Paraldehyde
Paraldehyde still has a minor role in premonitory stage given rectally, as an alternative to the benzodiazepines in situations where facilities for resuscitation are not available. Paraldehyde is rapidly and completely absorbed after IM injection or rectally. The risk of drug accumulation, hypotension or cardio-respiratory arrest is small, and seizures do not often recur after control has been obtained. Paraldehyde has been used for many years in status, and although there is wide experience in patients of all ages in status, no modern pharmacokinetic or clinical studies have been carried out. Toxicity is unusual provided the solution is freshly made, used immediately, and correctly diluted. The use of decomposed or inadequately diluted IV solu
tions is dangerous, causing precipitation, microembolism, thrombosis or cardio-respiratory collapse. The IM injection of paraldehdye is painful, and can cause sterile abscess and sciatic nerve damage if wrongly placed. Other side-effects include cardio-respiratory depression, sedation, and metabolic or lactic acidosis. The drug rapidly binds to plastic, and glass tubing and syringes are advisable unless injected immediately upon drawing the solution up. The drug should not be exposed to light. The half-life of paraldehyde is markedly increased by hepatic disease.
Post a comment