Status epilepticus paraldehyde

Paraldehyde, although not a drug of first choice, can be used for sleep induction. It is also still considered to be of some value in the treatment of status epilepticus. 

Paraldehyde is the cyclic trimer of acetaldehyde, a colorless or slightly yellow-colored liquid. It has been used as an anticonvulsant, but because of its adverse effects and because it is difficult to use it has been replaced by more modern agents. However, it is still sometimes used to treat status epilepticus that is resistant to first-line drugs (1). The usual adult rectal dose is 10-20 ml. 

Other Paraldehyde Class IV Exhaled via the lungs strong odor and disagreeable taste seldom used has been used to control delirium tremens (DTS) in alcoholics can be used for drug poisoning Status epilepticus and tetanus to control convulsions Pregnancy category C, PB UK half life 7.5 hours Sedative PO 5-10 mL q4—6h PRN in water or juice maximum dose of 30 mL Hypnotic PO 10-30 mL h.s. 

Status epilepticus is traditionally defined as a situation where there is continuous seizure activity for a period of 30 minutes or where there are a continuous series of seizures during which the sufferer does not regain consciousness. More recently, it has been suggested that any continuous seizure period of longer than 5 minutes should be classified as status epilepticus. In these situations the treatment employed may well consist of one of the previously indicated antiepileptic dmgs such as clonazepam (Fig. 13.15), phenobarbital and phenytoin (Fig. 13.15) or alternatively diazepam, fosphenytoin (a prodrug of phenytoin), loraze-pam, midazolam and paraldehyde (Fig. 13.16) may be employed. For the drugs used in the treatment of status epilepticus, the formulation and dose differ from conventional doses due to the situation and thus many of these will be administered by intravenous injection, intravenous infusion, buccal or rectal administration. 

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