Graham S R, Day R O, Lee R, Fulde G W
St. Vincent's Hospital, Darlinghurst, NSW.
Med J Aust. 1988;149(11-12):686-8. doi: 10.5694/j.1326-5377.1988.tb120823.x.
The purpose of this review is to highlight the toxicity of chloral hydrate and to review the management of overdoses with chloral hydrate. Three patients are presented in whom life-threatening cardiac arrhythmias dominated the clinical presentation. These arrhythmias were resistant to standard antiarrhythmic therapy. Also, we have reviewed selected features in eight patients who took overdoses of chloral hydrate who were admitted to an intensive care unit between 1981 and 1988. The pharmacology and toxicology of chloral hydrate are discussed with particular reference to the cardiac arrhythmias that are seen with overdosage. A proposed management scheme is detailed, including intravenously-administered propranolol as the preferred first-line antiarrhythmic agent. A case may be made for the discontinuation of the usage of chloral hydrate.
本综述的目的是强调水合氯醛的毒性，并回顾水合氯醛过量的处理方法。本文介绍了三名患者，他们的临床表现以危及生命的心律失常为主。这些心律失常对标准抗心律失常治疗无效。此外，我们还回顾了1981年至1988年间入住重症监护病房的八名过量服用水合氯醛患者的特定特征。本文讨论了水合氯醛的药理学和毒理学，特别提及了过量服用时出现的心律失常。详细介绍了一种建议的处理方案，包括将静脉注射普萘洛尔作为首选的一线抗心律失常药物。有理由停止使用水合氯醛。
