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- W2332066872 abstract "During therapy with chloral hydrate one of its major metabolites, trichloroacetic acid, accumulates in plasma to more than 80 mg per liter. Trichloroacetic acid is highly protein-bound and displaces warfarin from binding sites on plasma albumin at 3 and 37°C. The resulting increase in the concentration of free plasma warfarin leads to a 25 per cent shortening of the biologic half-life of warfarin. During chronic warfarin therapy the trichloroacetic acid-induced increase in free plasma warfarin also potentiates the depression of vitamin-K-sensitive clotting-factor synthesis in the liver. Administration of 1 g of chloral hydrate daily for one week increases the hypoprothrombinemic effect of warfarin by 40 to 80 per cent. Chloral hydrate must be used with caution in patients receiving oral anticoagulants. To prevent excessive hypoprothrombinemia a reduction in warfarin requirement should be anticipated when chloral hydrate therapy is begun." @default.
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- W2332066872 date "1970-10-15" @default.
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- W2332066872 title "Potentiation of Warfarin-Induced Hypoprothrombinemia by Chloral Hydrate" @default.
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- W2332066872 doi "https://doi.org/10.1056/nejm197010152831601" @default.
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