Chloral hydrate drug administration

Absorption of drugs, which occurs mainly via passive diffusion, changes little with advancing age. The changes listed in Table 1 could potentially affect drug absorption. More important changes result from the concurrent administration of several medications. For example, antacids decrease the oral absorption of cimet-idine, and alcohol accelerates the absorption of chloral hydrate. 

These drugs include alcohols (ethchlorvynol, chloral hydrate), piperidinediones (glutethimide, methyprylon), and carbamates (meprobamate). They are rarely used in therapy, though the low cost of chloral hydrate makes it attractive for institutional use. Little is known about their molecular mechanisms of action. Most of these drugs are biotransformed to more water-soluble compounds by hepatic enzymes. Trichloroethanol is the pharmacologically active metabolite of chloral hydrate and has a half-life of 6-10 hours. However, its toxic metabolite, trichloroacetic acid, is cleared very slowly and can accumulate with the nightly administration of chloral hydrate. 

Barbiturate overdose may be treated with gastric lavage and oral administration of activated charcoal. Supportive therapy of cardiovascular, respiratory, and renal function also should be provided. Coadministration of alcohol and barbiturates may increase the sedative effect of chloral hydrate. Long-term use of barbiturates leads to dependence. Sudden discontinuation of an antipsychotic drug may cause withdrawal symptoms such as nausea, vomiting, anorexia, diarrhea, rhinorrhea, sweating, insomnia, restlessness, and vertigo.151... 

Drug overdose Unintentional administration of a 10-fold dose of chloral hydrate (667 mg/kg) in a 3-month-old girl resulted in respiratory depression, requiring intubation and ventilation [130 ]. There were also esophagitis and gastric ulcers. The serum trichloroethanol concentration was 89 mg/1 6 hours later and fell to 20 mg/1 within 24 hours and dialysis was not required. 

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