Pharmacokinetics of Chloral Hydrate Poisoning Treated with Hemodialysis and Hemoperfusion

Buur, Tom; Larsson, Robert; Norlander, Björn

doi:10.1111/j.0954-6820.1988.tb15797.x

Cited by 15 publications

(4 citation statements)

References 8 publications

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“…It is bounded to plasma proteins in range of 70-80% and is dispensed to all tissues including cerebrospinal fluid. If any adverse effect emerges after enteral usage as well as general support-reinforcing and symptomatic treatment, hemodialysis and peritoneum dialysis are proposed to increase elimination of trichlorethanol in necessary cases in case of intoxication [6,7].…”

Section: Discussionmentioning

confidence: 99%

Unacceptable Intravenous Administration of Chloral Hydrate Oral Solution

Çokyaman¹

2016

Int Arch Clin Pharmacol

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Chloral hydrate is very frequently used in medical procedures with the purpose of sedation. After oral or rectal administration, central nervous system (CNS) and respiratory depression, cardiac arrhythmia and gastric irritation are known as classical adverse effects. Although the adverse effects developing after enteral usage are well known, there are limited data in literature about the misuse of chloral hydrate oral solution intravenously and the adverse effects that may be seen after this usage. In this article, it is intended that chloral hydrate oral solution has been mistakenly administered intravenously and it is a fact that there isn't any seen complication except localized skin erythema.

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Section: Discussionmentioning

confidence: 99%

Unacceptable Intravenous Administration of Chloral Hydrate Oral Solution

Çokyaman¹

2016

Int Arch Clin Pharmacol

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“…Hemodialysis and charcoal hemoperfusion have been used following acute chloral hydrate poisoning [15]. This makes intuitive sense, particularly for hemodialysis based on the molecular weight of TCE of 149 Da and low plasma protein binding of 35 % [16].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Chloral Hydrate Poisonings and Death Following Outpatient Procedural Sedation

et al. 2014

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Introduction Chloral hydrate has been used medicinally since the 1800 s as a sedative hypnotic, most commonly for procedural sedation. As it is administered orally and available in a liquid formulation, it is used almost exclusively in pediatric patients despite many safer and more effective alternative agents being available. Case Series We present three cases of pediatric chloral hydrate poisoning, all occurring following procedural sedation in outpatient clinic settings and presenting to the emergency department. The ages ranged from 15 months to 4 years of age and all required resuscitation. Unfortunately, the 4-yearold died. Conclusion Choral hydrate is associated with significant adverse effects, including death, and safer alternatives for pediatric procedural sedation should be sought and utilized. There are a number of more effective sedative agents with more predictable pharmacokinetic and safety profiles than chloral hydrate including parenteral and oral agents. The practice of pre-procedure sedation should be performed only in a supervised setting where cardiorespiratory monitoring can occur in all cases.

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“…Both haemoperfusion (HP) and haemodialysis (HD) have been shown to be highly effective for enhancing elimination of chloral hydrate metabolites. 35 Successful outcome of treatment with combined HP and HD in patients with severe chloral hydrate overdose resulting in shock and even cardiac arrest has been reported. 1,22 Thus, low blood pressure and poor clinical condition should not be regarded as contraindications for extracorporeal treatment in life-threatening overdose of chloral hydrate.…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Chloral Hydrate Overdose

Wong¹,

Lam²,

Fung³

2009

Hong Kong j. emerg. med.

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Chloral hydrate overdose is associated with cardiac toxicities, gastrointestinal tract injuries, central nervous system and respiratory depression. Among all the complications, cardiac arrhythmias are particularly concerning and frequently reported in the literature. The majorities of fatalities from chloral hydrate overdose are due to refractory cardiac arrhythmia. Chloral hydrate-induced arrhythmias are resistant to most of the standard anti-arrhythmic agents but have good response to propranolol. We report two cases of severe chloral hydrate overdose presenting with alarming cardiac rhythm disturbances. One of the patients was successfully treated with intravenous propranolol in the accident and emergency department. The management of chloral hydrate overdose in particular to its cardiac toxicity is reviewed.

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Pharmacokinetics of Chloral Hydrate Poisoning Treated with Hemodialysis and Hemoperfusion

Cited by 15 publications

References 8 publications

Unacceptable Intravenous Administration of Chloral Hydrate Oral Solution

Unacceptable Intravenous Administration of Chloral Hydrate Oral Solution

Pediatric Chloral Hydrate Poisonings and Death Following Outpatient Procedural Sedation

Two Cases of Chloral Hydrate Overdose

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