Chloral Hydrate and Warfarin Therapy

Letters and Comments1 July 1971Chloral Hydrate and Warfarin TherapyJAN KOCH-WESER, M.D., EDWARD M. SELLERS, M.D.JAN KOCH-WESER, M.D.Search for more papers by this author, EDWARD M. SELLERS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-75-1-141 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: During their carefully controlled study, reported in the April 1971 ANNALS, Dr. Griner and associates found that hypoprothrombinemic responses to warfarin were not chronically altered by concomitant administration of chloral hydrate. We reported previously that giving chloral hydrate to subjects stably anticoagulated with warfarin quickly enhances their hypoprothrombinemia (1). This potentiation is caused by displacement of warfarin from plasma albumin by trichloroacetic acid, a major metabolite of chloral hydrate, and is accompanied by a shortened warfarin halflife (1-3). We have since confirmed these observations in five more subjects studied in the same fashion. We do not believe...References1. SELLERSKOCH-WESER EJ: Potentiation of warfarin-induced hypoprothrombinemia by chloral hydrate. New Eng J Med 283:827-831, 1970 CrossrefMedlineGoogle Scholar2. MACDONALDROBINSONSYLWESTER MDD: The effects of phenobarbital, chloral betaine, and glutethimide administration of warfarin plasma levels and hypoprothrombinemic responses in man. Clin Pharmacol Ther 10:80-84, 1969 CrossrefMedlineGoogle Scholar3. SELLERSKOCH-WESER EJ: Kinetics and clinical importance of displacement of warfarin from albumin by acidic drugs. Ann NY Acad Sci. In press Google Scholar4. GOLDSTEINARONOWKALMAN ALS: Principles of Drug Action. New York, Harper & Row, Publishers, Inc., 1968, pp. 292-317 Google Scholar5. KOCH-WESERSELLERS JE: Drug interactions with coumarin anticoagulants. New Eng J Med. In press Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JAN KOCH-WESER, M.D.; EDWARD M. SELLERS, M.D.Affiliations: Clinical Pharmacology Unit Massachusetts General Hospital Boston, Mass. 02114 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHuman serum albumin: From bench to bedsideHDrug interactions in clinical perspectiveInteractions of CNS Drugs — Hypnotics and SedativesUNWANTED EFFECTS OF MINOR TRANQUILIZERS AND HYPNOTICSDrug interactions in cardiovascular therapyPharmacokinetic Drug InteractionsClinical implications of warfarin interactions with five sedativesWarfarin-Chloral Hydrate Interaction Pharmacological Activity and Clinical SignificanceJOHN A. UDALLDrug Interactions-The Pharmacist's Opportunities and His Limitations*Interaction between Chloral Hydrate and WarfarinComputer Analysis of Epidemiologic Data about Drug Interactions in Hospital Patients 1 July 1971Volume 75, Issue 1Page: 141-142KeywordsAlbuminsBlood plasmaHydratesMetabolites ePublished: 1 December 2008 Issue Published: 1 July 1971 PDF downloadLoading ...