what is chloral hydrate used for

Precautions

Chloral hydrate is no longer available in the United States. Why is this medication prescribed? Chloral hydrate, a sedative, is used in the short-term treatment of insomnia (to help you fall asleep and stay asleep for a proper rest) and to relieve anxiety and induce sleep before surgery.

Is chloral hydrate available in the United States?

Chloral hydrate slows the activity of your central nervous system. This medicine has both fast-acting and long-lasting sedative effects. Chloral hydrate is for short-term use as a sedative or sleep medicine. It is sometimes given before a surgery to help you relax.

What does chloral hydrate do to your body?

Chloral hydrate is a sedative, also called a hypnotic. Chloral hydrate slows the activity of your central nervous system. This medicine has both fast-acting and long-lasting sedative effects. Chloral hydrate is for short-term use as a sedative or sleep medicine.

Is chloral hydrate a sedative?

Chloral hydrate. More reputable uses of chloral hydrate include its use as a clearing agent for chitin and fibers and as a key ingredient in Hoyer's mounting medium, which is used to prepare permanent or semi-permanent microscope slides of small organisms, histological sections, and chromosome squashes.

What is chloral hydrate used for in microscopy?

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What is chloral hydrate street name?

Liquid chloral hydrate may be created from commonly-available household products. Street names for chloral hydrate include “Mickey Finn” and “Knockout Drops.”

Is chloral hydrate still prescribed?

In the United States, chloral hydrate is a schedule IV controlled substance and requires a physician's prescription.

How does chloral hydrate make you feel?

Drowsiness and trouble waking up in the morning, nausea, vomiting, stomach pain, diarrhea, and headache may occur. Stomach problems can be reduced by taking chloral hydrate with a full glass of water. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

What happens if you drink chloral hydrate?

The main side effects are digestive, cardiologic (risk of rhythm disorder), dermatologic, neuropsychiatric (withdrawn, delusions, hallucination, dependence) and ophthalmologic. Death occurs after absorption of doses of around 10 g of hydrate chloral, some cases were reported with 5 g.

Why is chloral hydrate no longer used?

Cardiac toxicity and hypotension Ventricular dysrhythmias and severe hypotension, which has led to some fatalities, from chloral hydrate toxicity have been reported. These effects were observed mostly after large doses or overdoses, as they are dose-dependent.

How much chloral hydrate is lethal?

Although the dose considered to be fatal for CH is about 10 g, fatalities have been documented with ingestion of as little as 4 g and the recovery of a patient following ingestion of 30 g CH was also reported.

How long does it take for chloral hydrate to work?

How long will it take to start working? Chloral Hydrate should start working within 30 minutes of a dose being given.

What is used instead of chloral hydrate?

Results demonstrated that the new clearing agent Visikol can be effectively used as a replacement of chloral hydrate in botanical microscopy. Visikol can thus be used for clearing herbal products for quality assessment and yielding high-quality images.

How much chloral hydrate should I take?

Chloral Hydrate 143mg/5ml Oral Solution should be administered as a single daily dose, between 15 to 30 minutes before bedtime with water or milk. Adults: The usual dose is 430-860 mg (15-30 ml of the 143mg/5ml strength).

What does chloral hydrate taste like?

This medicine usually works within 10 to 30 minutes. Chloral hydrate has a bitter taste, however a small amount of ribena or squash can be used to mask the taste. We use chloral hydrate routinely without any complications.

What kind of drug is a Mickey?

chloral hydrateIn slang, a Mickey Finn (or simply a Mickey) is a drink laced with a incapacitating agent, particularly chloral hydrate, given to someone without their knowledge with the intent to incapacitate them or "knock them out"; hence the colloquial name knockout drops.

What was in sleeping powders?

chloral hydrate, also called chloral, the first synthetically produced sedative-hypnotic drug, commonly used in the late 19th century to treat insomnia and still occasionally used to reduce anxiety or produce sleep before surgery.

What can be used instead of chloral hydrate?

