Usage
- Medical Conditions: Historically, chloroform was used as a general anesthetic for surgical procedures. However, due to its toxicity and potential for serious side effects, it is no longer used for this purpose.
- Pharmacological Classification: General anesthetic (historical). It also has analgesic, antitussive, and carminative properties (historical usage).
- Mechanism of Action: Chloroform depresses the central nervous system, leading to loss of consciousness and sensation. The precise mechanism at the cellular level is not fully understood but involves modulation of neuronal membrane activity.
Alternate Names
- Trichloromethane
- Methyl trichloride
- Formyl trichloride
- Methane trichloride
How It Works
- Pharmacodynamics: Chloroform’s primary effect is central nervous system depression, causing anesthesia. It can also affect cardiovascular function (cardiac arrhythmias, cardiac sensitization to catecholamines), respiratory function (respiratory depression), liver (hepatotoxicity), and kidneys (nephrotoxicity).
- Pharmacokinetics: Chloroform can be absorbed via inhalation, ingestion, and dermal routes. It is rapidly distributed throughout the body. Metabolism occurs primarily in the liver, with some metabolites, like phosgene, contributing to toxicity. Elimination is mainly via the lungs, with a small amount excreted in urine.
- Mode of Action: The exact molecular mechanism of chloroform’s anesthetic action is not fully elucidated but involves disrupting normal neuronal membrane function, affecting ion channels and neurotransmitter activity.
- Elimination Pathways: Primarily pulmonary excretion; minor renal excretion.
Dosage
Chloroform is no longer used clinically as an anesthetic due to safety concerns, hence dosage information for clinical use is not applicable. Any historical dosage information found in older texts should not be used.
Side Effects
Common Side Effects (Historical)
- Nausea
- Vomiting
- Dizziness
- Headache
- Drowsiness
- Irritation of eyes, nose, and throat (with inhalation)
- Burning sensation in the mouth and throat (with ingestion)
- Skin irritation (with dermal contact)
Rare but Serious Side Effects
- Cardiac arrhythmias (including ventricular fibrillation)
- Respiratory depression and arrest
- Hepatotoxicity (liver damage, jaundice)
- Nephrotoxicity (kidney damage)
- Malignant hyperthermia
Long-Term Effects
- Chronic liver disease
- Kidney dysfunction
Adverse Drug Reactions (ADR)
- Severe hepatotoxicity
- Nephrotoxicity
- Cardiac arrest
Contraindications
- Pre-existing liver or kidney disease
- Cardiac disease (especially arrhythmias)
- Pregnancy
- Hypersensitivity to chloroform
Drug Interactions
- Alcohol: Increased risk of hepatotoxicity.
- Barbiturates: Enhanced CNS depression.
- Catecholamines (e.g., epinephrine): Increased risk of cardiac arrhythmias.
- Other CNS depressants: Additive CNS depression.
Pregnancy and Breastfeeding
- Pregnancy Safety Category: Contraindicated. Chloroform is fetotoxic in animal studies and potentially teratogenic.
- Breastfeeding: Chloroform is excreted in breast milk and can potentially harm the nursing infant. Breastfeeding is contraindicated if chloroform exposure has occurred.
Drug Profile Summary
- Mechanism of Action: CNS depression (mechanism not fully understood)
- Side Effects: Nausea, vomiting, dizziness, hepatotoxicity, nephrotoxicity, cardiac arrhythmias.
- Contraindications: Liver/kidney disease, cardiac disease, pregnancy, breastfeeding.
- Drug Interactions: Alcohol, barbiturates, catecholamines.
- Pregnancy & Breastfeeding: Contraindicated.
- Dosage: Not applicable (chloroform is not used clinically).
- Monitoring Parameters: (Not applicable for current medical practice) Historically, vital signs (heart rate, respiratory rate, blood pressure), liver function tests, kidney function tests would have been monitored during anesthesia.
Popular Combinations
Not applicable. Chloroform is not used in current clinical practice and therefore has no popular combinations. Historically, it might have been used with other anesthetic agents, but this practice is now obsolete.
Precautions
Due to its toxicity and potential for serious adverse effects, chloroform is not used in modern medicine. Therefore, precautions are not applicable to its clinical use. General precautions for handling chloroform as a chemical substance include using appropriate personal protective equipment to prevent inhalation, ingestion, and dermal contact.
FAQs (Frequently Asked Questions)
A: Chloroform is no longer used clinically due to its toxicity. Therefore, there are no recommended dosages for medical use.
Q2: What are the main side effects of chloroform?
A: The main side effects include nausea, vomiting, dizziness, and potentially life-threatening complications like liver and kidney damage, cardiac arrhythmias, and respiratory arrest.
A: No. Chloroform is contraindicated during pregnancy and breastfeeding due to its potential to harm the fetus or nursing infant.
A: Signs of chloroform poisoning can range from mild symptoms like dizziness, headache, and drowsiness to severe complications such as loss of consciousness, respiratory depression, cardiac arrest, liver and kidney failure.
A: Treatment focuses on supportive care, including managing respiratory and cardiovascular function. There is no specific antidote for chloroform poisoning.
A: Long-term exposure can lead to chronic liver and kidney damage.
A: Due to its narrow therapeutic index, potential for severe side effects (liver and kidney toxicity, cardiac arrhythmias), and the availability of safer anesthetic agents, chloroform is no longer used in medical practice.
A: Chloroform depresses the central nervous system, leading to loss of consciousness and sensation.
A: Chloroform’s toxicity involves the formation of toxic metabolites during its breakdown in the liver, as well as direct effects on various organ systems, including the heart, liver, and kidneys.
