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Chloral hydrate is a geminal diol with the formula Cl 3 C−CH(OH) 2. It was first used as a sedative and hypnotic in Germany in the 1870s. Over time it was replaced by safer and more effective alternatives but it remained in usage in the United States until at least the 1970s. [ 4 ]
Total intravenous anesthesia (TIVA) refers to the intravenous administration of anesthetic agents to induce a temporary loss of sensation or awareness. The first study of TIVA was done in 1872 using chloral hydrate, [1] and the common anesthetic agent propofol was licensed in 1986.
Ethchlorvynol is a member of the class of sedative-hypnotic carbinols, which includes methylparafynol and tert-amyl alcohol.It is not a benzodiazepine, carbamate, or barbituric acid derivative, and its molecular structure is considerably simpler.
Dichloralphenazone is a 1:2 mixture of antipyrine with chloral hydrate. In combination with paracetamol and isometheptene, it is the active ingredient of medications for migraine and tension headaches, including Epidrin and Midrin. Performance impairments are common with this drug and caution is advised, for example when driving motor vehicles.
Trichloroethylene is metabolised to trichloroepoxyethane (TCE oxide) which rapidly isomerises to trichloroacetaldehyde (chloral). [37] Chloral hydrates to chloral hydrate in the body. Chloral hydrate is either reduced to 2,2,2-trichloroethanol or oxidised to trichloroacetic acid.
To induce general anesthesia, propofol is the drug used almost exclusively, having largely replaced sodium thiopental. [13]It is often administered as part of an anesthesia maintenance technique called total intravenous anesthesia, using either manually programmed infusion pumps or computer-controlled infusion pumps in a process called target controlled infusion (TCI).
It is a betaine complex of trimethylglycine with chloral hydrate, which acts as an extended-acting formulation of chloral hydrate which is then metabolized into trichloroethanol, which is responsible for most or all of its effects. [3] [4] [6]
Clomethiazole is particularly toxic and dangerous if overdosed and is potentially fatal. Alcohol multiplies the effect. As the drug can be fatal in high doses, prescribing clomethiazole for the management of alcohol dependence outside of a controlled environment, for example a hospital, is not recommended, especially because there are much less toxic alternatives, such as diazepam.