Editing Paraldehyde (section)

==Medical applications==
Paraldehyde was introduced into clinical practice in the UK by the Italian physician [[Vincenzo Cervello]] (1854–1918) in 1882.<ref>{{cite journal |vauthors=López-Muñoz F, Ucha-Udabe R, Alamo C |title=The history of barbiturates a century after their clinical introduction |journal=Neuropsychiatric Disease and Treatment |volume=1 |issue=4 |pages=329–43 |date=December 2005 |pmid=18568113 |pmc=2424120 }}</ref><ref>See: 
*  Cervello, Vincenzo (1883) [https://babel.hathitrust.org/cgi/pt?id=hvd.32044103019659;view=1up;seq=191 "Sull'azione fisiologica della paraldeide e contributo allo studio del cloralio idrato"] (On the physiological action of paraldehyde and contribution to the study of chloral hydrate), ''Archivio per le Scienze Mediche'', '''6''' (12) :  177–214.
*  Cervello, Vincenzo (1884) [https://books.google.com/books?id=GRNLAAAAYAAJ&pg=PA113 "Recherches cliniques et physiologiques sur la paraldehyde"] (Clinical and physiological investigations into paraldehyde), ''Archives italiennes de biologie'', '''6''' :  113–134.</ref><ref>For biographical information about Vencenzo Cervello, see:  [http://www.treccani.it/enciclopedia/vincenzo-cervello_(Dizionario-Biografico)/ Dizionario Biografico] (in Italian)</ref>

It is a [[central nervous system]] [[depressant]] and was soon found to be an effective [[anticonvulsant]], [[hypnotic]] and [[sedative]]. It was included in some [[cough medicine]]s as an expectorant (though there is no known mechanism for this function beyond the [[placebo effect]]).

Paraldehyde was the last injection given to [[Edith Alice Morrell]] in 1950 by the suspected serial killer [[John Bodkin Adams]]. He was tried for her murder but acquitted.

===As a hypnotic/sedative===
It was commonly used to induce sleep in sufferers from [[delirium tremens]] but has been replaced by other drugs in this regard. It was considered to have been one of the safest hypnotics and was regularly given at bedtime in [[psychiatric hospital]]s and [[geriatrics|geriatric]] wards until the 1970s {{citation needed|date=March 2023}}, but after it was confirmed that acetaldehyde is a confirmed category-1 human carcinogen, it could no longer be considered appropriately safe to use. Up to 30% of the dose is excreted via the lungs (the rest via the liver). This contributes to a strong unpleasant odour on the breath.

===As anti-seizure drug===
Today, paraldehyde is sometimes used to treat [[status epilepticus]]. Unlike [[diazepam]] and other [[benzodiazepines]], it does not suppress breathing at therapeutic doses and so is safer when no resuscitation facilities exist or when the patient's breathing is already compromised.<ref>{{cite journal
|vauthors=Norris E, Marzouk O, Nunn A, McIntyre J, Choonara I | title = Respiratory depression in children receiving diazepam for acute seizures: a prospective study | journal = Dev Med Child Neurol | volume = 41 | issue = 5 | pages = 340–3 | year = 1999 | pmid = 10378761 | doi = 10.1017/S0012162299000742| doi-broken-date = 9 December 2024 }}</ref> This makes it a useful emergency medication for parents and other caretakers of children with epilepsy. Since the dose margin between the anticonvulsant and hypnotic effect is small, paraldehyde treatment usually results in sleep.

===Administration===
{{More citations needed section|date=June 2015}}
[[Image:ParaldehydeAmpoule.jpg|left|100px|thumb|A 5 mL glass ampoule of paraldehyde.]]
Generic paraldehyde is available in 5 mL sealed glass ampoules. Production in the US has been discontinued, but it was previously marketed as '''Paral'''.

Paraldehyde has been given orally, rectally, intravenously and by intramuscular injection. It reacts with rubber and plastic which limits the time it may safely be kept in contact with some syringes or tubing before administration.

* '''Injection'''. Intramuscular injection can be very painful and lead to sterile abscesses, nerve damage, and tissue necrosis. Intravenous administration can lead to [[pulmonary edema]], [[circulatory collapse]] and other complications.
* '''Oral'''. Paraldehyde has a hot burning taste and can upset the stomach. It is often mixed with milk or fruit juice in a glass cup and stirred with a metal spoon.
* '''Rectal'''. It may be mixed 1 part paraldehyde with 9 parts saline or, alternatively, with an equal mixture of [[peanut oil|peanut]] or [[olive oil]].
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