VisikolVisikol is as effective as chloral hydrate in providing clarity and resolution of all tissues examined.

Is chloral hydrate still available in Canada?

Based on the most recent data, most commercial chloral hydrate is imported into Canada although a small quantity is manufactured in the country.

How long do the effects of chloral hydrate last?

Approximately half of all children will be back to their normal selves by 2 hours after the chloral hydrate was given. Some are sleepy for a longer period, most resuming normal activities within 4 - 8 hours. A few may take even longer.

How long does it take for chloral hydrate to work?

How long will it take to start working? Chloral Hydrate should start working within 30 minutes of a dose being given.

Why is chloral hydrate measured?

The plasma, serum or blood concentrations of chloral hydrate and/or trichloroethanol, its major active metabolite, may be measured to confirm a diagnosis of poisoning in hospitalized patients or to aid in the forensic investigation of fatalities.

How long does it take for chloral hydrate to work?

In therapeutic doses for insomnia, chloral hydrate is effective within 20 to 60 minutes. In humans it is metabolized within 7 hours into trichloroethanol and trichloroethanol glucuronide by erythrocytes and plasma esterases and into trichloroacetic acid in 4 to 5 days.

What reacts with aniline and hydroxylamine to give a condensation product?

In this synthesis, chloral hydrate reacts with aniline and hydroxylamine to give a condensation product which cyclicizes in sulfuric acid to give the target compound: Moreover, chloral hydrate is used as a reagent for the deprotection of acetals, dithioacetals and tetrahydropyranyl ethers in organic solvents.

What is Melzer's reagent?

Melzer's reagent. Chloral hydrate is an ingredient used to make Melzer's reagent, an aqueous solution that is used to identify certain species of fungi. The other ingredients are potassium iodide, and iodine. Whether tissue or spores react to this reagent is vital for the correct identification of some mushrooms.

Is chloral hydrate FDA approved?

Chloral hydrate has not been approved by the FDA in the United States or the EMA in the European Union for any medical indication and is on the FDA list of unapproved drugs that are still prescribed by clinicians. Usage of the drug as a sedative or hypnotic may carry some risk given the lack of clinical trials.

Is chloral hydrate soluble in water?

One notable recreational user, for instance, was the poet and illustrator Dante Gabriel Rossetti. Chloral hydrate is soluble in both water and ethanol, readily forming concentrated solutions. A solution of chloral hydrate in ethanol called "knockout drops" was used to prepare a Mickey Finn.

Is chloral hydrate a grandfathered drug?

Prior to that, chloral hydrate may have been sold as a "legacy" or "grandfathered" drug;" that is, a drug that existed prior to the time certain FDA regulations took effect and therefore, some pharmaceutical companies have argued, has never required FDA approval.

Why is chloral hydrate prescribed?

Chloral hydrate, a sedative, is used in the short-term treatment of insomnia (to help you fall asleep and stay asleep for a proper rest) and to relieve anxiety and induce sleep before surgery. It is also used after surgery for pain and to treat alcohol withdrawal.

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature, away from excess heat and moisture (not in the bathroom). Protect the liquid from light; do not freeze.

Can you take chloral hydrate rectally?

Take chloral hydrate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Can chloral hydrate make you drowsy?

if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking chloral hydrate. you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you. remember that alcohol can add to the drowsiness caused by this drug.

Can you stop taking chloral hydrate?

Continue to take chloral hydrate even if you feel well. Do not stop taking chloral hydrate without talking to your doctor, especially if you have taken large doses for a long time.

What happens if you stop taking chloral?

If you suddenly stop using this medication, you may have withdrawal symptoms (such as sweating, trembling, anxiety, confusion, seizures, and hallucinations ). Withdrawal from chloral hydrate can be severe (rarely fatal). To help prevent withdrawal, your doctor may lower your dose slowly.

Does chloral hydrate cause stomach pain?

