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Bromids And Chloral
Source: Disturbances Of The Heart
If there is much restlessness and the circulation is good, that is,
if myocarditis is probably not present, the bromids may be of great
value, especially in children. The dose should be sufficient to
quiet the nervous system. The drug may be discontinued after a few
days, if the conditions improve. If the bromid, except in large
doses, will not cause sleep, a sufficient dose of chloral should be
given. Chloral is one of the most satisfactorily acting drugs which
we have to produce sleep and to cause cardiac rest. While it should
not be given if there is real cardiac weakness, the good which it
does is so much greater than the possible bad effect on the heart,
that it should not be forgotten for some newer hypnotic. The worst
part of this drug is its taste, and the best way to administer it is
to have it in solution in water and the dose given on cracked ice
with a little lemon juice to be followed by a good drink of water
and a piece of orange pulp for the patient to chew. Ordinarily a
bad-tasting drug such as chloral is well administered in
effervescing water, but effeverscing waters are generally
inadvisable when there is any kind of inflammation of the heart, as
they are liable to cause distention of the stomach and pressure on
the heart. Some physicians prefer chloralamid as a less disagreeable
drug and one which acts almost as efficiently as chloral. As the
close of this must be larger than the dose of chloral, it is a
question of doubt as to which is the better drug to use. Of the
newer hypnotics, veronal=sodium (sodium-diethyl-barbiturate) is
among the best. It acts quickly, is less depressant and is a safer
salt than most of the other newer hypnotics. It is the readily
soluble sodium salt of veronal (diethyl-barbituric acid). When
combined with any active drug, sodium seems to make it less toxic
and less depressant. The dose of this drug is from 0.2 to 0.3 gm. (3
to 5 grains).