7 duymaktad\u0131r (Tablo 3)<\/strong>.<\/p>\n\n\n\n<p>Bu bulgu, klinik tan\u0131 her zaman do\u011fru olmasa bile,&nbsp;triyaj kararlar\u0131n\u0131n genel olarak g\u00fcvenli&nbsp;oldu\u011funu g\u00f6stermektedir. Yani klinisyenler, yanl\u0131\u015f tan\u0131 koymu\u015f olsalar bile, y\u00fcksek riskli hastalar\u0131 genellikle do\u011fru \u015fekilde \u00fcst basamak bak\u0131ma y\u00f6nlendirmi\u015ftir.<\/p>\n\n\n\n<p>Bu durum, acil servis ve ambulans triyaj sistemlerinin&nbsp;<strong>hassas ama g\u00fcvenli<\/strong>&nbsp;\u00e7al\u0131\u015ft\u0131\u011f\u0131n\u0131 d\u00fc\u015f\u00fcnd\u00fcrmektedir.<\/p>\n\n\n\n<p>Tablo 3: Klinik olarak gama-hidroksib\u00fctirat zehirlenmesi tan\u0131s\u0131 konulan, hastanede tedavi gereksinimi olan veya olmayan hastalar\u0131n demografik \u00f6zellikleri, klinik g\u00f6zlemleri, tedavileri ve tespit edilen di\u011fer ila\u00e7lar.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"964\" height=\"580\" src=\"https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-2.png\" alt=\"\" class=\"wp-image-4028\" srcset=\"https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-2.png 964w, https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-2-300x180.png 300w, https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-2-768x462.png 768w, https:\/\/tatd.org.tr\/toksikoloji\/wp-content\/uploads\/sites\/6\/2026\/01\/image-2-585x352.png 585w\" sizes=\"(max-width: 964px) 100vw, 964px\" \/><\/figure>\n\n\n\n<p><strong>\u00c7al\u0131\u015fman\u0131n G\u00fc\u00e7l\u00fc Y\u00f6nleri ve S\u0131n\u0131rl\u0131l\u0131klar\u0131<\/strong><\/p>\n\n\n\n<p><strong>G\u00fc\u00e7l\u00fc y\u00f6nler:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Prospektif tasar\u0131m,<\/li>\n\n\n\n<li>Ger\u00e7ek ya\u015fam prati\u011fine uygun klinik karar s\u00fcreci,<\/li>\n\n\n\n<li>Geli\u015fmi\u015f toksikolojik analiz y\u00f6ntemleri.<\/li>\n<\/ul>\n\n\n\n<p><strong>S\u0131n\u0131rl\u0131l\u0131klar:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Klinik tan\u0131, hekimler aras\u0131nda de\u011fi\u015fkenlik g\u00f6sterebilir,<\/li>\n\n\n\n<li>GHB\u2019nin k\u0131sa yar\u0131 \u00f6mr\u00fc nedeniyle baz\u0131 ger\u00e7ek vakalar laboratuvarda negatif \u00e7\u0131km\u0131\u015f olabilir,<\/li>\n\n\n\n<li>Klinik olarak GHB d\u00fc\u015f\u00fcn\u00fclmeyen ancak ger\u00e7ekte GHB alan hastalar \u00e7al\u0131\u015fmaya dahil edilmemi\u015ftir (yalanc\u0131 negatifler).<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" \/>\n\n\n\n<p><strong>Sonu\u00e7 ve Klinik Mesajlar<\/strong><\/p>\n\n\n\n<p>Bu \u00e7al\u0131\u015fma bize birka\u00e7 net mesaj vermektedir:<\/p>\n\n\n\n<ol start=\"1\" class=\"wp-block-list\">\n<li><strong>Klinik olarak d\u00fc\u015f\u00fcn\u00fclen her GHB zehirlenmesi ger\u00e7ekten GHB de\u011fildir.<\/strong><\/li>\n\n\n\n<li><strong>Polisubstans kullan\u0131m\u0131<\/strong>, klinik tabloyu ciddi \u015fekilde maskelemekte ve tan\u0131y\u0131 zorla\u015ft\u0131rmaktad\u0131r.<\/li>\n\n\n\n<li><strong>Derin koma ve d\u00fc\u015f\u00fck GKS<\/strong>, ger\u00e7ek GHB zehirlenmesi ile daha g\u00fc\u00e7l\u00fc ili\u015fkilidir.<\/li>\n\n\n\n<li>Klinik tan\u0131 m\u00fckemmel olmasa da,&nbsp;<strong>triyaj ve hastane yat\u0131\u015f\u0131 kararlar\u0131 genellikle g\u00fcvenlidir<\/strong>.<\/li>\n\n\n\n<li>Gelecekte, GHB zehirlenmesi i\u00e7in&nbsp;<strong>daha spesifik klinik kriterlere<\/strong>&nbsp;ihtiya\u00e7 vard\u0131r.<\/li>\n<\/ol>\n\n\n\n<p><strong>Kaynak<\/strong><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Didrik Skjelland, Benedicte M. J\u00f8rgenrud, Karsten Gundersen, Mari Asphjell Bj\u00f8rnaas, Mette Brekke, Vivian M. Dalaker, H\u00e5vard Furuhaugen &amp; Odd Martin Vallersnes (2025) Gamma-hydroxybutyrate poisoning: clinical diagnosis versus laboratory findings, Clinical Toxicology, 63:4, 253-260, DOI: 10.1080\/15563650.2025.2463700<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Herkese merhabalar, bu yaz\u0131da son y\u0131llarda pop\u00fcler hale gelmi\u015f, gama-hidrosib\u00fctirat zehirlenmesi ile ilgili 2025 y\u0131l\u0131nda Clinical Toxicology dergisinde yay\u0131nlanm\u0131\u015f Skjelland ve ark.&hellip;<\/p>\n","protected":false},"author":5069,"featured_media":4033,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10014,10019],"tags":[27,202,10022,406,413,449],"class_list":["post-4026","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-akademik-blog-yazisi","category-tft","tag-acil-tip","tag-intoksikasyon","tag-tft","tag-toksikoloji","tag-toksisite","tag-zehirlenme"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/posts\/4026","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/users\/5069"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/comments?post=4026"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/posts\/4026\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/media\/4033"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/media?parent=4026"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/categories?post=4026"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/tags?post=4026"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}