Side Effects. Drowsiness and trouble waking up in the morning, nausea, vomiting, stomach pain, diarrhea, and headache may occur. Stomach problems can be reduced by taking chloral hydrate with a full glass of water. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Can chloral hydrate be used for a long time?

To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used chloral hydrate for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal. When this medication is used for a long time, it may not work as well.

Are you currently using Chloral Hydrate Capsule?

This survey is being conducted by the WebMD marketing sciences department.

What is chloral hydrate used for?

This form of chloral hydrate is used in drug-facilitated sexual assault, or "date rape".

Is chloral hydrate addictive?

It is not considered an addictive drug like cocaine, heroin or alcohol because it does not produce the same compulsive drug-seeking behavior. However, like addictive drugs, chloral hydrate produces greater tolerance in some users who take the drug repeatedly.

How long does chloral hydrate last?

Chloral hydrate is rapidly converted to an active metabolite (trichloroethanol) responsible for its sedative properties, which has a half-life at therapeutic doses of up to 66 hours in neonates, 28-40 hours in infants, 8-12 hours in children, and much longer following an overdose. 2,7. No reversal agent.

How long did it take for a 15-month-old to vomit after taking chloral hydrate?

Within 25 minutes of receiving the drug, the child vomited, became obtunded, and developed stridor, periods of apnea, and cyanosis. The child improved after an oral airway was established and oxygen was administered. She was transferred to the ED, monitored for 12 hours, and then discharged.

Is chloral hydrate bitter?

Large volume per dose. Chloral hydrate is very bitter tasting and requires a large volume per dose. Poor palatability has necessitated administration via a nasogastric tube at times. 9 In addition, compounded chloral hydrate is difficult to concentrate, leading to even larger volumes per dose than the previously available commercial formulation. 5 This can lead to vomiting or spitting out of unquantifiable amounts of the dose.

Can chloral hydrate be absorbed with food?

Irritating gastric effects. Nordt et al. notes that chloral hydrate is more rapidly absorbed with food; fasting before a procedure where chloral hydrate is used for sedation is not recommended since it can delay the drug’s onset, leading to sedation failures. 2 However, gastric irritation has led to vomiting, which can result in aspiration of the stomach contents.

Does chloral hydrate have a narrow therapeutic index?

Narrow therapeutic index. Chloral hydrate has a relatively narrow therapeutic index, which can increase the risk of adverse effects when higher therapeutic doses or overdoses are administered. 2

Is chloral hydrate FDA approved?

There are no FDA-approved drug products that contain chloral hydrate. As mentioned above, the firms commercially manufacturing and distributing drug products containing chloral hydrate without FDA-approval voluntarily removed their products from the market in 2012. We were thinking about removing chloral hydrate from our lists of high-alert medications but have not done so given the unknown frequency of prescribing and compounding the drug. There have also been worrisome, more recent adverse events associated with the drug as reported in the news media and professional literature. Chloral hydrate has a US Pharmacopeial Convention (USP) monograph so pharmacists can compound it under section 503A (individual prescription) of the Federal Food, Drug, and Cosmetic (FD&C Act), but it can’t be compounded under 503B (outsourcing facilities) because it is NOT on FDA’s list of bulk drug substances.

Can you compound chloral hydrate?

Chloral hydrate has a US Pharmacopeial Convention (USP) monograph so pharmacists can compound it under section 503A (individual prescription) of the Federal Food, Drug, and Cosmetic (FD&C Act), but it can’t be compounded under 503B (outsourcing facilities) because it is NOT on FDA’s list of bulk drug substances.

What is chloral hydrate?

Chloral Hydrate is a synthetic monohydrate of chloral with sedative, hypnotic, and anticonvulsive properties. Chloral hydrate is converted to the active compound trichloroethanol by hepatic alcohol dehydrogenase. The agent interacts with various neurotransmitter-operated ion channels, thereby enhancing gamma-aminobutyric acid ( GABA )-A receptor mediated chloride currents and inhibiting amino acid receptor-activated ion currents. In addition, chloral hydrate enhances the agonistic effects of glycine receptors, inhibits AMPA -induced calcium influx in cortical neurons, and facilitates 5-HT 3 receptor-mediated currents in ganglionic neurons. Overall, this results in a depressive effect on the central nervous system.

