Chloral hydrate drug overdose

Barbiturates and barbiturate-like drugs, such as chloral hydrate, although effective hypnotics, are considered far less safe than BZDs in terms of tolerance, interaction with alcohol, and lethality in overdose. Therefore, their use is not generally recommended. 

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... 

HYPNOTICS are agents that induce sleep. They are used mainly to treat short-term insomnia, for instance in shiftwork, to cope with Jet-lag or in sleep disturbances due to emotional problems or in serious illness. The best-known and most-used hypnotics in current use are the benzodiazepines - and this class of drug is also used, at a lower dose, as ANXIOLYTICS. Examples from the class that are of relatively long-lasting action and may cause drowsiness the next day include diazepam, flunitrazepam, flurazepam and nitrazepam. Examples with a shorter duration include loprazolam, lormetazepam and temazepam. All can cause drug dependence on continued usage. Examples of hypnotics that are now much less used include chloral hydrate, chlormethiazole and triclofos. The barbiturates (e.g. amylobarbitone) are now very little used, as they are prone to cause serious dependence and are dangerous in overdose. 

Bromides were followed by paraldehyde, urethane, and sulfonal. These medications were no great improvement because they could be addictive, and an overdose could kill. The launching of chloral hydrate was an improvement because chloral hydrate is a relatively safe hypnotic drug. 

Drug overdose A case of chloral hydrate overdose has been reported [23 ]. 

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. 

A solution of chloral, trichloroethanal, in aqueous alcohol is known as knockout drops or a Mickey Finn. The original Mickey Finn was a bartender in Chicago around 1900, who drugged and then robbed his customers. Chloral hydrate has had legitimate uses as an aid to sleep, and in dental anesthesia, and has also been used recreationally. Therapeutic doses of chloral were implicated in the drug overdose death of Anna Nicole Smith in 2007, and Marilyn Monroe was reported to have chloral hydrate in her system when she died. 

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