Chloral hydrate Disease Interactions

There are 7 disease interactions with chloral hydrate:

Anxiolytic, sedative, and hypnotic agents should generally not be given to patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of these agents may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with such agents should be administered cautiously in patients who might be prone to acute alcohol intake.

Anxiolytic, sedative, and hypnotic agents have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages, and abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance, overdosage can still produce respiratory depression and death. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously and for as brief a period as possible. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with these agents. In addition, it may be prudent to refrain from dispensing large quantities of medication to such patients. After prolonged use or if dependency is suspected, withdrawal of medication should be undertaken gradually using a dosage-tapering schedule.

The use of chloral hydrate is contraindicated in patients with marked renal and/or hepatic impairment due to the potential for significant drug and metabolite accumulation. Chloral hydrate is metabolized by the liver and erythrocytes to the pharmacologically active compound, trichloroethanol (TCE), which has a plasma half-life of 8 to 12 hours. TCE is then metabolized further by both the liver and kidney to inactive substances that are slowly excreted in the urine. High plasma levels of chloral hydrate and TCE may produce respiratory depression and adverse cardiovascular effects such as peripheral vasodilation, hypotension, arrhythmias, and myocardial depression.

Anxiolytic, sedative, and hypnotic agents depress the central nervous system and may cause or exacerbate mental depression. Therapy with these agents should be administered cautiously in patients with a history of depression or suicidal tendencies. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Oral anxiolytic, sedative, and hypnotic agents may cause respiratory depression and apnea when given in high dosages or following acute overdose. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are recommended.

Although continued use of chloral hydrate at therapeutic dosages has not been associated with deleterious effects on the heart, large doses may produce peripheral vasodilation, hypotension, arrhythmias, and myocardial depression. High dosages of chloral hydrate should be avoided in patients with severe cardiac disease.

Chloral hydrate may cause esophageal and gastric irritation. Oral use of chloral hydrate should be avoided in patients with esophagitis, gastritis, duodenitis, or peptic ulcer disease.

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