How is chloral hydrate released?

Chloral hydrate is a disinfection by-product formed as a result of water treatment using chlorine with ozone or chloramine with ozone which may result in its release to the environment through various waste streams. Chloral hydrate's production in organic synthesis and use as a sedative may result in its release to the environment through various waste streams. If released to air, a vapor pressure of 15 mm Hg at 25 °C indicates chloral hydrate will exist solely as a vapor in the atmosphere. Vapor-phase chloral hydrate will be degraded in the atmosphere by reaction with photochemically-produced hydroxyl radicals; the half-life for this reaction in air is estimated to be 8 days. The related aldehyde chloral is readily photolyzed in sunlight based on its atmospheric half-life of 4.5-6 hours; therefore, atmospheric photolysis of chloral hydrate may be a major degradation pathway. If released to soil, chloral hydrate is expected to have high mobility based upon an estimated Koc of 82. Volatilization from moist soil surfaces is expected to be an important fate process based upon an estimated Henry's Law constant of 5.7X10-9 atm-cu m/mole. Biodegradation data for chloral hydrate were not available. In water, chloral hydrate is formed from the exothermic reaction of chloral with water, in which chloral hydrate is in equilibrium. Chloral hydrate hydrolyzes to form chloroform at high pH. Chloral hydrate is not expected to adsorb to suspended solids and sediment based upon the estimated Koc. Volatilization from water surfaces is expected to be an important fate process based upon this compound's estimated Henry's Law constant. An estimated BCF of 3 suggests the potential for bioconcentration in aquatic organisms is low. Chloral hydrate hydrolyzes to form chloroform at high pH. Occupational exposure to chloral hydrate may occur through inhalation and dermal contact with this compound at workplaces where chloral hydrate is produced or used. Monitoring data indicate that the general population may be exposed to chloral hydrate via ingestion of chlorinated drinking water, and dermal contact with this compound when swimming in chlorinated pools; limited exposure is expected from its use as a sedative. (SRC)

How long should you monitor chloral hydrate?

Treat coma, hypothermia, hypotension, and pulmonary edema if they occur. Monitor patients for at least 6 hours after ingestion, because delayed absorption may occur. Patients with chloral hydrate ingestion should be monitored 18 to 24 hours because of the risk of cardiac arrhythmias. Tachyarrhythmias caused by myocardial sensitization may be treated with propranolol or esmolol. ... Administer activated charcoal orally if conditions are appropriate. Gastric lavage is not necessary after small to moderate ingestions if activated charcoal can be given promptly. ... /Sedative-Hypnotic Agents/

How long does trichloroethanol glucuronide last?

The average half-life of trichloroethanol glucuronide was 6.7 hr. The average plasma half-life for chloral hydrate metabolites was 8.2 hr; the half-life of the third chloral hydrate metabolite, trichloroacetic acid, was about four days, as it binds extensively to plasma proteins.

What is the metabolite of trichloroethanol?

Metabolized by the liver and erythrocytes to form trichloroethanol, an active metabolite. This reaction is catalyzed by alcohol dehydrogenase and other enzymes. Oxidation of chloral hydrate and trichloroethanol to trichloroacetic acid in the liver and kidneys also occurs to a lesser extent. Trichloroethanol also undergoes glucuronidation to produce an inactive metabolism.

How much chloral hydrate is lethal?

The lethal oral dose of chloral hydrate in adults is about 10 g ; however, ingestion of 4 g has caused death, and some patients have survived ingestion of as much as 30 g.

Where is chloral hydrate absorbed?

Rapidly absorbed in the GI tract following oral or rectal administration. Chloral hydrate and its active metabolite, trichloroethanol, have been detected in CSF, umbilical cord blood, fetal blood, and amniotic fluid.

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