Clinical Drug Investigation

, Volume 25, Issue 8, pp 551–554 | Cite as

Rapid Reversible Coma with Intravenous Gamma-Hydroxybutyrate in a Moxifloxacin-Treated Patient

  • Gerd Koehler
  • Anika Haimann
  • Hermann Laferl
  • Christoph Wenisch
Case Report

An adverse reaction rate of 5.0–37.0% has been reported with moxifloxacin.[1, 2, 3] The most common adverse effects are gastrointestinal reactions (nausea 8%, diarrhoea 6%, vomiting 2% and taste perversion 1%); next most common are symptoms of the central nervous system (CNS) [mostly headache 2% and dizziness 3%]; less frequent are restlessness, insomnia, sleep disorders, agitation and vision changes. More rare adverse effects of moxifloxacin include QTc prolongations, dermatological reactions, liver changes, tendon ruptures and arthropathy.

In an attempt to explain the underlying mechanism for the neurological adverse effects of quinolones, the gamma-aminobutyric acid (GABA) receptor has been proposed as a possible target for this class of antibacterials. Quinolones inhibit binding of GABA to its receptor.[2,4,5] Gamma-hydroxybutyrate (GHB), a metabolite of GABA, is a naturally occurring transmitter in the brain that plays a role in sleep regulation and affects cerebral energy...


Carvedilol Moxifloxacin Flumazenil Mental Status Change Levothyroxine Sodium 
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Copyright information

© Adis Data Information BV 2005

Authors and Affiliations

  • Gerd Koehler
    • 1
  • Anika Haimann
    • 1
  • Hermann Laferl
    • 2
  • Christoph Wenisch
    • 2
  1. 1.Department of Medicine, Infectious Disease and Intensive CareUniversity HospitalGrazAustria
  2. 2.Medizinische Abteilung mit Infektione und Tropenmedizin, SMZ SüdKaiser Franz Josef SpitalWienAustria

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